PDF
ePub
Citation
Print
Abstract
Although total meniscectomy had been performed as a treatment of meniscal tear, many published articles reported progression of the degeneration process and development of the osteoarthritis after meniscectomy. Meniscal repair has been performed increasingly, with the increased knowledge of the biomechanical properties of the meniscus. However, resection of the meniscus is still needed for irreparable tear and should be performed as minimally as possible to maintain the important functions of the meniscus. When substantial meniscal tissue is resected, meniscal allograft transplantation is considered to be a therapeutic option for young active patients to prevent the progress of degenerative change of the cartilage. In this review, indications and outcomes after meniscectomy, meniscal repair, and meniscal transplantation for the treatment of the meniscal injury are discussed.
Figures and Tables
Figure 1
Sagittal magnetic resonance image shows longitudinal tear of the posterior horn of the medial meniscus.
Figure 2
Absorbable sutures are placed vertically to capture the circumferential fibers of the collagen bundle of the meniscus.
Figure 3
Follow-up magnetic resonance image shows complete healing of previous tear site at 6 months after surgery.
References
1. Andersson-Molina H, Karlsson H, Rockborn P. Arthroscopic partial and total meniscectomy: a long-term follow-up study with matched controls. Arthroscopy. 2002. 18:183–189.
2. Hoser C, Fink C, Brown C, Reichkendler M, Hackl W, Bartlett J. Long-term results of arthroscopic partial lateral meniscectomy in knees without associated damage. J Bone Joint Surg Br. 2001. 83:513–516.
3. Arnoczky SP, Warren RF. Microvasculature of the human meniscus. Am J Sports Med. 1982. 10:90–95.
4. Cannon WD Jr, Vittori JM. The incidence of healing in arthroscopic meniscal repairs in anterior cruciate ligament-reconstructed knees versus stable knees. Am J Sports Med. 1992. 20:176–181.
5. Choi NH, Kim TH, Son KM, Victoroff BN. Meniscal repair for radial tears of the midbody of the lateral meniscus. Am J Sports Med. 2010. 38:2472–2476.
6. Choi NH, Son KM, Victoroff BN. Arthroscopic all-inside repair for a tear of posterior root of the medial meniscus: a technical note. Knee Surg Sports Traumatol Arthrosc. 2008. 16:891–893.
7. Kurzweil PR, Tifford CD, Ignacio EM. Unsatisfactory clinical results of meniscal repair using the meniscus arrow. Arthroscopy. 2005. 21:905.
8. Lee GP, Diduch DR. Deteriorating outcomes after meniscal repair using the Meniscus Arrow in knees undergoing concurrent anterior cruciate ligament reconstruction: increased failure rate with long-term follow-up. Am J Sports Med. 2005. 33:1138–1141.
9. Ahn JH, Wang JH, Yoo JC. Arthroscopic all-inside suture repair of medial meniscus lesion in anterior cruciate ligament--deficient knees: results of second-look arthroscopies in 39 cases. Arthroscopy. 2004. 20:936–945.
10. Venkatachalam S, Godsiff SP, Harding ML. Review of the clinical results of arthroscopic meniscal repair. Knee. 2001. 8:129–133.
11. Steenbrugge F, Verdonk R, Verstraete K. Long-term assessment of arthroscopic meniscus repair: a 13-year follow-up study. Knee. 2002. 9:181–187.
12. Garrett JC, Steensen RN. Meniscal transplantation in the human knee: a preliminary report. Arthroscopy. 1991. 7:57–62.
13. Noyes FR, Barber-Westin SD, Butler DL, Wilkins RM. The role of allografts in repair and reconstruction of knee joint ligaments and menisci. Instr Course Lect. 1998. 47:379–396.
14. Rodeo SA. Meniscal allografts--where do we stand? Am J Sports Med. 2001. 29:246–261.
15. Choi NH, Yoo SY, Victoroff BN. Position of the bony bridge of lateral meniscal transplants can aff ect meniscal extrusion. Am J Sports Med. 2011. 39:1955–1959.
16. Milachowski KA, Weismeier K, Erhardt W, Remberger K. Meniscus transplantation--animal experiment study. Sportverletz Sportschaden. 1987. 1:20–24.
17. Carter TR. Meniscal allograft transplantation. Sports Med Arthrosc Rev. 1999. 7:51–62.
18. Ryu RK, Dunbar VWH, Morse GG. Meniscal allograft replacement: a 1-year to 6-year experience. Arthroscopy. 2002. 18:989–994.
19. Goble EM, Kohn D, Verdonk R, Kane SM. Meniscal substitutes--human experience. Scand J Med Sci Sports. 1999. 9:146–157.
20. Verdonk R. Alternative treatments for meniscal injuries. J Bone Joint Surg Br. 1997. 79:866–873.
21. Stollsteimer GT, Shelton WR, Dukes A, Bomboy AL. Meniscal allograft transplantation: a 1- to 5-year follow-up of 22 patients. Arthroscopy. 2000. 16:343–347.
22. Rodeo SA, Seneviratne A, Suzuki K, Felker K, Wickiewicz TL, Warren RF. Histological analysis of human meniscal allografts. A preliminary report. J Bone Joint Surg Am. 2000. 82:1071–1082.
XML Download