Journal of Pediatric Orthopaedics - 2026-03-03 - Journal Article
Favorable Long-term Outcomes Following Arthroscopic Preservation Surgery for Pediatric and Adolescent Discoid Lateral Meniscus.
Said M, Henick SM, Samuel Z, Charla JN, Ferreri ED, Gjonbalaj E, Mehraban Alvandi L, Schulz JF, Fornari ED, Drummond Junior M
Topics
Key Takeaway
Arthroscopic saucerization with or without repair for pediatric discoid lateral meniscus achieves 97.2% return to full activity and 8.3% reoperation rate at median 8.08-year follow-up.
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Summary
This study evaluated long-term PROs and reoperation rates after arthroscopic saucerization alone versus saucerization with repair for symptomatic DLM in patients under 21 at a single academic center from 2012–2022. Median Pedi-IKDC (88.5 vs. 94.0), Tegner-Lysholm (86.0 vs. 98.0), and KOOS-Child QoL (70.8 vs. 87.8) scores were favorable in both groups with no statistically significant between-group differences. Reoperation occurred in 3/36 patients (8.3%) and 35/36 (97.2%) returned to full activity.
Key Limitation
PRO follow-up was achieved in only 66.7% of the cohort, and the small sample size (n=36) is underpowered to detect clinically meaningful between-group differences in saucerization-alone versus saucerization-with-repair outcomes.
Original Abstract
BACKGROUND
Discoid lateral meniscus (DLM) is a congenital anomaly associated with increased risk of tearing and peripheral rim instability due to abnormal morphology and deficient capsular attachments. While total meniscectomy was historically performed, long-term complications have prompted a shift toward arthroscopic saucerization with or without repair. Though midterm outcomes are favorable, long-term data remain limited. This study aimed to evaluate long-term clinical outcomes following arthroscopic preservation surgery for symptomatic DLM and compare results between saucerization alone and saucerization with repair.
METHODS
We performed a retrospective cohort study of patients <21 years who underwent arthroscopic treatment for symptomatic DLM at a single academic pediatric center (2012 to 2022) with a minimum of 5 years of follow-up. Treatment was determined intraoperatively: stable menisci underwent saucerization alone, whereas menisci with PRI and/or meniscocapsular disruption underwent saucerization with repair. PROs included Tegner-Lysholm, Pedi-International Knee Documentation Committee (Pedi-IKDC), and KOOS-Child. Return to full activity and reoperation were assessed via chart review and follow-up documentation.
RESULTS
Thirty-six patients met the inclusion criteria (mean age, 13.3±3.8 y) with a median follow-up of 8.08 years. PROs at ≥5 years were available for 24 patients (66.7%). Median PROs were favorable in both groups, including Pedi-IKDC (88.5 saucerization-only vs. 94.0 saucerization+repair), Tegner-Lysholm (86.0 vs. 98.0), and KOOS-Child Quality of Life (70.8 vs. 87.8), with no statistically significant differences between groups. Return to full activity was achieved by 35/36 patients (97.2%). Three patients (8.3%) underwent reoperation, with no difference between groups.
CONCLUSIONS
Arthroscopic meniscal preservation for symptomatic DLM in pediatric and adolescent patients is associated with favorable long-term outcomes, high return to full activity, and low reoperation rates. Outcomes were favorable for both stable and unstable DLM treated with saucerization with or without repair.