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Review Question - QID 8545

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QID 8545 (Type "8545" in App Search)
At the time of arthroscopy, a 9-year-old boy was found to have a Watanabe type II discoid lateral meniscus. What is the most appropriate treatment?

Saucerization of the meniscus only

62%

170/274

Saucerization and stabilization of the meniscus

27%

75/274

Stabilization of the meniscus only

8%

23/274

Complete menisectomy

1%

2/274

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The Watanabe type II meniscus should only require saucerization for treatment because it is not unstable. The Watanabe classification defines 3 types of discoid mensici. In type I (stable, complete), the block-shaped lateral meniscus covers the entire lateral tibial plateau, whereas in type II (stable, partial), the lateral meniscus covers less than or equal to 80% of the tibial plateau. Type III discoid menisci (unstable, ligament of Wrisberg) appear to be normal except for a thickened posterior horn, but they lack posterior meniscal attachments, including the meniscotibial (ie, coronary) ligament. The type III discoid meniscus is stabilized only by the meniscofemoral ligament of Wrisberg. This results in hypermobility of the lateral meniscus at the posterior horn, which pulls into the intercondylar notch with knee extension, resulting in snapping knee syndrome. Complete menisectomy should be avoided if possible.

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