New Repairable Meniscal Lesions

Preserve the meniscus is crucial. This concept of meniscal preservation is typically applicable in case of a traumatic meniscal lesion (occurring in a stable knee or concomitant ACl injury). But a meniscus can be saved in case of more rare lesions. Preserve menisci tends to preserve the knee from early cartilage degereration (osteoarthritis). In this review, we will present the main anatomy of the meniscus, diagnostic tools and some meniscal repair techniques of unusual lesions. Meniscal root tears are close to the tibial attachment of the meniscus onto the tibia. If traumatic and repairable, it can be fixed by transtibial poolout sutures. Radial tears of the meniscus (mainly the lateral meniscus) can be repaired arthroscopically by side-to-side sutures. Posterior capsulomeniscal lesions (mainly medial meniscus) can be found by systematic posteromedial exploration during arthroscopic ACL reconstruction. Arthroscopic suture using a hook can restore a better anterior stabilization of the knee. Horizontal meniscal lesions occuring in a young athlete are not strictly degenerative. It can be repaired by a surgical technique combining arthroscopic debridement and open repair.