Review Question - QID 5433

This patient has undergone arthroscopic saucerization of his discoid meniscus. The indication for this procedure is treatment of a symptomatic meniscal tear.

Arthroscopic treatment of lateral discoid meniscus injuries has the advantages of reducing trauma, precise resection or repair of the meniscus and saucerization of the remaining discoid meniscus. Operative treatment is usually limited to patients with pain and mechanical symptoms that are undergoing partial meniscectomy or repair. Asymptomatic discoid meniscus without tears are not considered a surgical indication for routine saucerization.

Kramer et al. reviewed the diagnosis and treatment of traumatic discoid meniscal tears in children. They report that knee shape, size and skeletal maturity must be considered when determining the optimal method of repair. However, all symptomatic torn discoid menisci are best treated with saucerization and repair.

Good et al. looked at the arthroscopic techniques of discoid meniscus repair. Arthroscopic saucerization was successful in 28 of 30 knees and meniscal repair in 23 of 30 knees. At final follow-up, all patients exhibited full knee flexion beyond 135 degrees. In 3 of 30 patients there was residual knee pain, and four reported intermittent mechanical symptoms.

Figure A shows a series of arthroscopic images of the right knee lateral compartment. There is a sequential saucerization of the discoid meniscus.

Incorrect Answers:
Answer 1: A displaced torn discoid meniscus may block extension.
Answer 2: Valgus instability is not an indication for saucerization of the discoid meniscus.
Answer 3: Saucerization does not prevent knee malalignment.
Answer 5: An intact discoid meniscus seen on MRI is not an indication for saucerization.