The diagnosis and management of meniscus injuries in the skeletally immature athlete

Abstract

Meniscus injuries of the knee in skeletally immature athletes are uncommon. Although the epidemiology of theseinjuries is inadequately documented in the literature, it is clear that meniscus injuries in children are often found with congenitally abnormal menisci. In the adolescent, these injuries are often found with associated ligamentous injury. Longitudinal and peripheral injury patterns prevail. Because of these injury patterns and the enhanced healing potential of youth, meniscus repair is preferred more often in youths than in adults. The Snapping Knee syndrome is typically associated with discoid menisci in children and youth. Watanabe described a classification of discoid menisci that includes the unstable Wrisberg ligament type as well as the partial and complete types. No treatment is required for the asymptomatic discoid meniscus, but the symptomatically unstable meniscus may be repaired and the symptomatic stable partial or complete discoid meniscus saucerized or, if torn, replaced if possible. Although meniscus replacement is theoretically an attractive alternative choice of treatment over excision or debridement, not enough is known about clinical outcomes and safety to justify their use in the skeletally immature patient.