Cysts of the lateral meniscus: arthroscopy versus arthroscopy plus open cystectomy

A retrospective analysis was performed on 32 knees in 31 patients with the diagnosis of cyst of the lateral meniscus. Average follow-up was 41 months, with a range of 16-72 months. Surgical and histological examination demonstrated pathology varying from large meniscal tears with minimal cyst formation to large cysts with no demonstrable meniscal tear. Two theories of etiology emerged: (a) The tear begins in the meniscus and spreads through the periphery. (b) The lesion begins as a compression injury to the vascular periphery and spreads centrally, producing a meniscus tear, or peripherally, producing a cyst, or both. In our series, 20 patients managed by arthroscopic partial meniscectomy and open cystectomy had 80% excellent-good results versus 50% excellent-good results in 12 patients treated with arthroscopy and partial meniscectomy without extraarticular cystectomy. We recommend the following treatment: arthroscopy with a diligent search for a lateral meniscal tear, especially peripherally. If none is found, proceed to extraarticular cystectomy. If a tear is found, remove all unstable meniscal fragments, leaving a rim, if possible, especially adjacent to the popliteus recess, and then proceed to open cystectomy.     

Arthroscopic Meniscal Repair and Needle Aspiration for Meniscal Tear With Meniscal Cyst

Treatment of patients with meniscal cysts of the meniscus usually requires surgery. Arthroscopic partial meniscectomy of the involved torn meniscus with intra-articular cyst drainage has become the accepted intervention. However, if the meniscal tear is peripheral, a lot of healthy meniscal tissue is needlessly sacrificed with subtotal meniscectomy. Moreover, the meniscal cyst is not a true cyst, so it may be treated more conservatively after the underlying disease has been corrected. We report a case of a meniscal cyst arising from the anterior segment of the lateral torn meniscus that was arthroscopically repaired with an outside-in technique. With the use of a 19-gauge long needle to penetrate the peripheral rim inframeniscally, a nonabsorbable No. 3-0 nylon suture was passed into the joint and brought out suprameniscally to loop the meniscal fragment. The second suture was passed and was used to secure the meniscal rim and fragment by the same means approximately 8 to 10 mm from the first one. Then the cyst was aspirated. A good result was obtained, and no recurrence of the cyst or mechanical problems occurred after a follow-up of 14 months.     

Non-operative treatment of meniscal tears

In a retrospective review of the results of 3,612 arthroscopic procedures that were performed for the treatment of an acute or a chronic meniscal lesion, with or without an associated ligamentous lesion, we identified eighty meniscal tears (in seventy-five patients) that had been assumed to be stable. Seventy were vertical longitudinal tears and ten were vertical radial tears. The seventy longitudinal tears included fifty-two lateral and eighteen medial meniscal lesions. All of the radial tears were in the lateral meniscus. Of the seventy-five patients, fifty-two had been followed for two to ten years. At the time of follow-up, only six of these fifty-two patients had needed additional intervention because of symptoms that were related to the meniscal tear. Four of them had the intervention after a sports-related traumatic extension of a stable tear, and two, because persistent symptoms were caused by the original meniscal lesion. A repeat arthroscopy was performed on thirty-two patients (twenty-six of whom had a longitudinal tear and six of whom had a radial tear), at an average of twenty-six months after the original arthroscopy. Seventeen of the twenty-six longitudinal tears had completely healed. Five of the six radial tears had no evidence of healing and one had extended. Neither ligamentous laxity nor a meniscal tear that was chronic at the time when it was discovered appeared to preclude healing of the stable longitudinal tears. No localized degenerative changes in the adjacent articular cartilage were found in association with any of the stable vertical longitudinal or radial meniscal lesions. Excluding the six patients who had had additional surgical treatment, none of the fifty-two patients who filled out a questionnaire reported that they had symptoms of a meniscal lesion, and none of the forty-two patients who were re-examined two years or more after the operation had signs of a meniscal lesion. Stable vertical longitudinal tears, which tend to occur in the peripheral vascular portions of the menisci, have great potential for healing. The tear should be left alone unless it is the only abnormality that is found and it is causing symptoms that warrant treatment. Stable radial tears, which tend to occur in the avascular inner one-third of the meniscus, have little potential for healing. Whether it is best to leave these lesions alone or to fashion an intact rim by contouring the meniscus was not established by this study.     

Suture of new and old peripheral meniscus tears

A prospective study of repaired vertical peripheral tears of the meniscus in fifty patients (nine women and forty-one men) was carried out from January 1977 to June 1980. All tears were confirmed preoperatively by arthroscopy. Forty-three medial and seven lateral menisci were repaired. Fifteen tears were treated within two weeks and thirty-five were operated on as long as seven years after injury. Only eight patients had a meniscal tear that was not accompanied by injuries of either the anterior cruciate ligament or the collateral ligaments, or both. At a mean follow-up of eighteen months (range, six to thirty-nine months), forty-two patients (84 per cent) had clinically apparent healing of the sutured meniscal tear. Repeat arthroscopy was done in twenty-seven (64 per cent) of these patients, four to twenty-nine months (mean, twelve months) after the operation. The arthroscopy proved that all of these repaired tears had healed. Eight patients had a second tear after the initial repair: four were reruptures at the sutured area and four were new ruptures in another area of the meniscus and were associated with fresh trauma. All of these patients subsequently had an arthroscopic meniscectomy.     

Patient outcomes following T-Fix meniscal repair and a modifiable,progressive rehabilitation program,a retrospective study

INTRODUCTION: This retrospective study presents clinical patient outcomes following meniscal repair using T-Fix devices and a modifiable, progressive rehabilitation program. MATERIALS AND METHODS: Fifty-two patients (35 males and 17 females) with a mean age of 26.7 years (range 13-50 years) representing all of the patients who underwent arthroscopic meniscal repair (43 medial meniscus, 12 lateral meniscus) over a 3-year period by the same surgeon (D.C.) (55 menisci) participated in this study. Thirty-two of the patients (62%) had an associated ACL tear. All patients with an ACL tear underwent reconstruction (tibialis anterior allograft) at the time of meniscal repair. All meniscal tears were located in either the red-red zone (29) or the red-white zone (26). All patients who underwent meniscal repair participated in a modifiable (based on meniscal tear size, type, and location) progressive rehabilitation program. Operative notes and photographs were reviewed to identify the meniscal tear location, tear type, tear length, and the number of T-Fix devices used. Orthopedic clinic and physical therapy reports were also reviewed for postoperative range of motion, knee joint effusion, knee joint pain, McMurray test findings, and single-leg broad-jump test performance (90% bilateral equivalence goal). The average postoperative clinical follow-up period was 10.3 months (range 4-24 months). RESULTS: Most (22/23, 96%) patients who underwent meniscal repair alone displayed excellent results. All patients (32/32, 100%) who underwent combined ACL reconstruction-meniscal repair displayed excellent results. During an acute event such as a sudden directional change while running or contact with another player, 5 of these patients re-injured their meniscus at the repair site in conjunction with tearing the reconstructed ACL at 12+/-3 months following the index surgical procedure. Each of these 1-2 cm meniscal tears had been previously repaired with two T-Fix devices. CONCLUSION: The T-Fix device used in combination with a modifiable progressive rehabilitation program produced excellent clinical patient outcomes among this patient group.     

Arthroscopic meniscal repair: analysis of treatment failures

The rationale for meniscal repair is based on the importance of the meniscus in overall knee function and stability as well as the inferior results seen with meniscectomy. The high success rate usually seen with arthroscopic meniscal repair has made it the treatment of choice for peripheral meniscal tears. This study reviewed the records of patients who have failed meniscal repair surgery to gain greater understanding of the factors that may predispose a patient to a failed outcome. From 1987 to 2002, three hundred meniscal repairs were performed (203 medial and 97 lateral). Thirty-seven patients had failed meniscal repairs. Records were available for 33 (89%) patients. The mean patient age was 25 years (range: 13-48 years) at the time of meniscal injury. The average initial tear size was 2.7 cm with a mean rim width of 2.3 mm. Eighty-eight percent occurred in ACL tears. The average time interval from initial repair to the recurrence of symptoms was 34 months. Patients who were older at the time of meniscal repair failed significantly later than those patients who were younger at the time of repair. With age stratification, those patients who were aged > or =29 years at time of meniscal repair failed at an average of 23 months. In contrast, patients who were aged > or =30 years at the time of repair failed at an average of 53 months. Larger initial tears failed significantly sooner than smaller tears. Initial tears with larger rim widths demonstrated a trend toward shorter time to failure. Patients who underwent combined ligament reconstruction with meniscal repair failed at an average of 37 months. Deficient ACLs that were treated with isolated meniscal repairs (ACL intact) failed at an average of 16 months.     

关节镜下清除并钢丝引导缝合治疗膝关节外侧半月板囊肿

目的:探讨关节镜下清除并钢丝引导缝合治疗膝关节外侧半月板囊肿的临床疗效。方法:2014年7月至2017年12月,采用关节镜下清除并钢丝引导缝合治疗膝关节外侧半月板囊肿33例,其中男13例,女20例,年龄20～55 (36.23±2.30)岁;病程3～14 (4.60±0.83)个月;术前MRI检查均诊断明确。关节镜下按囊肿具体部位分前角14例,体部18例,后角1例。所有囊肿为单发,其中3例为多房。术前及术后6个月采用Lysholm膝关节功能评分、GLASOW评分进行临床疗效。结果:术后33例均获得随访,时间6～24 (7.5±1.2)个月。患者术前症状消失或明显减轻,切口均甲级愈合,无伤口感染、神经血管损伤等并发症。MRI示半月板撕裂部及囊肿缺损区已愈合,囊肿无复发。伤口愈合时间8～12(9.6±1.6)周,恢复日常生活及运动。术后6个月Lysholm评分(91.32±3.36)分,与术前(61.12±4.35)分比较差异有统计学意义(t=46.11,P0.01)。根据GLASOW评分,优31例,良2例。结论:采用关节镜下清除并钢丝引导缝合治疗膝关节外侧半月板囊肿,最大程度地保留了半月板,并同时行半月板损伤修复,术后膝关节功能恢复好,值得临床推广应用。     

关节镜下后内侧入路切除胭窝囊肿的临床研究

目的 探讨关节镜下后内侧入路切除腘窝囊肿的手术方法与疗效.方法 2012年1月至2013年3月,采用关节镜下后内侧入路切除腘窝囊肿41例（均为单侧腘窝囊肿）,男17例、女24例,年龄40～55岁.左膝19例、右膝22例,术前均行膝关节MRI检查,来观察膝关节内病变及囊肿与周围组织关系.术中处理膝关节腔内病变后,探查腓肠肌内侧头-半膜肌滑液囊与膝关节腔之间的裂隙样结构并扩大通道或建立双通道,同时刨削切除囊壁,所有操作均在关节镜下操作.本组使用 Rauschning 和 Lindgren标准来评价术后临床效果.结果 术中发现内侧半月板损伤14例、外侧半月板损伤9例、骨关节炎15例（4例合并内侧半月板损伤、3例合并外侧半月板损伤）、关节内游离体5例、髌股关节软骨损伤5例.术中及术后均无感染及重要血管神经损伤,术后随访6～8个月,1例复发.结论 腘窝囊肿并非独立存在,应重视关节内病变的治疗,关节镜下后内侧入路切除腘窝囊肿方法可行,安全可靠,疗效满意.     

Arthroscopic management of degenerative meniscus tears in patients with degenerative arthritis

Frequently, meniscal pathology accompanies degenerative changes affecting the articular surface of the knee. The attritional changes in the meniscus lead to fragmentation of the meniscus and a variety of tears, usually of the posterior horn of the medial meniscus. A prospective study of the results of arthroscopic partial meniscectomy in the presence of at least Outerbridge Grade III chondromalacia of the accompanying joint surface was performed between 1980 and 1984. Eighty-seven knees in 84 patients were studied. The mean age was 62 (29-84) years. The right knee was involved in 44 patients, and 47 were men. Preoperative radiographs demonstrated osteoarthritis in 53 patients. The medial meniscus was involved in 82, while the lateral meniscus was affected in nine knees. Four knees had involvement of both menisci. In 72 knees, the most frequent lesion was a tear of the posterior horn of the medial meniscus. The most frequent configuration of the tears was a flap in 42. The morbidity was small with the use of ambulatory aids being 10 +/- 13 (mean +/- SD) days. Subsequent surgery was performed on six knees consisting of two total knee arthroplasties, two upper-tibial osteotomies, one repeat arthroscopic meniscectomy, and one popliteal cyst excision. Two patients had poor results related to progression of their arthritis and one developed osteonecrosis. Five patients were unchanged from their preoperative status. Subchondral sclerosis or osteophytes on the preoperative radiographs correlated with 72% compared to 90% satisfactory results in the absence of these findings (p less than 0.03). Complications consisted of superficial thrombophlebitis in three, hemarthrosis in one, and superficial infection in one patient.(ABSTRACT TRUNCATED AT 250 WORDS)     

Meniscectomy

To review the meniscus from a historical perspective especially on surgical management and general guidelines for arthroscopic meniscectomy procedures for various types of meniscal tears. We searched MEDLINE and PubMed for the years of 1980-2010 using the terms meniscus, meniscal repair, menisectomy, and arthroscopy. Orthopedic surgeons frequently encounter patients with pain or functional impairment of the knee joint and repair or resection of the injured meniscus is one of the most common orthopedic operative procedures. The object of meniscal surgery is to reduce pain, restore functional meniscus and prevent the development of degenerative osteoarthritis in the involved knee. Historically, total meniscectomy was a common procedure performed for meniscus tear symptoms. However, it has been reported that total meniscectomy has deleterious effects on the knee. In the past, the menisci were thought as a functionless remnant tissue. Currently, it is known that the meniscus is an important structure for knee joint function. Menisci provide several vital functions including mechanical support, localized pressure distribution, and lubrication to the knee joint. It is widely accepted that the function of the meniscus can be preserved through minimal excision. An arthroscopic partial meniscectomy preserving more of the meniscus is preferred over total meniscectomy. In recent decades, this shift toward arthroscopic partial meniscectomy has led to the development of new surgical techniques.     

Unusual solitary ganglion cysts of the anterior segment of the lateral meniscus

Generally, ganglion or synovial cysts have been reported to originate from numerous structures in and around the knee joint, including the anterior cruciate ligament, posterior cruciate ligament, popliteal tendon, and menisci. Nevertheless, a ganglion is not a synovial cyst and there is no synovial lining. Meniscal cysts present a subgroup of ganglion cysts that occur in association with meniscal tears. We report 2 cases of unusual meniscal cyst from the anterior segment of the lateral meniscus without any meniscal tear and discuss the possibility of their pathogenesis and treatment.Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 19, No 3 (March), 2003: pp E16     

关节镜下半月板切除与缝合修补治疗半月板桶柄样撕裂的临床对比研究

目的 通过对比分析关节镜下缝合修补术和半月板次全/全切除术治疗半月板桶柄样撕裂的临床疗效,探讨缝合修补治疗半月板桶柄样撕裂的应用价值.方法 回顾性分析2005年1月至2009年1月经关节镜治疗的34例(34膝)半月板桶柄样撕裂患者,其中采用全内缝合或全内和外内联合缝合的患者15例(A组),男9例,女6例;平均年龄为(30.3±6.8)岁;受伤至手术时间平均为(10.6±3.8)d;内侧半月板损伤12例,外侧半月板损伤3例.同期采用半月板次全/全切除术19例(B组),男11例,女8例;平均年龄为(29.1±5.5)岁,受伤至手术时间平均为(10.2 ±2.8)d;内侧半月板损伤15例,外侧半月板损伤4例.记录两组的手术时间,并通过患者的症状、体征、关节活动度和Lysholm评分等比较两组患者疗效.结果 手术时间:A组为(71.3±8.8)min,B组为(45.7±9.4)min,差异有统计学意义(P<0.05).两组患者术后获12～24个月(平均17.2个月)随访.术后6个月关节活动度A组平均为138.7°±5.1°,B组平均为136.0°±4.6°;术后12个月关节活动度A组平均为140.1°±3.1°,B组平均为139.8°±3.3°,两组比较差异均无统计学意义(P>0.05).术后6个月Lysholm评分A组平均为(90.1±7.1)分,B组平均为(89.9±6.9)分,差异元统计学意义(P>0.05);术后12个月Lysholm评分A组平均为(94.5 ±3.9)分,B组平均为(90.3±5.8)分,差异有统计学意义(P<0.05),A组优于B组.结论 对于大型半月板撕裂,采用合适的缝合技术可使撕裂的全长段获得有效修补,能尽可能多地保留半月板的功能,临床疗效优于传统的半月板次全/全切除术.     

Hi-frequency electrical cautery stimulation in the treatment of displaced meniscal tears

This is a preliminary report of four cases of meniscal displaced tears: two bucket handle medial meniscus tears, one complex tear in the avascular zone or lateral meniscus, and one longitudinal full-thickness tear on the lateral meniscus. These tears were treated by applying hi- frequency current stimulation to the tissues and obtaining total meniscal visual healing on a second arthroscopic view after 6 weeks.Arthroscopy 1998 Sep;14(6):566-71     

Die arthroskopische Meniskusrefixation mit einem All-inside-Nahtsystem

OBJECTIVE: Application of an arthroscopic suture system to restore the form and function of the meniscus by adaptation of a longitudinal tear close to the base. INDICATIONS: Unstable longitudinal tears near the base of the meniscus, mainly in the posterior horn of the medial or lateral of the meniscus. Dislocated bucket-handle tears of the medial and lateral meniscus close to the base. CONTRAINDICATIONS: Poor tissue quality with fibrillated meniscal tissue. Meniscal tears in the avascular zone (zone I). Insufficient blood supply from the joint capsule and the base of the meniscus. Degenerative meniscal lesions. Anterior or posterior knee joint instability. Allergic reactions to nonresorbable suture material. SURGICAL TECHNIQUE: Standard anterior arthroscopic portals. Arthroscopic assessment of the meniscal tear using the probe. Revitalization of the tear margins and perforation of the meniscal base to induce bleeding. Adaptation of the tear margins and fixation with a suture-anchor system using an ipsilateral standard portal for tears in the posterior horn or by way of a contralateral standard portal for tears in the lateral horn. POSTOPERATIVE MANAGEMENT: Full weight bearing with the knee in extension in a knee immobilizer, relative to the pain threshold in the 1st postoperative week. Range of motion exercises without weight bearing from full extension to 90 degrees knee flexion (0/0/90). If simultaneous reconstruction of the anterior cruciate ligament (ACL) is being performed, rehabilitation protocols follow the principles for ACL reconstruction. RESULTS: Since the year 2000, meniscal tears in more than 300 patients have been repaired with the all-inside suture system. In the context of a multicenter study by ESSKA (European Society for Sports Medicine, Surgery and Arthroscopy) involving 20 patients, the result was evaluated by direct MRI arthrography (gadolinium). The suture bar anchors were generally not detectable, the incision channels produced a hypodense signal in the meniscus tissue. If re-rupture occurred, it was because the meniscus had pulled out of the suture loop. Cartilaginous lesions were not found. There were no complications related to the nonresorbable suture bar anchors.     

Arthroscopic surgery of the knee in local anaesthesia

Summary Arthroscopy of the knee joint was performed in 356 consecutive outpatients in local anaesthesia and without premedication. A continuous pressure-irrigation system was used with 0.2% lidocaine chloride solution in the irrigation fluid, following administration of 5–7 ml prilocaine with epinephrine in each portal. All patients had clinical symptoms of internal derangement of the knee, such as meniscal, cruciate ligament injury or osteoarthritis. Associated intra-articular pathology was registered. Intra-articular surgery was performed in 228 cases. This included partial or subtotal meniscectomy in 207 cases and meniscus suture in 3 cases. In 18 of 228 cases (8%) the operative procedure had to be terminated due to patient discomfort. Of the meniscal injuries 84% were medial and 16% lateral. The age distribution of the medial meniscus tears was as follows: bucket handles 33 ± 9 years; flap tears 42 ± 10 years and degenerative tears 53 ± 10 years. For the lateral meniscus the age distribution was: bucket handles 34 ± 9 years, cleavage and radiating tears 37.5 ± 12 years, flap tears 29 ± 7 years, peripheral tears 32 ± 9 years and degenerative tears 48 ± 11 years. Osteoarthritis was observed in 52% of all medial degenerative tears, whereas a low frequency was found in the remaining tears. The majority of patients tolerated the procedure well. In summary, 64% of the consecutive arthroscopies were operative, including 3 meniscal sutures. Only 8% of these procedures had to be abandoned due to patient discomfort. Thus, arthroscopic surgery in local anaesthesia with no premedication is an efficient and well-tolerated method in outpatient practice.     

关节镜下经关节腔入路治疗成人腘窝囊肿

目的 探讨关节镜下经关节腔入路治疗成人胭窝囊肿的方法及临床疗效.方法 2004年10月至2006年10月,采用关节镜下经关节腔入路治疗成人腘窝囊肿15例.男5例,女10例;年龄45～60岁,平均50.5岁.胭窝囊肿均为单侧,其中右膝8例,左膝7例,术前均行MR检查,观察胭窝囊肿与膝关节腔是否相通.术中在扩大腓肠肌一半膜肌滑囊与关节腔后内侧室裂隙样结构的同时,处理关节腔内病变,全部手术均在关节镜下完成,并根据Rausohning和Lindgren评价方法评定手术效果.结果 术中发现15例胭窝囊肿患者均伴有不同程度的膝关节内病变,其中内侧半月板撕裂6例,外侧半月板撕裂3例,骨关节炎9例(4例合并内侧半月板撕裂,2例合并外侧半月板损伤),类风湿关节炎2例,前十字韧带损伤1例.术中及术后未出现重要血管和神经损伤.随访时间12～48个月,平均18.5个月,术后14例未出现囊肿复发.Rauschning和Lindgren评价方法:术前,Ⅰ级1例,Ⅱ级5例,Ⅲ级9例;术后,0级13例,Ⅰ级1例,Ⅱ级1例.随访结果满意.结论 成人腘窝囊肿是一种继发性疾病,治疗胭窝囊肿的同时应处理关节内的病变.关节镜下经关节腔入路治疗成人胭窝囊肿,具有创伤小、恢复快、复发率低、并发症发生率低等优点.     

An Unusual Meniscal Ganglion Cyst That Triggered Recurrent Hemarthrosis of the Knee

A 58-year-old woman suffered spontaneous recurrent hemarthrosis of the knee. In the clinical course, pigmented villonodular synovitis was mostly suspected, but in arthroscopic surgery the lateral meniscus appeared to be upturned and stuck into the lateral pouch with the meniscal ganglion cyst. It was suggested that meniscal tear with meniscal ganglion cyst was related with recurrent hemarthrosis. Generally, both the meniscal ganglion cysts and spontaneous recurrent hemarthrosis are highly rare conditions. In this case, we speculated that a negligible power could induce the meniscal tear with recurrent hemarthrosis in the particular situation in which the meniscal ganglion cyst existed. In other words, the meniscal ganglion cyst might basically and physically relate with hemorrhagic condition. Arthroscopically, the meniscal ganglion cyst was removed together with the anterior segment of the lateral meniscus. Recurrent hemarthrosis was treated successfully by resection of the meniscus.     

Discoid lateral meniscus: prevalence of peripheral rim instability

The purpose of this study was to determine the prevalence of peripheral rim instability in discoid lateral meniscus. A consecutive series of 112 patients (128 knees) (mean age 10.0 years [range 1 month to 22 years]) who underwent arthroscopic evaluation and treatment of a discoid lateral meniscus between 1993 and 2001 was reviewed. Of those discoid menisci classified intraoperatively (n = 87), 62.1% (n = 54) were complete discoid lateral menisci and 37.9% (n = 33) were incomplete discoid lateral menisci. An associated meniscal tear was present in 69.5% (n = 89) of all knees studied. Overall, 28.1% (n = 36) of discoid lateral menisci had peripheral rim instability: 47.2% (n = 17) were unstable at the anterior-third peripheral attachment, 11.1% (n = 4) at the middle-third peripheral attachment, and 38.9% (n = 14) at the posterior-third peripheral attachment. Thirty-one of the 36 unstable discoid menisci underwent repair of the peripheral meniscal rim attachment. One patient underwent a complete, open meniscectomy. Peripheral rim instability was significantly more common in complete discoid lateral menisci (38.9% vs. 18.2%; P = 0.043) and in younger patients (8.2 vs. 10.7 years; P = 0.002). The frequency of peripheral instability mandates a thorough assessment of meniscal stability at all peripheral attachments during the arthroscopic evaluation and treatment of discoid lateral meniscus, particularly in complete variants and in younger children.     

Arthroscopic meniscectomy for discoid lateral meniscus in children

We reviewed the cases of forty-six children who were less than fifteen years old and in whom total, subtotal, or partial arthroscopic meniscectomy was performed for symptomatic discoid lateral meniscus in fifty-three knees. The average length of follow-up was 31.2 months. A meniscal tear was evident in each knee. The extent of the meniscectomy depended on the site and shape of the tear, as did the symptoms and signs. We tried to establish the width of partial meniscectomy of a discoid meniscus that would prevent new tears.