The knee meniscus: management of traumatic tears and degenerative lesions

  • Philippe Beaufils
    Department of Orthopaedics and Traumatology, Centre Hospitalier de Versailles, 78150 Le Chesnay, France
  • Roland Becker
    Department of Orthopaedics and Traumatology, Hospital Brandenburg, Medical School Theodor Fontane, Hochstrasse 26, 14770 Brandburg/Havel, Germany
  • Sebastian Kopf
    Center for Musculoskeletal Surgery, Charité University Medicine, Berlin, Charitéplatz 1, 10117 Berlin, Germany
  • Ollivier Matthieu
    Department of Orthopaedics and Traumatology, Centre Hospitalier de Versailles, 78150 Le Chesnay, and Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, 13000 Marseille, France
  • Nicolas Pujol
    Department of Orthopaedics and Traumatology, Centre Hospitalier de Versailles, 78150 Le Chesnay, France

抄録

<jats:p> Meniscectomy is one of the most popular orthopaedic procedures, but long-term results are not entirely satisfactory and the concept of meniscal preservation has therefore progressed over the years. However, the meniscectomy rate remains too high even though robust scientific publications indicate the value of meniscal repair or non-removal in traumatic tears and non-operative treatment rather than meniscectomy in degenerative meniscal lesions In traumatic tears, the first-line choice is repair or non-removal. Longitudinal vertical tears are a proper indication for repair, especially in the red-white or red-red zones. Success rate is high and cartilage preservation has been proven. Non-removal can be discussed for stable asymptomatic lateral meniscal tears in conjunction with anterior cruciate ligament (ACL) reconstruction. Extended indications are now recommended for some specific conditions: horizontal cleavage tears in young athletes, hidden posterior capsulo-meniscal tears in ACL injuries, radial tears and root tears. Degenerative meniscal lesions are very common findings which can be considered as an early stage of osteoarthritis in middle-aged patients. Recent randomised studies found that arthroscopic partial meniscectomy (APM) has no superiority over non-operative treatment. Thus, non-operative treatment should be the first-line choice and APM should be considered in case of failure: three months has been accepted as a threshold in the ESSKA Meniscus Consensus Project presented in 2016. Earlier indications may be proposed in cases with considerable mechanical symptoms. The main message remains: save the meniscus! </jats:p><jats:p> Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.160056. Originally published online at www.efortopenreviews.org </jats:p>

収録刊行物

被引用文献 (2)*注記

もっと見る

問題の指摘

ページトップへ