Discoid Meniscus in Children: Why Meniscal Preservation and Repair Should Be the Goal in Modern Pediatric Knee Surgery.

Discoid meniscus is the most common congenital meniscal abnormality encountered in pediatric patients and frequently involves the lateral meniscus. While some discoid menisci remain asymptomatic, many children and adolescents develop pain, mechanical symptoms, or instability requiring surgical treatment. Historically, subtotal or total meniscectomy was commonly performed to address pain, mechanical symptoms, and functional limitation associated with symptomatic discoid meniscus. However, growing evidence regarding the biomechanical and long-term consequences of meniscal loss has led to a significant shift in treatment philosophy. Contemporary surgical management therefore emphasizes preservation of meniscal tissue whenever possible. Arthroscopic reshaping of the discoid meniscus combined with repair of associated tears or peripheral instability allows restoration of meniscal morphology while maintaining its biomechanical function. Given the long life expectancy and activity demands of pediatric patients, meniscal preservation should be considered the primary objective when surgically treating symptomatic discoid meniscus in children.