The management of meniscal pathology: from partial meniscectomy to transplantation

The management of meniscal pathology continues to evolve as researchers gain a better understanding of the role of the meniscus in normal knee kinematics. Evidence now supports retention or transplantation of meniscal tissue to maintain homeostatic knee mechanisms because the removal of meniscal tissue changes the contact stresses and leads to structural and biomechanical changes in the articular cartilage and the subchondral plate that predisposes the knee to the development of degenerative arthritis. Advances in repair techniques, biologic adjuvants, and progressive tissue-engineering strategies are rapidly adding to the surgeon's armamentarium when dealing with meniscal injury and insufficiency. Early clinical data support many of these advanced techniques. It is helpful to explore meniscal function, pathology, and current treatment modalities, with a focus on meniscal repair and transplantation as well as adjuvants to biologic healing and future directions in this field.