Saucerization

What is Saucerization?

Saucerization is a surgical procedure performed to treat a discoid (disc-shaped) meniscus in the knee joint which is more prone to injury. The normal meniscus is crescent-shaped cartilage cushioning the ends of the femur (thighbone) and tibia (shinbone) in the knee. There are two menisci in each knee, one on either side. During saucerization, the abnormally thick discoid meniscus is cut and re-shaped into a crescent.

Overview of Discoid Meniscus

A discoid meniscus is a rare congenital condition (occurs at birth) usually involving the outer meniscus. This meniscus is more prone to injury due to its increased thickness, but some people may not experience any problems. Once injured, the meniscus does not heal well as it has a poor blood supply. A discoid meniscus may have poor ligamentous attachments increasing its mobility.  Injuries are more prevalent among the young population especially during sports involving forceful knee twisting. Symptoms of discoid meniscal injuries include knee pain, popping sensation, stiffness, and instability.

Saucerization Procedure

Saucerization is usually performed arthroscopically. The method is found to be adequate to perform both discoid meniscal saucerization and meniscal tear repair. 

Your surgeon uses an arthroscope which contains a miniature camera, a pump, and instruments such as a punch and shaver to carry out the procedure. During saucerization, your surgeon will:

• Make small incisions (portals) over the knee to access the meniscus
• Insert the arthroscope and surgical instruments through the portals 
• Cut and re-shape the discoid meniscus into a crescent with the help of a punch
• Smooth down the discoid meniscal rim with the help of the shaver
• Trim away a torn portion or repair the meniscal tear with stitches
• Stabilize a hypermobile meniscus with stitches 
• Perform a microfracture procedure where an underlying bone is penetrated to release marrow in order to promote healing 
• Close the incision with stitches and apply a dry sterile bandage
• Immobilize the knee with a brace  

Post-surgery Care and Rehabilitation

After saucerization, crutches or a wheelchair is recommended depending on your age. Knee movement is restricted to a certain range for a period of 4-6 weeks. 

Based on the level of healing, your surgeon may prescribe physical therapy to restore strength and mobility in the knee. These exercises typically begin 1-2 weeks after the surgery and continue for about 3-6 months. 

Benefits of Saucerization

Saucerization has the following advantages: 

• Simple, safe and effective approach
• Meniscus preservation and stabilization
• Minimally invasive
• Minimal neurovascular damage
• Reduced injury to knee cartilage
• Faster recovery

Prognosis

Recovery time varies from person to person depending on your age and progress with rehabilitation. Younger patients typically have better results. Recovery usually takes 3 to 6 months with an adequate rehabilitation program.