{"paper_id":"375df790-29a9-4d28-9f8a-b775a8dc16c1","body_text":"Epidemiology, Clinical Presentation, and Functional Outcomes of Discoid Lateral Meniscus in Indian Children: A 10-Year Single-Centre Cohort Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Epidemiology, Clinical Presentation, and Functional Outcomes of Discoid Lateral Meniscus in Indian Children: A 10-Year Single-Centre Cohort Study Jonathan Reddy, Thomas Palocaren, Madhavi Kandagaddala, Abhay Gahukamble This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9026179/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 10 You are reading this latest preprint version Abstract Background: Discoid lateral meniscus is a relatively uncommon congenital anomaly of the knee, with reported prevalence ranging from 0.4% to 16.6% and higher rates in Asian populations. However, epidemiological and outcome data in Indian children remain limited. This study aimed to describe the clinical profile, morphological variants, and functional outcomes following arthroscopic partial meniscectomy in a pediatric Indian cohort. Methods: We retrospectively reviewed 24 children (aged 4–16 years) who underwent arthroscopic partial meniscectomy for symptomatic discoid lateral meniscus between January 2010 and February 2020. Diagnosis was based on clinical, radiological, and arthroscopic findings. Menisci were classified according to Watanabe’s system with Monllau’s modification. Functional outcome was assessed using the Lysholm knee score preoperatively and at 12 months postoperatively. Results: The mean age was 9.3 ± 2.7 years, with 13 boys and 11 girls. Bilateral involvement was identified in 25% of cases. Pain was the most frequent symptom, reported in two-thirds of children, while snapping and locking were less common. Arthroscopically, 14 knees had complete discoid meniscus, 9 had incomplete type, and 1 had a Wrisberg variant. Intra-substance tears were present in 11 children (45.8%). The mean Lysholm score improved from 67.8 ± 8.6 preoperatively to 92.5 ± 8.4 at 12 months (p < 0.001). Outcomes were graded as excellent in 50%, good in 41.7%, and satisfactory or poor in 4.2% each. No intraoperative complications or radiographic degenerative changes were observed. Conclusions: This 10-year cohort represents one of the largest pediatric series of discoid lateral meniscus reported from India. Compared with Western reports, our children presented at a younger age, with pain rather than snapping as the predominant symptom, and had a higher rate of bilateral involvement. Arthroscopic partial meniscectomy provided excellent functional outcomes in most cases, supporting meniscus-preserving techniques as the treatment of choice in children. Discoid lateral meniscus Arthroscopy Pediatric knee Saucerization Lysholm score Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Introduction Discoid meniscus is an uncommon congenital malformation of the knee meniscus, characterized by abnormal morphology and increased coverage of the tibial plateau. Its prevalence varies widely, from 0.4% to 16.6%, and is consistently higher in Asian than Western populations ( 1 , 2 ). Bilateral involvement has been described in up to one-quarter of cases. In India, Rao et al. reported an incidence of 5.8% among arthroscopy patients ( 3 ), but pediatric data remain limited. The classification system proposed by Watanabe et al. describes three morphological types: complete, incomplete, and Wrisberg ligament variant, while Monllau et al. later added a ring-shaped variant ( 4 , 5 ). These variations are clinically important because abnormal collagen orientation and deficient attachments predispose discoid menisci to tearing and instability ( 6 ). Although some discoid menisci remain asymptomatic, symptomatic cases present with pain, swelling, snapping, or locking. Younger children may initially exhibit painless snapping, while older children are more likely to present with pain during activity ( 7 , 16 ). Historically, open meniscectomy was the standard treatment, but this is now avoided in children due to the risk of early degenerative arthritis ( 8 ). Current surgical management emphasizes arthroscopic partial meniscectomy (saucerization) with preservation of a stable rim, combined with repair if necessary ( 9 ). Published pediatric series from India are few, and there is limited data comparing clinical profiles and outcomes with international literature. The present study reports a 10-year experience of children treated surgically for discoid lateral meniscus at a tertiary pediatric orthopaedic centre. The objectives were to describe the clinical profile and morphological variants, evaluate functional outcomes after arthroscopic partial meniscectomy, and compare findings with Asian and Western studies. Materials and Methods This was a retrospective cohort study conducted in the Department of Paediatric Orthopaedics at a tertiary care teaching hospital. We reviewed the records of 24 children aged 4 to 16 years who underwent arthroscopic partial meniscectomy for symptomatic discoid lateral meniscus between January 2010 and February 2020. Children with a history of previous knee surgery, less than 12 months of follow-up, or whose families declined participation were excluded. Institutional Review Board approval was obtained, and a waiver of informed consent was granted due to the retrospective nature of the study. Diagnosis was based on clinical evaluation, MRI, and confirmed intraoperatively. Menisci were classified according to Watanabe’s classification with Monllau’s modification. MRI was performed using a 1.5-Tesla system (Signa, GE Healthcare, USA). All procedures were performed arthroscopically with the patient supine under general anaesthesia. Using standard anterolateral and anteromedial portals, saucerization was carried out with shavers and punches to reduce the meniscus to a stable semilunar rim of approximately 6–8 mm. Peripheral instability and tears were repaired when indicated. Representative intraoperative arthroscopic images are shown in Fig. 1 . Postoperative rehabilitation included immediate quadriceps strengthening, with progression to active knee mobilization and partial weight-bearing by the second week, and return to unrestricted activity after 4–5 weeks. Postoperative clinical recovery and restoration of range of motion are illustrated in Fig. 6 . Functional outcome was assessed using the Lysholm knee score, recorded preoperatively and at 12 months postoperatively. Secondary outcomes included range of motion, symptom resolution, and complications. Statistical analysis was performed using SPSS Version 22.0 (IBM Corp., Chicago, IL, USA). Continuous variables were expressed as mean ± standard deviation, and pre- and postoperative scores compared using Student’s t -test. Pearson’s correlation was used to evaluate associations between clinical variables and outcomes. A p value < 0.05 was considered statistically significant. Results Twenty-four children (13 boys, 11 girls) were included, with a mean age of 9.3 ± 2.7 years (range, 4–16 years). Presentation occurred earlier than the average reported in Western series (12–15 years) ( 5 , 6 ) and was comparable to Asian studies ( 2 , 4 ). There was no clear sex preponderance (male-to-female ratio 1.18:1). Bilateral involvement was seen in 6 children (25%), consistent with Asian reports (15–25%) and higher than in most Western cohorts (~ 10%) ( 3 , 4 ). Pain was the predominant symptom, reported by 16 children, while snapping was present in 5 and true locking in 4. Six had recurrent effusion, and 9 presented with fixed flexion deformity. Four children developed contralateral knee pain during follow-up. On examination, quadriceps wasting, lateral joint line tenderness, restricted motion, and a positive McMurray test were frequent findings. Radiographs most often showed widening of the lateral joint space (Fig. 3 , Fig. 4 ). MRI demonstrated characteristic imaging features of discoid lateral meniscus, including increased meniscal thickness and coverage of the lateral tibial plateau (Fig. 2 ). MRI and arthroscopy confirmed 14 complete, 9 incomplete, and 1 Wrisberg type discoid meniscus, as described by Singh et al. ( 9 ). Additional radiological examples of discoid lateral meniscus are shown in Fig. 5 . Intra-substance tears were found in 11 children, predominantly in complete types. One child developed transient postoperative swelling that resolved within a month. No intraoperative complications, re-tears, or degenerative changes were noted during follow-up. Most children resumed normal activity within 4–5 weeks. The mean Lysholm score improved significantly from 67.8 ± 8.6 preoperatively to 92.5 ± 8.4 at 12 months ( p < 0.001). Functional outcomes were excellent in 12 patients (50%), good in 10 (41.7%), and satisfactory or poor in 1 patient each (4.2%). Outcomes were not significantly influenced by sex ( p = 0.62), tear pattern ( p = 0.48), or presence of effusion/locking ( p = 0.55). Discussion Discoid lateral meniscus, though uncommon, has significant clinical implications because of its abnormal morphology, predisposition to tears, and impact on long-term joint health. Reported prevalence varies widely, from 0.4% to 16.6%, and is consistently higher in Asian populations compared to Western cohorts ( 2 , 7 ). In India, Rao et al. reported a frequency of 5.8% in arthroscopy patients ( 3 ), but pediatric series remain rare. Our study therefore provides important epidemiological and clinical insights from an Indian cohort, contributing to the global understanding of this condition. Epidemiology and Demographic Patterns The mean age at presentation in our study was 9.3 years, which is younger than the 12–15 years typically reported in Western studies ( 5 , 6 ). This aligns with Asian studies, where symptomatic discoid meniscus often presents in the first decade of life ( 2 ). This difference may reflect genetic, anatomical, or activity-related factors that predispose Asian children to earlier manifestation. Importantly, early presentation has practical implications, as treatment decisions in skeletally immature children must prioritize long-term joint preservation. Our findings of nearly equal sex distribution also differ from some Western reports that describe a female predominance ( 5 ). Such variability across populations highlights the need for regional epidemiological data to inform clinical expectations. Bilateral involvement was observed in 25% of our cohort, comparable to Asian literature (15–25%) ( 2 , 4 ) and higher than the 10% typically described in Western populations. This underlines the importance of evaluating the contralateral knee, even in asymptomatic children, with MRI when feasible. Clinical Spectrum Classically, snapping knee has been considered the hallmark symptom of discoid meniscus ( 10 ). However, in our study (Table 1 ), pain was the predominant complaint, affecting two-thirds of patients, while snapping and locking were less common. This shift has also been highlighted in more recent literature, which notes that pain and activity-related symptoms may dominate the presentation in pediatric cohorts ( 12 , 15 ). This has important clinical relevance, as reliance on snapping alone could delay diagnosis in children whose primary symptom is pain. Table 1 Demographics, Clinical Features, Morphology, Outcomes, and Statistical Analysis of 24 Children with Discoid Lateral Meniscus Parameter Findings Demographics Number of patients 24 Sex (M:F) 13:11 Mean age (years) 9.3 ± 2.7 (range, 4–16) Bilateral involvement 6 (25%) Clinical presentation Pain 16 (67%) Snapping 5 (21%) Locking 4 (17%) Effusion 6 (25%) Fixed flexion deformity 9 (38%) Contralateral symptoms during follow-up 4 (17%) Imaging/Arthroscopy Complete discoid meniscus 14 (58%) Incomplete discoid meniscus 9 (38%) Wrisberg variant 1 (4%) Intra-substance tears 11 (46%) Outcomes Mean Lysholm score (pre-op) 67.8 ± 8.6 Mean Lysholm score (12 months) 92.5 ± 8.4 Change in Lysholm score p < 0.001 (significant) Excellent outcome 12 (50%) Good outcome 10 (41.7%) Satisfactory outcome 1 (4.2%) Poor outcome 1 (4.2%) Influence of sex NS (p = 0.62) Influence of tear pattern NS (p = 0.48) Influence of effusion/locking NS (p = 0.55) Complications 1 transient swelling; no re-tears or degenerative changes Fixed flexion deformity was present in over one-third of our children, suggesting a chronic process in many cases. Quadriceps wasting, tenderness, and restricted motion were also common. These findings reinforce the need for a high index of suspicion, as the clinical presentation of discoid meniscus can overlap with other pediatric knee disorders such as juvenile arthritis, osteochondritis dissecans, or ligamentous injuries. Morphological Variants and Pathology The most frequent type in our series was the complete discoid meniscus, followed by incomplete and one Wrisberg variant. The Wrisberg type, though rare, is clinically important because its deficient posterior attachments predispose it to instability and symptomatic hypermobility ( 4 ). Intra-substance tears were observed in nearly half of our patients, particularly in complete discoid types, echoing prior studies that attribute this vulnerability to abnormal collagen fibril orientation and peripheral rim instability ( 1 , 14 ). Recognition of these structural weaknesses supports early surgical intervention in symptomatic cases to prevent progressive damage. Surgical Outcomes Arthroscopic partial meniscectomy (saucerization) has become the treatment of choice in children, replacing earlier approaches of open or total meniscectomy ( 13 , 11 ). The rationale is to preserve as much meniscal tissue as possible to maintain load distribution and minimize the risk of early degenerative arthritis. In our series, saucerization with repair when indicated yielded excellent or good outcomes in 92% of children, comparable to reported success rates of 85–95% ( 17 , 18 ). One of the strengths of our series is the absence of complications, re-tears, or early degenerative changes during follow-up. While our follow-up was limited to 12 months for functional outcomes, these results are encouraging and suggest that meniscus-preserving techniques are safe and effective in Indian children. Longer follow-up will be important to confirm the durability of these outcomes. Comparison With Recent Literature Our findings are consistent with recent large-scale and long-term studies. The SCORE multicenter database (2023) reported that younger children are more likely to have complete morphology and peripheral instability, but also achieve excellent outcomes with saucerization and repair when indicated ( 19 ). Similarly, Aksoy et al. (2025) demonstrated durable functional results and limited radiological progression of degeneration at mid- to long-term follow-up after saucerization ( 20 ). Rublev et al. (2024) reported excellent outcomes in children younger than 12 years treated with saucerization with or without repair ( 21 ). Carabajal et al. (2020) also reported favorable mid-term results after remodelling combined with peripheral repair in unstable discoid menisci ( 22 ). These studies reinforce the paradigm shift toward preservation and repair, which our data also support. Clinical Implications This study underscores three clinically relevant points. First, the age of presentation and predominance of pain symptoms in our cohort highlight the need for heightened awareness among pediatricians and orthopedic surgeons, particularly in Asian populations. Second, the high rate of bilateral involvement justifies imaging of the contralateral knee, even if asymptomatic. Third, arthroscopic saucerization provides reliable short-term outcomes and should remain the standard of care, with repair added in cases of instability. Limitations The main limitations of our study are its retrospective design, modest sample size, and relatively short follow-up for radiological outcomes. Functional assessment was limited to the Lysholm score, and more comprehensive pediatric-specific outcome measures may provide additional insights in future studies. Nonetheless, this study represents one of the largest pediatric series of discoid meniscus from India and contributes novel epidemiological and clinical data from this region. Conclusion Discoid lateral meniscus in Indian children may present at a younger age than in Western populations, with pain more commonly reported than snapping or locking. Bilateral involvement was relatively frequent, consistent with Asian literature. Arthroscopic partial meniscectomy provided excellent or good functional outcomes in most cases, with no significant complications or early degenerative changes. This study contributes to the limited epidemiological data on pediatric discoid meniscus in India and supports meniscus-preserving arthroscopic techniques as the standard of care. Early recognition and surgical management tailored to meniscal morphology can restore function effectively and may reduce the risk of long-term joint degeneration. Declarations Ethics approval and consent to participate This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Institutional Review Board of Christian Medical College, Vellore. Due to the retrospective nature of the study, the requirement for written informed consent was waived by the ethics committee. Consent for publication Not applicable. Availability of data and materials The datasets used and analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Authors’ contributions JR conceived the study, collected the clinical data, and drafted the manuscript. TP supervised the study and critically revised the manuscript. MK interpreted the radiological data. AG supervised the study, contributed to data analysis, and served as the corresponding author. Acknowledgements The authors thank the Department of Paediatric Orthopaedics and Radiology at Christian Medical College, Vellore for their support. References Jordan MR. Lateral meniscal variants: evaluation and treatment. J Am Acad Orthop Surg. 1996;4(4):191–200. Bae JH, Lim HC, Hwang DH, Song JK, Byun JS, Nha KW. Incidence of bilateral discoid lateral meniscus in an Asian population: an arthroscopic assessment of contralateral knees. Arthroscopy. 2012;28(7):936–41. 10.1016/j.arthro.2011.12.007 . Rao PS, Rao SK, Paul R. Clinical, radiologic, and arthroscopic assessment of discoid lateral meniscus. Arthroscopy. 2001;17(3):275–7. 10.1053/jars.2001.21222 . Ahn JH, Lee SH, Yoo JC, Lee HJ, Lee JS. Bilateral discoid lateral meniscus in knees: evaluation of the contralateral knee in patients with symptomatic discoid lateral meniscus. Arthroscopy. 2010;26(10):1348–56. 10.1016/j.arthro.2010.02.021 . 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Carabajal M, Allende GJ, Masquijo JJ. Mid-term results of arthroscopic remodelling combined with peripheral repair in children with unstable discoid meniscus. Rev Esp Cir Ortop Traumatol. 2020;64(3):206–12. 10.1016/j.recote.2020.03.004 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 13 May, 2026 Reviews received at journal 19 Apr, 2026 Reviews received at journal 10 Apr, 2026 Reviewers agreed at journal 07 Apr, 2026 Reviewers agreed at journal 07 Apr, 2026 Reviewers agreed at journal 05 Apr, 2026 Reviewers invited by journal 19 Mar, 2026 Editor assigned by journal 10 Mar, 2026 Submission checks completed at journal 10 Mar, 2026 First submitted to journal 04 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-9026179\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":false,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":610102264,\"identity\":\"30915f89-d7ae-455b-9192-eaf0ae4226cf\",\"order_by\":0,\"name\":\"Jonathan Reddy\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Christian Medical College \\u0026 Hospital\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Jonathan\",\"middleName\":\"\",\"lastName\":\"Reddy\",\"suffix\":\"\"},{\"id\":610102265,\"identity\":\"569426b9-4952-4b7f-a824-184b626726c0\",\"order_by\":1,\"name\":\"Thomas 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semilunar contour following meniscoplasty.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"1.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9026179/v1/6773367ba44559feded3058c.jpg\"},{\"id\":105296849,\"identity\":\"c296693f-af3c-4266-ba3e-f4ec340106c6\",\"added_by\":\"auto\",\"created_at\":\"2026-03-24 13:14:32\",\"extension\":\"jpg\",\"order_by\":2,\"title\":\"Figure 2\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":192193,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003e\\u003cstrong\\u003eMRI of the right knee demonstrating features of discoid lateral meniscus.\\u003c/strong\\u003e\\u003cbr\\u003e\\n(a) Coronal image showing widening of the lateral tibiofemoral joint space, squaring of the lateral femoral condyle, and cupping of the lateral tibial plateau.\\u003cbr\\u003e\\n(b) Proton density–weighted fat-suppressed (PDW-FS) coronal image demonstrating a thick lateral meniscus completely covering the lateral tibial plateau (thin short white arrow), consistent with a complete discoid meniscus.\\u003cbr\\u003e\\n(c) PDW-FS coronal image showing a complete discoid meniscus with a horizontal tear (thick short arrow).\\u003cbr\\u003e\\n(d) PDW-FS coronal image showing intra-meniscal mucoid degeneration within a complete discoid meniscus (thin long white arrow).\\u003cbr\\u003e\\n(e) PDW-FS sagittal image demonstrating a discoid lateral meniscus with absent popliteomeniscal ligament (yellow arrow), characteristic of the Wrisberg variant.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"2.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9026179/v1/fba8bd3575a0c91a1eb3fc86.jpg\"},{\"id\":105296848,\"identity\":\"f2f1008e-44a0-4d60-b82c-3cd6b954a0bd\",\"added_by\":\"auto\",\"created_at\":\"2026-03-24 13:14:32\",\"extension\":\"jpg\",\"order_by\":3,\"title\":\"Figure 3\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":156826,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003e\\u003cstrong\\u003eImaging of an adolescent girl with discoid lateral meniscus.\\u003c/strong\\u003e\\u003cbr\\u003e\\n(a, b) Preoperative radiographs demonstrating widening of the lateral joint space.\\u003cbr\\u003e\\n(c–f) MRI sequences confirming an injured discoid lateral meniscus.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"3.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9026179/v1/8076dc206069326504fe6283.jpg\"},{\"id\":105296852,\"identity\":\"d2eb5aad-9d57-410c-a368-c9656206b1f5\",\"added_by\":\"auto\",\"created_at\":\"2026-03-24 13:14:32\",\"extension\":\"jpg\",\"order_by\":4,\"title\":\"Figure 4\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":111752,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003e\\u003cstrong\\u003eImaging of an adolescent boy with discoid lateral meniscus.\\u003c/strong\\u003e\\u003cbr\\u003e\\n(a) Preoperative radiograph demonstrating widening of the lateral joint space.\\u003cbr\\u003e\\n(c, d) MRI images confirming a discoid lateral meniscus.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"4.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9026179/v1/93015aa2503ed8f217fc9f80.jpg\"},{\"id\":105296851,\"identity\":\"c893d054-6427-48ff-808c-fc5d7fd104ba\",\"added_by\":\"auto\",\"created_at\":\"2026-03-24 13:14:32\",\"extension\":\"jpg\",\"order_by\":5,\"title\":\"Figure 5\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":133994,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003e\\u003cstrong\\u003eImaging of an adolescent boy with discoid lateral meniscus.\\u003c/strong\\u003e\\u003cbr\\u003e\\n(a–f) Preoperative radiograph and MRI sequences demonstrating a discoid lateral meniscus.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"5.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9026179/v1/266cf8b6875528af55c973af.jpg\"},{\"id\":105296850,\"identity\":\"faddb106-44b7-4f8d-ab9f-a26a96292ac5\",\"added_by\":\"auto\",\"created_at\":\"2026-03-24 13:14:32\",\"extension\":\"jpg\",\"order_by\":6,\"title\":\"Figure 6\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":114885,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003e\\u003cstrong\\u003ePostoperative follow-up clinical images of an adolescent boy after saucerization for discoid lateral meniscus.\\u003c/strong\\u003e\\u003cbr\\u003e\\n(a–d) Follow-up examination demonstrating restoration of knee range of motion and recovery of quadriceps muscle bulk, which had been atrophied prior to surgery.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"6.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9026179/v1/e1cdc6a90239e4c0fc34f039.jpg\"},{\"id\":105296867,\"identity\":\"0775d35c-9599-43f0-bd8e-3446ea2f475e\",\"added_by\":\"auto\",\"created_at\":\"2026-03-24 13:14:37\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":1581124,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9026179/v1/1fc1226a-02d9-47db-9076-2e4a18a1fa43.pdf\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Epidemiology, Clinical Presentation, and Functional Outcomes of Discoid Lateral Meniscus in Indian Children: A 10-Year Single-Centre Cohort Study\",\"fulltext\":[{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eDiscoid meniscus is an uncommon congenital malformation of the knee meniscus, characterized by abnormal morphology and increased coverage of the tibial plateau. Its prevalence varies widely, from 0.4% to 16.6%, and is consistently higher in Asian than Western populations (\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e). Bilateral involvement has been described in up to one-quarter of cases. In India, Rao et al. reported an incidence of 5.8% among arthroscopy patients (\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e), but pediatric data remain limited.\\u003c/p\\u003e \\u003cp\\u003eThe classification system proposed by Watanabe et al. describes three morphological types: complete, incomplete, and Wrisberg ligament variant, while Monllau et al. later added a ring-shaped variant (\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e). These variations are clinically important because abnormal collagen orientation and deficient attachments predispose discoid menisci to tearing and instability (\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eAlthough some discoid menisci remain asymptomatic, symptomatic cases present with pain, swelling, snapping, or locking. Younger children may initially exhibit painless snapping, while older children are more likely to present with pain during activity (\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e). Historically, open meniscectomy was the standard treatment, but this is now avoided in children due to the risk of early degenerative arthritis (\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e). Current surgical management emphasizes arthroscopic partial meniscectomy (saucerization) with preservation of a stable rim, combined with repair if necessary (\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003ePublished pediatric series from India are few, and there is limited data comparing clinical profiles and outcomes with international literature. The present study reports a 10-year experience of children treated surgically for discoid lateral meniscus at a tertiary pediatric orthopaedic centre. The objectives were to describe the clinical profile and morphological variants, evaluate functional outcomes after arthroscopic partial meniscectomy, and compare findings with Asian and Western studies.\\u003c/p\\u003e\"},{\"header\":\"Materials and Methods\",\"content\":\"\\u003cp\\u003eThis was a retrospective cohort study conducted in the Department of Paediatric Orthopaedics at a tertiary care teaching hospital. We reviewed the records of 24 children aged 4 to 16 years who underwent arthroscopic partial meniscectomy for symptomatic discoid lateral meniscus between January 2010 and February 2020. Children with a history of previous knee surgery, less than 12 months of follow-up, or whose families declined participation were excluded. Institutional Review Board approval was obtained, and a waiver of informed consent was granted due to the retrospective nature of the study.\\u003c/p\\u003e \\u003cp\\u003eDiagnosis was based on clinical evaluation, MRI, and confirmed intraoperatively. Menisci were classified according to Watanabe\\u0026rsquo;s classification with Monllau\\u0026rsquo;s modification. MRI was performed using a 1.5-Tesla system (Signa, GE Healthcare, USA).\\u003c/p\\u003e \\u003cp\\u003eAll procedures were performed arthroscopically with the patient supine under general anaesthesia. Using standard anterolateral and anteromedial portals, saucerization was carried out with shavers and punches to reduce the meniscus to a stable semilunar rim of approximately 6\\u0026ndash;8 mm. Peripheral instability and tears were repaired when indicated. Representative intraoperative arthroscopic images are shown in Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e.\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003cp\\u003ePostoperative rehabilitation included immediate quadriceps strengthening, with progression to active knee mobilization and partial weight-bearing by the second week, and return to unrestricted activity after 4\\u0026ndash;5 weeks. Postoperative clinical recovery and restoration of range of motion are illustrated in Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig2\\\" class=\\\"InternalRef\\\"\\u003e6\\u003c/span\\u003e.\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003cp\\u003eFunctional outcome was assessed using the Lysholm knee score, recorded preoperatively and at 12 months postoperatively. Secondary outcomes included range of motion, symptom resolution, and complications. Statistical analysis was performed using SPSS Version 22.0 (IBM Corp., Chicago, IL, USA). Continuous variables were expressed as mean\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;standard deviation, and pre- and postoperative scores compared using Student\\u0026rsquo;s \\u003cem\\u003et\\u003c/em\\u003e-test. Pearson\\u0026rsquo;s correlation was used to evaluate associations between clinical variables and outcomes. A \\u003cem\\u003ep\\u003c/em\\u003e value\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05 was considered statistically significant.\\u003c/p\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003eTwenty-four children (13 boys, 11 girls) were included, with a mean age of 9.3\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;2.7 years (range, 4\\u0026ndash;16 years). Presentation occurred earlier than the average reported in Western series (12\\u0026ndash;15 years) (\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e) and was comparable to Asian studies (\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e). There was no clear sex preponderance (male-to-female ratio 1.18:1). Bilateral involvement was seen in 6 children (25%), consistent with Asian reports (15\\u0026ndash;25%) and higher than in most Western cohorts (~\\u0026thinsp;10%) (\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003ePain was the predominant symptom, reported by 16 children, while snapping was present in 5 and true locking in 4. Six had recurrent effusion, and 9 presented with fixed flexion deformity. Four children developed contralateral knee pain during follow-up. On examination, quadriceps wasting, lateral joint line tenderness, restricted motion, and a positive McMurray test were frequent findings.\\u003c/p\\u003e \\u003cp\\u003eRadiographs most often showed widening of the lateral joint space (Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig4\\\" class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e, Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig5\\\" class=\\\"InternalRef\\\"\\u003e4\\u003c/span\\u003e). MRI demonstrated characteristic imaging features of discoid lateral meniscus, including increased meniscal thickness and coverage of the lateral tibial plateau (Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig3\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e). MRI and arthroscopy confirmed 14 complete, 9 incomplete, and 1 Wrisberg type discoid meniscus, as described by Singh et al. (\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e). Additional radiological examples of discoid lateral meniscus are shown in Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig6\\\" class=\\\"InternalRef\\\"\\u003e5\\u003c/span\\u003e. Intra-substance tears were found in 11 children, predominantly in complete types.\\u003c/p\\u003e \\u003cp\\u003eOne child developed transient postoperative swelling that resolved within a month. No intraoperative complications, re-tears, or degenerative changes were noted during follow-up. Most children resumed normal activity within 4\\u0026ndash;5 weeks.\\u003c/p\\u003e \\u003cp\\u003eThe mean Lysholm score improved significantly from 67.8\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;8.6 preoperatively to 92.5\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;8.4 at 12 months (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001). Functional outcomes were excellent in 12 patients (50%), good in 10 (41.7%), and satisfactory or poor in 1 patient each (4.2%). Outcomes were not significantly influenced by sex (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.62), tear pattern (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.48), or presence of effusion/locking (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.55).\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eDiscoid lateral meniscus, though uncommon, has significant clinical implications because of its abnormal morphology, predisposition to tears, and impact on long-term joint health. Reported prevalence varies widely, from 0.4% to 16.6%, and is consistently higher in Asian populations compared to Western cohorts (\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e). In India, Rao et al. reported a frequency of 5.8% in arthroscopy patients (\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e), but pediatric series remain rare. Our study therefore provides important epidemiological and clinical insights from an Indian cohort, contributing to the global understanding of this condition.\\u003c/p\\u003e\\n\\u003ch3\\u003eEpidemiology and Demographic Patterns\\u003c/h3\\u003e\\n\\u003cp\\u003eThe mean age at presentation in our study was 9.3 years, which is younger than the 12\\u0026ndash;15 years typically reported in Western studies (\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e). This aligns with Asian studies, where symptomatic discoid meniscus often presents in the first decade of life (\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e). This difference may reflect genetic, anatomical, or activity-related factors that predispose Asian children to earlier manifestation. Importantly, early presentation has practical implications, as treatment decisions in skeletally immature children must prioritize long-term joint preservation.\\u003c/p\\u003e \\u003cp\\u003eOur findings of nearly equal sex distribution also differ from some Western reports that describe a female predominance (\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e). Such variability across populations highlights the need for regional epidemiological data to inform clinical expectations. Bilateral involvement was observed in 25% of our cohort, comparable to Asian literature (15\\u0026ndash;25%) (\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e) and higher than the 10% typically described in Western populations. This underlines the importance of evaluating the contralateral knee, even in asymptomatic children, with MRI when feasible.\\u003c/p\\u003e\\n\\u003ch3\\u003eClinical Spectrum\\u003c/h3\\u003e\\n\\u003cp\\u003eClassically, snapping knee has been considered the hallmark symptom of discoid meniscus (\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e). However, in our study (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e), pain was the predominant complaint, affecting two-thirds of patients, while snapping and locking were less common. This shift has also been highlighted in more recent literature, which notes that pain and activity-related symptoms may dominate the presentation in pediatric cohorts (\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e). This has important clinical relevance, as reliance on snapping alone could delay diagnosis in children whose primary symptom is pain.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eDemographics, Clinical Features, Morphology, Outcomes, and Statistical Analysis of 24 Children with Discoid Lateral Meniscus\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"2\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eParameter\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFindings\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eDemographics\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNumber of patients\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e24\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSex (M:F)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e13:11\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMean age (years)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e9.3\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;2.7 (range, 4\\u0026ndash;16)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eBilateral involvement\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e6 (25%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eClinical presentation\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePain\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e16 (67%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSnapping\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e5 (21%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eLocking\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e4 (17%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eEffusion\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e6 (25%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFixed flexion deformity\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e9 (38%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eContralateral symptoms during follow-up\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e4 (17%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eImaging/Arthroscopy\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eComplete discoid meniscus\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e14 (58%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eIncomplete discoid meniscus\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e9 (38%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eWrisberg variant\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1 (4%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eIntra-substance tears\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e11 (46%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eOutcomes\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMean Lysholm score (pre-op)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e67.8\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;8.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMean Lysholm score (12 months)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e92.5\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;8.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eChange in Lysholm score\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ep\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001 (significant)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eExcellent outcome\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e12 (50%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eGood outcome\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e10 (41.7%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSatisfactory outcome\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1 (4.2%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePoor outcome\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1 (4.2%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eInfluence of sex\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eNS (p\\u0026thinsp;=\\u0026thinsp;0.62)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eInfluence of tear pattern\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eNS (p\\u0026thinsp;=\\u0026thinsp;0.48)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eInfluence of effusion/locking\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eNS (p\\u0026thinsp;=\\u0026thinsp;0.55)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eComplications\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1 transient swelling; no re-tears or degenerative changes\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eFixed flexion deformity was present in over one-third of our children, suggesting a chronic process in many cases. Quadriceps wasting, tenderness, and restricted motion were also common. These findings reinforce the need for a high index of suspicion, as the clinical presentation of discoid meniscus can overlap with other pediatric knee disorders such as juvenile arthritis, osteochondritis dissecans, or ligamentous injuries.\\u003c/p\\u003e\\n\\u003ch3\\u003eMorphological Variants and Pathology\\u003c/h3\\u003e\\n\\u003cp\\u003eThe most frequent type in our series was the complete discoid meniscus, followed by incomplete and one Wrisberg variant. The Wrisberg type, though rare, is clinically important because its deficient posterior attachments predispose it to instability and symptomatic hypermobility (\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e). Intra-substance tears were observed in nearly half of our patients, particularly in complete discoid types, echoing prior studies that attribute this vulnerability to abnormal collagen fibril orientation and peripheral rim instability (\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e). Recognition of these structural weaknesses supports early surgical intervention in symptomatic cases to prevent progressive damage.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec8\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eSurgical Outcomes\\u003c/h2\\u003e \\u003cp\\u003eArthroscopic partial meniscectomy (saucerization) has become the treatment of choice in children, replacing earlier approaches of open or total meniscectomy (\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e). The rationale is to preserve as much meniscal tissue as possible to maintain load distribution and minimize the risk of early degenerative arthritis. In our series, saucerization with repair when indicated yielded excellent or good outcomes in 92% of children, comparable to reported success rates of 85\\u0026ndash;95% (\\u003cspan citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e17\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eOne of the strengths of our series is the absence of complications, re-tears, or early degenerative changes during follow-up. While our follow-up was limited to 12 months for functional outcomes, these results are encouraging and suggest that meniscus-preserving techniques are safe and effective in Indian children. Longer follow-up will be important to confirm the durability of these outcomes.\\u003c/p\\u003e \\u003c/div\\u003e\\n\\u003ch3\\u003eComparison With Recent Literature\\u003c/h3\\u003e\\n\\u003cp\\u003eOur findings are consistent with recent large-scale and long-term studies. The SCORE multicenter database (2023) reported that younger children are more likely to have complete morphology and peripheral instability, but also achieve excellent outcomes with saucerization and repair when indicated (\\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e). Similarly, Aksoy et al. (2025) demonstrated durable functional results and limited radiological progression of degeneration at mid- to long-term follow-up after saucerization (\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e). Rublev et al. (2024) reported excellent outcomes in children younger than 12 years treated with saucerization with or without repair (\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e). Carabajal et al. (2020) also reported favorable mid-term results after remodelling combined with peripheral repair in unstable discoid menisci (\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e). These studies reinforce the paradigm shift toward preservation and repair, which our data also support.\\u003c/p\\u003e\\n\\u003ch3\\u003eClinical Implications\\u003c/h3\\u003e\\n\\u003cp\\u003eThis study underscores three clinically relevant points. First, the age of presentation and predominance of pain symptoms in our cohort highlight the need for heightened awareness among pediatricians and orthopedic surgeons, particularly in Asian populations. Second, the high rate of bilateral involvement justifies imaging of the contralateral knee, even if asymptomatic. Third, arthroscopic saucerization provides reliable short-term outcomes and should remain the standard of care, with repair added in cases of instability.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec11\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eLimitations\\u003c/h2\\u003e \\u003cp\\u003e The main limitations of our study are its retrospective design, modest sample size, and relatively short follow-up for radiological outcomes. Functional assessment was limited to the Lysholm score, and more comprehensive pediatric-specific outcome measures may provide additional insights in future studies. Nonetheless, this study represents one of the largest pediatric series of discoid meniscus from India and contributes novel epidemiological and clinical data from this region.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Conclusion\",\"content\":\"\\u003cp\\u003eDiscoid lateral meniscus in Indian children may present at a younger age than in Western populations, with pain more commonly reported than snapping or locking. Bilateral involvement was relatively frequent, consistent with Asian literature. Arthroscopic partial meniscectomy provided excellent or good functional outcomes in most cases, with no significant complications or early degenerative changes.\\u003c/p\\u003e \\u003cp\\u003e This study contributes to the limited epidemiological data on pediatric discoid meniscus in India and supports meniscus-preserving arthroscopic techniques as the standard of care. Early recognition and surgical management tailored to meniscal morphology can restore function effectively and may reduce the risk of long-term joint degeneration.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eEthics approval and consent to participate\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThis study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Institutional Review Board of Christian Medical College, Vellore. Due to the retrospective nature of the study, the requirement for written informed consent was waived by the ethics committee.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConsent for publication\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNot applicable.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAvailability of data and materials\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe datasets used and analysed during the current study are available from the corresponding author on reasonable request.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCompeting interests\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe authors declare that they have no competing interests.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eFunding\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthors\\u0026rsquo; contributions\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eJR conceived the study, collected the clinical data, and drafted the manuscript.\\u003cbr\\u003e\\u0026nbsp;TP supervised the study and critically revised the manuscript.\\u003cbr\\u003e\\u0026nbsp;MK interpreted the radiological data.\\u003cbr\\u003e\\u0026nbsp;AG supervised the study, contributed to data analysis, and served as the corresponding author.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAcknowledgements\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe authors thank the Department of Paediatric Orthopaedics and Radiology at Christian Medical College, Vellore for their support.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eJordan MR. 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Knee. 2011;18(5):369\\u0026ndash;72. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1016/j.knee.2010.08.011\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.knee.2010.08.011\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSun Y, Jiang Q. Review of discoid meniscus. Orthop Surg. 2011;3(4):219\\u0026ndash;23. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1111/j.1757-7861.2011.00148.x\\u003c/span\\u003e\\u003cspan address=\\\"10.1111/j.1757-7861.2011.00148.x\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBellier G, Du Pont JY, Larrain M, Caudron C, Carlioz H. Lateral discoid menisci in children. Arthroscopy. 1989;5(1):52\\u0026ndash;6.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePellacci F, Montanari G, Prosperi P, Galli G, Celli V. Lateral discoid meniscus: treatment and results. Arthroscopy. 1992;8(4):526\\u0026ndash;30.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAdsit E, Albright J, Christino M, et al. Relationship Between Age and Pathology With Treatment of Pediatric and Adolescent Discoid Lateral Meniscus: A Report From the SCORE Multicenter Database. Am J Sports Med. 2023;51(13):3493\\u0026ndash;501. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1177/03635465231206173\\u003c/span\\u003e\\u003cspan address=\\\"10.1177/03635465231206173\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAksoy T, Goymen IM, Huri G, Turhan E, Kocher MS, Atay OA. Midterm to Long-term Follow-up After Limited Saucerization of a Discoid Lateral Meniscus: Radiological and Functional Outcomes With Age-Dependent Variations. Am J Sports Med. 2025;53(4):817\\u0026ndash;25. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1177/03635465241313137\\u003c/span\\u003e\\u003cspan address=\\\"10.1177/03635465241313137\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eRublev GA, Popkin CA, Potter HG, Kocher MS, Micheli LJ, Shea KG. Arthroscopic saucerization of discoid lateral meniscus, with meniscus repair as indicated, results in excellent outcomes in pediatric patients younger than 12 years. Arthroscopy. 2024;40(6):1607\\u0026ndash;15. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1016/j.arthro.2023.12.017\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.arthro.2023.12.017\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCarabajal M, Allende GJ, Masquijo JJ. Mid-term results of arthroscopic remodelling combined with peripheral repair in children with unstable discoid meniscus. Rev Esp Cir Ortop Traumatol. 2020;64(3):206\\u0026ndash;12. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1016/j.recote.2020.03.004\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.recote.2020.03.004\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"journal-of-orthopaedic-surgery-and-research\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"josr\",\"sideBox\":\"Learn more about [Journal of Orthopaedic Surgery and Research](http://josr-online.biomedcentral.com)\",\"snPcode\":\"13018\",\"submissionUrl\":\"https://submission.nature.com/new-submission/13018/3\",\"title\":\"Journal of Orthopaedic Surgery and Research\",\"twitterHandle\":\"@MSKmedBMC\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"BMC/SO AJ\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Discoid lateral meniscus, Arthroscopy, Pediatric knee, Saucerization, Lysholm score\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-9026179/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-9026179/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003ch2\\u003eBackground:\\u003c/h2\\u003e \\u003cp\\u003eDiscoid lateral meniscus is a relatively uncommon congenital anomaly of the knee, with reported prevalence ranging from 0.4% to 16.6% and higher rates in Asian populations. However, epidemiological and outcome data in Indian children remain limited. This study aimed to describe the clinical profile, morphological variants, and functional outcomes following arthroscopic partial meniscectomy in a pediatric Indian cohort.\\u003c/p\\u003e\\u003ch2\\u003eMethods:\\u003c/h2\\u003e \\u003cp\\u003eWe retrospectively reviewed 24 children (aged 4\\u0026ndash;16 years) who underwent arthroscopic partial meniscectomy for symptomatic discoid lateral meniscus between January 2010 and February 2020. Diagnosis was based on clinical, radiological, and arthroscopic findings. Menisci were classified according to Watanabe\\u0026rsquo;s system with Monllau\\u0026rsquo;s modification. Functional outcome was assessed using the Lysholm knee score preoperatively and at 12 months postoperatively.\\u003c/p\\u003e\\u003ch2\\u003eResults:\\u003c/h2\\u003e \\u003cp\\u003eThe mean age was 9.3\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;2.7 years, with 13 boys and 11 girls. Bilateral involvement was identified in 25% of cases. Pain was the most frequent symptom, reported in two-thirds of children, while snapping and locking were less common. Arthroscopically, 14 knees had complete discoid meniscus, 9 had incomplete type, and 1 had a Wrisberg variant. Intra-substance tears were present in 11 children (45.8%). The mean Lysholm score improved from 67.8\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;8.6 preoperatively to 92.5\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;8.4 at 12 months (p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001). Outcomes were graded as excellent in 50%, good in 41.7%, and satisfactory or poor in 4.2% each. No intraoperative complications or radiographic degenerative changes were observed.\\u003c/p\\u003e\\u003ch2\\u003eConclusions:\\u003c/h2\\u003e \\u003cp\\u003eThis 10-year cohort represents one of the largest pediatric series of discoid lateral meniscus reported from India. Compared with Western reports, our children presented at a younger age, with pain rather than snapping as the predominant symptom, and had a higher rate of bilateral involvement. Arthroscopic partial meniscectomy provided excellent functional outcomes in most cases, supporting meniscus-preserving techniques as the treatment of choice in children.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Epidemiology, Clinical Presentation, and Functional Outcomes of Discoid Lateral Meniscus in Indian Children: A 10-Year Single-Centre Cohort Study\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2026-03-24 13:14:25\",\"doi\":\"10.21203/rs.3.rs-9026179/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0},{\"type\":\"decision\",\"content\":\"Revision requested\",\"date\":\"2026-05-13T10:18:28+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2026-04-20T01:35:09+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2026-04-10T20:11:10+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"141007938415929892676661745544223464281\",\"date\":\"2026-04-08T00:39:44+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"90812028871969152144672178814150857735\",\"date\":\"2026-04-07T05:55:40+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"324565290529343681674629414245526992915\",\"date\":\"2026-04-05T09:54:00+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewersInvited\",\"content\":\"\",\"date\":\"2026-03-19T04:42:34+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorAssigned\",\"content\":\"\",\"date\":\"2026-03-10T10:42:34+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"checksComplete\",\"content\":\"\",\"date\":\"2026-03-10T10:41:48+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"submitted\",\"content\":\"Journal of Orthopaedic Surgery and Research\",\"date\":\"2026-03-04T05:47:03+00:00\",\"index\":\"\",\"fulltext\":\"\"}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"journal-of-orthopaedic-surgery-and-research\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"josr\",\"sideBox\":\"Learn more about [Journal of Orthopaedic Surgery and Research](http://josr-online.biomedcentral.com)\",\"snPcode\":\"13018\",\"submissionUrl\":\"https://submission.nature.com/new-submission/13018/3\",\"title\":\"Journal of Orthopaedic Surgery and Research\",\"twitterHandle\":\"@MSKmedBMC\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"BMC/SO AJ\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"099ad368-b72b-406e-93b4-84b0c833da5d\",\"owner\":[],\"postedDate\":\"March 24th, 2026\",\"published\":true,\"recentEditorialEvents\":[{\"type\":\"decision\",\"content\":\"Revision requested\",\"date\":\"2026-05-13T10:18:28+00:00\",\"index\":\"\",\"fulltext\":\"\"}],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"in-revision\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2026-05-13T10:28:20+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2026-03-24 13:14:25\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-9026179\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-9026179\",\"identity\":\"rs-9026179\",\"version\":[\"v1\"]},\"buildId\":\"XKTyCvWXoU3ODBz1xrDgd\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}