Chief Complaint/Injury
9 year-old male hockey player presents for evaluation of lateral knee pain with intermittent swelling and mechanical symptoms.
Workup/Images
MRI Reveals a Discoid Lateral Meniscus with a central tear. The MRI appearance of a discoid lateral meniscus is consistent and diagnostic when sequential cuts reveal a homogenous, intact communication between the posterior and anterior horns of the lateral meniscus.
Surgery
The patient undergoes successful arthroscopic partial lateral meniscectomy in a procedure which converts the torn discoid lateral meniscus into a normal functional lateral meniscus. This procedure is performed through two small incisions which measure less than 1 cm and enable placement of a high-definition fiber optic video camera. Patients experience mild, transient pain and go home within 1-2 hours after surgery.
Result
The patient participates in a comprehensive rehabilitation protocol and makes a complete recovery with a full return to sports including travel hockey and lacrosse. Approximately 5 years later, he has competed at the highest levels of Tier 1 elite youth hockey in the U.S. and Canada. This success is a result of his dedication to physical therapy and the collaboration between our patient, his parents, physical therapists, coaches and training specialists.
Discoid Lateral Meniscus is a developmental variant in which a normal semi-circular meniscus fails to form. These may be a symptomatic however they commonly will result in symptoms of swelling, catching, and locking. Surgery typically involves an arthroscopic saucerization or resection of the central portion of the meniscal tissue. It may also involve placement of sutures to secure or stabilize the remaining meniscal tissue. Careful evaluation with a thorough history, physical exam and appropriate diagnostic imaging is essential to help develop an optimal treatment plan.
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