Discoid meniscus: Treatment considerations and updates

Abstract

A discoid meniscus is a morphological abnormality wherein the meniscus loses its normal ‘C’ shape. Although most patients are asymptomatic, patients might still present with symptoms such as locking, pain, swelling, or giving way. Magnetic resonance imaging is usually needed for confirmation of diagnosis. Based on a constellation of factors, including clinical and radiological, different approaches are chosen for the management of discoid meniscus. The purpose of this review is to outline the treatment of discoid meniscus, starting from conservative approach, to the different surgical options for this condition. The PubMed and Google Scholar databases were used for this review. Studies discussing the treatment of discoid meniscus from 2018 to 2023 were searched. Initially there were 369 studies retrieved, and after removal of studies using the exclusion criteria, 26 studies were included in this review. Factors such as stability, presence of tear, and morphology can help with surgical planning. Many approaches have been used to treat discoid meniscus, where the choice is tailored for each patient individually. Postoperatively, factors that may positively impact patient outcomes include male sex, body mass index < 18.5, age at symptom onset < 25 years, and duration of symptoms < 24 months. The conventional approach is partial meniscectomy with or without repair; however, recently, there has been an increased emphasis on discoid-preserving techniques such as meniscoplasty, meniscopexy, and meniscal allograft transplantation.

Keywords: Discoid meniscus; Saucerization; Partial meniscectomy; Meniscoplasty; Meniscopexy; Meniscal allograft transplantation; Arthroscopy; Knee

Core Tip: Discoid meniscus can be treated both conservatively and surgically. Conservative approach is mainly used for asymptomatic patients, or for patients whose daily activities are not affected. The classic surgical approach for discoid meniscus had always been partial meniscectomy. Nevertheless, there are newer techniques developed aimed at preserving the meniscus like meniscoplasty, meniscopexy, and meniscal allograft transplantation. This study aims to compare the outcomes of the aforementioned techniques and compare them to one another using standardized criteria including the Knee Documentation Committee scores and Lysholm scores.