Discoid meniscus: Treatment considerations and updates

Table 1 Summary of conservative and surgical options in the treatment of discoid meniscus

Conservative therapy	Physical therapy
	Prevention of overload sports
Surgical options	Partial meniscectomy with or without repair
	Meniscoplasty
	Meniscopexy
	Meniscal allograft transplantation

Table 2 Summary of surgical procedure used and outcomes

Ref.	No. of patients	Mean age (range)	DLM/DMM	Procedure	Mean follow-up and results
Perkins et al[18]	44	12.4 (5-17)	DLM	Arthroscopic meniscus repair	At 19 months: Saucerization and repair of discoid lateral meniscus tears in the pediatric population have good outcomes with low rates of reoperation
Anderson et al[28]	21 (22 knees)	12.8 (9-16.6)	DMM	Arthroscopic saucerization; repair for torn menisci	At 24 months: Tears were present in over half of knees with discoid medial menisci, and reoperation was more common in knees that underwent repair of tears than those without repair
Feroe et al[29]	8 (12 knees)	13.8 (7.8-19.8)	DMM	Arthroscopic saucerization; repair for torn menisci	At 25.8 months: Symptom resolution is common short-term, but long-term outcomes include recurrent meniscal tears
Dai et al[23]	29	Not available	DLM	Group A (14); PRP augmented; Group B (15) non-PRP augmented	At 24 months: No significant difference observed in the Lysholm score, the Ikeuchi grade and the VAS score for pain at the last follow-up between the two groups
Ng et al[24]	24 (24 knees)	14 (8-21)	DLM	Meniscoplasty	At 84 months: Lysholm score; Preop: 53 (11-95) vs postop: 100 (60-100); Ikeuchi grade; 23 patients (excellent), 1 patient (good)
Johnson et al[26]	11 (12 knees)	9 (6-14)	DLM	Meniscopexy	At 4.5 yr: Lysholm score, 91 (86-100)
Wang et al[27]	18	Not available	DLM	Group A (8) MAT; Group B (10) ME	At 12 yr: No difference in Lysholm, IKDC, Tegner or VAS scores among both groups. Compared to meniscectomy, MAT achieved similar long-term symptom relief and superior chondroprotection in discoid meniscus patients

DLM: Discoid lateral meniscus; DMM: Discoid medial meniscus; PRP: Platelet-rich plasma; VAS: Visual analog scale; MAT: Meniscal allograft transplantation; ME: Meniscectomy; IKDC: International Knee Documentation Committee.

Table 3 Good and unfavorable prognostic factors

Good prognostic factors	Male sex
	BMI < 18.5
	Age of onset < 25 yr
	Symptoms duration < 24 months
Unfavorable prognostic factors	Increased work intensity
	Increased severity of cartilage lesion
	Preoperative cartilage instability
	Smaller width and thickness of the remnant meniscus

BMI: Body mass index.