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Horizontal Cleavage Meniscus Tears: Biomechanics, Indications, Techniques, and Outcomes
Noah Mallory1,2, Charles Qin1, David Gibbs1,2
1Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Insights
Horizontal cleavage tears (HCTs) are common knee injuries. Repairing HCTs shows promising results, restoring knee function and enabling a return to activity, unlike older partial meniscectomy methods.
Area of Science:
- Orthopaedic Surgery
- Sports Medicine
- Knee Biomechanics
Background:
- Horizontal cleavage tears (HCTs) constitute up to 24% of all meniscus tears.
- Historically treated with partial meniscectomy, this approach has shown adverse biomechanical effects.
- Current evidence suggests HCT repair restores natural knee biomechanics.
Purpose of the Study:
- To review the current understanding and management of horizontal cleavage tears (HCTs).
- To evaluate the efficacy of surgical repair for HCTs compared to historical treatments.
- To discuss indications and early clinical outcomes of HCT repair.
Main Methods:
- Literature review of studies on horizontal cleavage tear management.
- Analysis of biomechanical effects of partial meniscectomy versus HCT repair.
- Evaluation of early clinical findings and functional outcomes following HCT repair.
Main Results:
- HCT repair restores knee biomechanics, contrasting with adverse effects of partial meniscectomy.
- Indications for repair include young, active patients and older patients without significant osteoarthritis.
- Early clinical findings indicate successful meniscus mechanics restoration and good functional outcomes.
Conclusions:
- Surgical repair of horizontal cleavage tears is a viable option with promising early results.
- HCT repair facilitates a high likelihood of return to preinjury activity levels.
- Orthopaedic practitioners should be proficient in managing HCTs, considering repair over meniscectomy.
Abstract:
» Accounting for up to 24% of all meniscus tears, horizontal cleavage tears (HCTs) are a common pathology orthopaedic practitioners should be comfortable managing.» Historically, HCTs were treated with partial meniscectomy; however, recent studies have demonstrated that these procedures have an adverse biomechanical effect, while HCT repairs restore the knee's natural biomechanics.» Indications for the surgical repair of HCTs remain disputed, but surgery is generally considered for young, active patients and older patients without significant concomitant osteoarthritis.» Early clinical findings surrounding HCT repair are promising. They suggest that this treatment adequately restores meniscus mechanics, leads to good knee functional outcomes, and results in a high likelihood of return to preinjury activity levels.
