Meniscus preservation; rationale, repair techniques and results

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Knee Biomechanics

Background:

• Meniscus structure loss significantly alters knee biomechanics, leading to chondral deterioration and osteoarthritis.
• Preserving meniscus function is a primary goal for knee surgeons to prevent long-term joint damage.
• Traditionally, only peripheral longitudinal meniscal tears were considered repairable.

Purpose of the Study:

• To report on advanced meniscus repair techniques for challenging tear configurations.
• To evaluate the feasibility and outcomes of repairing tears previously considered irreparable.
• To advocate for meniscus preservation when clinically indicated, regardless of tear type.

Main Methods:

• Retrospective analysis of 288 meniscus repairs in 265 patients over 12 years.
• Repairs included various tear types, often combined with anterior cruciate ligament reconstruction.
• Techniques involved adequate rim preparation, careful suturing, and delayed rehabilitation protocols.

Main Results:

• Successful repair of radial tears, horn avulsions, double longitudinal tears, and retears.
• A low estimated retear rate of less than 10% was observed.
• Minimal complications (2 infections, 1 neuropraxia) fully resolved with treatment.

Conclusions:

• Complex meniscus tears, not classically indicated for repair, can be successfully treated.
• Meniscus repair should be considered when clinical evidence supports meniscal preservation.
• Advanced repair techniques can restore function and potentially mitigate osteoarthritis progression.