meniscal injury

Question 1

Indications for meniscal repair:

Answer 1

• Tear >1cm and <4cm in length
• Red-red zone tears (MOST IMPORTANT INTRINSIC FACTOR IN HEALING)
  
  • Tears w/I 2mm of meniscal vascular rim have highest rates of healing following repair
• Vertical/longitudinal tears
  
  • Radial tears generally not repairable – managed with partial meniscetomy as in avascular zone
  • Horizontal tears often not repaired – difficult as parallel to plane of knee joint, also frequently degenerative
• Patient age >40 years
• No mechanical axis malalignment
• Acute tears (ie <6/52)
• Concurrent ACL reconstruction
• Repair technique – GOLD STANDARD is still inside-out suture technique for meniscal repair