Arthroscopic Saucerization and Anatomic Repair of a Wrisberg Variant Discoid Lateral Meniscus: A Physeal-Sparing Knotless Anchor Technique.

Discoid lateral meniscus (DLM) is a congenital variant of the knee characterized by an abnormally shaped meniscus prone to tearing and instability. When symptomatic, the treatment plan is based on the location and pattern of the tear, as well as the presence of instability. In most cases, posterior horn instability is present, but some meniscotibial or root attachments remain. This technical note describes a comprehensive arthroscopic approach to a Wrisberg variant DLM, with a complete absence of posterior root and lateral capsular attachments. A comprehensive arthroscopic reconstruction using a physeal-sparing, knotless anchor technique is described to recreate the posterior root attachment while avoiding danger to the growth plate that can result from standard transtibial drilling. This anchor-first, retensionable method allowed for precise adjustment of root tension. Meniscal saucerization, all-inside and inside-out peripheral stabilization, and biologic augmentation through microfracture were performed to restore hoop stress transmission and long-term function. This approach highlights a growth plate-conscious than standard DLM repair in a uniquely unstable DLM variant.