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Current and future directions for meniscus repair and replacement.
1Stone Foundation for Sports Medicine and Arthritis Research, Stone Clinic, San Francisco, CA 94123, USA.
Clinical Orthopaedics and Related Research
|November 5, 1999
Summary
Meniscus tears often lead to knee arthroscopy, but repair rates remain low. This review explores current practices versus aggressive tissue salvage and replacement strategies for knee meniscus injuries.
Area of Science:
- Orthopedic surgery
- Knee arthroscopy
- Meniscus biomechanics
Background:
- Meniscal tears are a primary reason for knee arthroscopy.
- Shift from complete to partial meniscectomy due to arthroscopic advancements.
- Despite known importance, meniscus repair rates are below 10%.
Purpose of the Study:
- Discuss reasons for the conservative clinical approach to meniscus tears.
- Compare current partial meniscectomy with aggressive tissue salvage/replacement.
- Speculate on future directions for meniscus repair and reconstruction.
Main Methods:
- Literature review and clinical practice analysis.
- Comparison of outcomes between different meniscal surgical strategies.
- Discussion of basic science principles related to meniscus function.
Main Results:
- Partial meniscectomy is common despite evidence supporting complete meniscus function.
- Low rates of meniscus repair (<10%) indicate a gap between science and practice.
- Current approaches often lead to meniscus tissue loss.
Conclusions:
- Clinical practice lags behind basic science regarding meniscus preservation.
- Aggressive strategies for meniscus salvage, repair, and replacement warrant further investigation.
- Future research should focus on improving meniscus repair and reconstruction techniques.