Meniscal surgery 2002 update: Indications and techniques for resection, repair, regeneration, and replacement

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The meniscus: Basic science and indications for repair

Treatment of meniscal pathology depends on understanding the basic science of the human meniscus. This includes familiarity with its normal anatomy and vascularity when determining the appropriateness of resection versus repair. Only through understanding its normal biomechanical function can we successfully replicate its design through transplantation techniques. We first review the basic science of the normal meniscus, thus laying the foundation for providing clinical decision making in cases

Meniscus transplantation: Indications, technique, and results

In growing recognition of the importance of the meniscus to normal knee function, an emphasis on meniscal preservation has characterized arthroscopic meniscal surgery over the past 2 decades, both through limiting the amount of resection and through meniscus repair. Yet despite such emphasis, preservation is not always possible. Meniscectomy remains the most common orthopaedic procedures performed in the United States today; unfortunately, a number of these include subtotal meniscectomies or

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      In the PCL-deficient knee, the tibial tuberosity will rise from a sagged position. Approximately one third of meniscal injuries are associated with ACL injuries.18 Reported symptoms such as popping, catching, locking, buckling, and/or joint line tenderness are suggestive of meniscal injuries.

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      After the extent of the meniscal tear was evaluated, partial meniscectomy was performed for tears that were not suitable for repair. We did not perform meniscectomy for partial-thickness tears, relatively asymptomatic degenerative tears, horizontal tears less than 7 mm, radial tears less than 5 mm, and stable tears, defined clinically as tears with less than 3 to 5 mm of movement on arthroscopic probing and longitudinal tears less than 1 cm in length.11,12,25 After meniscectomy, we contoured the peripheral rim, leaving a balanced, stable rim of meniscal tissue with a shaver; and we removed the small intra-articular morcellized meniscal fragments.

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