Meniscal injuries: A critical review.

Area of Science:

• Orthopedics
• Sports Medicine
• Knee Surgery

Background:

• Menisci, once overlooked, are crucial knee structures now recognized as common sources of pain and disability.
• Medial meniscus injuries are frequent due to its ligament attachment; lateral meniscus tears often occur with ACL injuries.
• Meniscal tears result from sudden knee rotation or, in older adults, degenerative processes.

Purpose of the Study:

• To review the diagnosis and management of knee meniscal injuries.
• To highlight the diagnostic utility of physical examination and Magnetic Resonance Imaging (MRI).
• To discuss current treatment strategies, including non-surgical and surgical options, and their impact on patient outcomes.

Main Methods:

• Diagnosis involves physical examination maneuvers (McMurray, Apley, bounce home), assessment of joint line tenderness, and knee effusion.
• Magnetic Resonance Imaging (MRI) is the gold standard for confirming meniscal tears, detailing type, location, and severity.
• Treatment approaches range from conservative management (swelling reduction, pain control, rehabilitation) to arthroscopic surgery.

Main Results:

• Peripheral, well-vascularized meniscal tears show potential for healing with non-surgical management.
• Rehabilitation programs focus on functional retraining, progressing to sport- or work-specific activities.
• Arthroscopic surgery is common for bucket handle and non-vascularized tears, with meniscal repair favored over partial meniscectomy.

Conclusions:

• Accurate diagnosis through physical exam and MRI is key for effective management of meniscal injuries.
• A combination of appropriate recognition, functional rehabilitation, and timely surgical intervention can restore high function levels.
• Prioritizing meniscal repair over resection helps prevent premature osteoarthritis, improving long-term knee health.