Meniscal reconstruction. Part I: indications, techniques, and graft considerations

Menisci are specialized structures capable of bearing loads, absorbing shock, stabilizing, and lubricating the knee joint. Increased knowledge of meniscal anatomy and function, as well as studies of chronic anterior cruciate ligament-deficient and -reconstructed knees, have indicated that loss of meniscal function is associated with progression of degenerative changes within the knee. Meniscal reconstruction has been developed to preserve those functions prior to the development of significant degenerative changes in patients who have undergone meniscectomy. Indications are still being defined. Meniscal reconstruction has been achieved by either arthroscopically assisted or open techniques. Anatomic placement and secure fixation of the graft are requirements to allow the optimal revascularization needed for successful incorporation of the graft. Part I of this review will discuss the anatomy and function of the meniscus, followed by the indications, techniques, and graft considerations for meniscal allograft reconstruction. In Part II, which will be published in the May 1999 issue, we will review the results, potential complications, and future directions of meniscal allograft reconstruction.