Current concepts in meniscus pathology and repair

In the intact state, the medial and lateral menisci are important shock absorbers of the knee and contribute to knee stability. Meniscal pathology can lead to pain, mechanical symptoms, and progression of degenerative changes. Meniscal repair provides improved clinical outcomes and limits arthritis progression versus partial meniscus resection. Tears that would previously have been treated with subtotal or total meniscectomy are now being considered for surgical repair as techniques have advanced and new biologic augmentation methods continue to evolve. A thorough understanding of the importance of meniscal preservation and the current surgical techniques is essential for practitioners treating these pathologies. This chapter will describe the diagnosis, surgical indications, techniques, and outcomes of typical meniscus tears, meniscal root injuries, ramp lesions, and discoid menisci. Biologic augmentation and post-operative rehabilitation will also be discussed.