[Reattachment of the meniscus. Techniques, long-term results and recommendation for individual treatment]

To prevent the joint degeneration which commonly occurs after meniscectomy, meniscal repair has become the treatment of choice. With more advanced arthroscopic techniques, including application of fibrin clot and synovial flaps, almost all types of meniscal ruptures are technically accessible and have been found to heal. However, from a biomechanical point of view only a meniscus with a peripheral longitudinal rupture functions as a normal meniscus after repair and, therefore, minimizes cartilage degeneration; this statement was confirmed by long-term follow-up evaluations. In this respect, the biomechanical value of healed intra-substance ruptures is more doubtful; long-term follow-up evaluations are not yet available. The different arthroscopic repair techniques seem to be safe if used properly and are followed by healing rates similar to after open techniques. No technique has been shown to be superior to another, but they are sometimes more effective if combined.