All-arthroscopic meniscus repair of avascular and biologically at-risk meniscal tears

Meniscal repair strategies have evolved over time from a more invasive open method to less invasive, all-arthroscopic approaches. Novel devices and surgical techniques currently enable the successful arthroscopic placement of biomechanically optimal sutures that provide compression across the tear site with less potential surgical morbidity. Current techniques do not require accessory posteromedial or posterolateral incisions and significantly reduce the incidence of complications and pain associated with more invasive surgery. Along with these improved methods, the indications for meniscal repair are expanding to include tear patterns previously considered biologically at risk for poor healing. More recently, with the addition of biologic augmentation methods, such as the introduction of platelet- rich plasma as well as reported tissue engineering advances, it may be possible to continue to broaden the indications and success of meniscal preservation through repair and replacement.