Arthroscopic Management of Symptomatic Discoid Lateral Meniscus in Children and Adolescents: Is Repair Always Necessary?

Background: Discoid lateral meniscus (DLM) is a congen-ital knee anomaly with a reported prevalence of up to 13% in Asiatic populations, often necessitating surgical intervention when symptomatic. The optimal management whether arthro-scopic repair or saucerization alone remains a subject of debate. Aim of Study: To determine whether all symptomatic DLM cases in children and adolescents require arthroscopic repair or if saucerization alone is sufficient. Patients and Methods: A prospective case series included 20 patients (13 male, 7 female; aged 7–18 years) with sympto-matic DLM who underwent arthroscopic saucerization. Repair using the outside-in technique was performed for unstable or torn menisci. Outcomes were assessed at 1, 6, and 12 months using the Lysholm score (0–25, higher scores indicating less pain) and range of motion (ROM). Results: Of 20 patients (14 right knee, 6 left knee), 2 had bilateral DLM. The mean Lysholm score was 15.25±3.43, with 16 patients scoring ≥15. Mean ROM at 6 weeks was 77.05±2.30 degrees (p<0.001), improving progressively to 12 months. Saucerization alone was performed in 14 stable cases, while 6 unstable/torn cases required repair. No postoperative infections or complications were reported. Conclusion: Saucerization alone is effective for stable symptomatic DLM, while repair is indicated for unstable or torn menisci. These findings support a tailored surgical ap-proach, particularly relevant for Asiatic populations with a higher DLM prevalence. Larger studies with longer follow-up are recommended.