Arthroscopic Repair of a Bucket-Handle Tear of a Discoid Lateral Meniscus in a 14-Year-Old Child: Case Report

Abstract

A discoid meniscus is a rare congenital anatomic variation with an estimated incidence of 1% to 3% in children. Due to their abnormal shape, discoid meniscus are associated with reduced tissue quality, less vascularization and looser peripheral attachments when compared to normal ones. Individuals with this abnormality are more predisposed to sustain meniscal injuries. Although meniscal injuries are less prevalent in children, they are associated with a higher healing potential when comparing to adult population. Currently, treatment options are either partial meniscectomy or meniscal repair. However, meniscectomy in children is associated with a faster progression to osteoarthritis than in adults. It is of great importance to identify and repair these injuries when possible, to achieve favorable long-term outcomes. The authors report the pre-operative evaluation, arthroscopic findings, repair technique, and post-operative outcome of a 14-year-old basketball player who sustained a displaced bucket handle tear of a discoid lateral meniscus. This is a rare injury pattern in pediatric population with sparse reports being found in literature. The meniscus reduced well and was found to be stable after repair. The patient regained full range of motion and returned to full unimpeded activity at three months post-operatively. At six months she returned to play without limitations. This report presents a rare meniscal injury in a pediatric patient who underwent surgical repair with successful recovery to date. It highlights a technique for meniscus repair which is of particular benefit when comparing to partial meniscectomy, especially in pediatric population.