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Principles and decision making in meniscal surgery

A P Newman1, A U Daniels, R T Burks

  • 1Division of Orthopedic Surgery, University of Utah School Of Medicine, Salt Lake City 94132.

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|January 1, 1993
PubMed
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The meniscus is crucial for knee function, aiding load transmission and stability. Preserving meniscal tissue is vital, as its removal can lead to degenerative changes, guiding surgical decisions.

Area of Science:

  • Orthopedic Surgery
  • Knee Biomechanics
  • Meniscal Biology

Background:

  • Menisci play key roles in knee function, including load transmission, shock absorption, and joint stability.
  • Historical approaches to meniscal surgery have evolved due to a better understanding of meniscal function and consequences of meniscectomy.
  • Degenerative changes are common after meniscectomy, emphasizing the need for tissue preservation.

Purpose of the Study:

  • To review the basic science and clinical information underpinning a systematic approach to meniscal surgery.
  • To synthesize current knowledge on meniscal structure, biology, and function to guide surgical decision-making.
  • To present an algorithm for managing meniscal lesions based on evidence and principles of tissue conservation.

Main Methods:

Related Experiment Videos

  • Review of laboratory investigations on meniscal function (load transmission, shock absorption, lubrication, stabilization).
  • Analysis of histologic and structural properties of menisci, focusing on collagen fibers and bony attachments.
  • Examination of biologic studies on meniscal healing pathways (intrinsic and extrinsic).
  • Main Results:

    • Menisci are essential for normal knee function, distributing load and providing stability.
    • Meniscal healing is possible through intrinsic cellular activity or extrinsic neovascularization in peripheral injuries.
    • Evidence strongly supports meniscal tissue preservation over resection to prevent degenerative joint disease.

    Conclusions:

    • Meniscal preservation techniques are possible and mandatory for optimal knee health.
    • A thorough understanding of meniscal structure, biology, and function is essential for modern meniscal surgery.
    • An evidence-based algorithm can guide surgeons in making informed decisions for various meniscal lesions.