Current status of meniscus salvage.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Meniscus tears are common knee injuries, often requiring surgical intervention.
• The healing potential of meniscus tears varies based on tear type, location, and patient factors.
• Current repair techniques aim to restore meniscal function and prevent degenerative joint disease.

Purpose of the Study:

• To evaluate the effectiveness of direct meniscus repair techniques for various tear types.
• To identify optimal surgical strategies based on tear characteristics and meniscal healing potential.
• To outline contraindications and necessary precautions for successful meniscus repair.

Main Methods:

• Direct repair using rasp preparation, suture fixation, and exogenous clot injection for specific tear types.
• Fascia sheath augmentation for chronic tears with peripheral white rims (≥5 mm) and complex tears (flaps, radial splits).
• Structured rehabilitation protocols tailored to tear location and repair method.

Main Results:

• Direct repair is effective for single longitudinal tears with peripheral white rims ≤4 mm.
• Radial split and flap tears of the lateral meniscus posterior horn are amenable to direct repair.
• Fascia sheath technique shows reliability for larger or complex tears.
• Tears in the white zone are more sensitive to early weight-bearing than peripheral tears.

Conclusions:

• Direct meniscus repair, with or without fascia sheath augmentation, offers effective treatment for specific tear patterns.
• Careful patient selection, appropriate surgical technique, and structured rehabilitation are crucial for successful meniscus healing.
• Contraindications include short tears (<10 mm), stable partial tears (<50% height), and shallow radial tears (<3 mm).