Outcomes of Saucerization With or Without Repair for Symptomatic Discoid Lateral Meniscus in Pediatric Patients: A Systematic Review

To determine outcomes following operative treatment of symptomatic discoid lateral meniscus (DLM) in pediatric patients. In March of 2024, a systematic review of the MEDLINE, EMBASE, and Cochrane Library databases was conducted. Studies were included if they were published between the years 2013 to 2023, evaluated surgical outcomes of DLM in pediatric patients, and had a minimum of 10 patients per study with a 1-year follow-up. The primary outcome measure was clinical outcomes with a secondary outcome of adverse events. Surgical technique cohorts included the following: saucerization only, saucerization + repair, and subtotal meniscectomy. Twenty-four studies met inclusion criteria and were included in the analysis. There was a total of 1225 patients (1401 knees; of the studies that reported sex, there were 524/1075 male patients (48.5%) and 553/1075 (51.5%) female patients) who underwent surgical treatment for DLM. The postoperative follow-up time was 1.2 to 10.1 years, and age range was 8.3 to 13.7 years. Saucerization only, saucerization + repair, and total and subtotal meniscectomy cohorts showed significant improvements in Lysholm scores. Saucerization + repair had the highest reoperation (8.9%) and complication rate (6.8%), while saucerization only had the lowest complication (2.7%) and reoperation rate (7.3%). Osteoarthritis and osteochondritis dissecans were the most common complications reported. All surgical techniques for symptomatic discoid lateral meniscus in pediatric patients resulted in significant functional improvement and low complication and reoperation rates. Apparent differences between cohorts likely reflect variation in tear complexity and follow-up duration rather than procedural risk. Saucerization with or without repair remains safe and effective when guided by intraoperative assessment of meniscal stability and tear characteristics. Level IV, systematic review of Level III and IV studies.