2024 AANA/ISAKOS Specialty Day All-Access Pass-Case Panel Discussion: Meniscus Tears: Save the Meniscus

Video Transcription

Video Summary

The panel discussion focuses on meniscus tears, emphasizing diagnosis, repair techniques, and rehabilitation strategies. For a collegiate lineman with a radial lateral meniscus tear and valgus malalignment, experts favor meniscus repair, possibly combined with osteotomy, discouraging return to play before healing. Various suture techniques like tie grip and modified Mason-Allen are highlighted for their biomechanical advantages. In ACL injuries, posterior lateral meniscus root avulsions are common yet often missed on MRI, underscoring the importance of intraoperative probing and appropriate tunnel placement. Ramp lesions of the medial meniscus are also frequently overlooked but crucial for rotational stability; routine arthroscopic inspection through the notch is advised. Treatments include all-inside and inside-out suture methods, with pie-crusting used selectively to improve visualization. Discoid menisci with instability need careful arthroscopic assessment, with repairs focusing on stabilizing the root and potentially saucerization. Postoperative rehab protocols vary, but weight-bearing is typically restricted for meniscus root repairs. Overall, proper diagnosis, surgical technique, and rehabilitation are key to preserving meniscal function and knee stability.

Asset Caption

Seth L. Sherman, M.D., Brian R. Waterman, M.D., FAANA, Nicholas A. Sgaglione, M.D., R. Kyle Martin, M.D., F.R.C.S.C., Ryosuke Kuroda, M.D., Ph.D., John G. Lane, M.D., Patrick A. Smith, M.D.

Keywords

meniscus tears

meniscus repair

suture techniques

ACL injuries

ramp lesions

postoperative rehabilitation