AANA Fellowship Education - The Meniscus: From Tear to Transplant-The Meniscus: From Tear to Transplant

Video Transcription

Video Summary

This Arthroscopy Association of North America webinar focuses on meniscus preservation, repair, and transplantation, aiming to supplement arthroscopy fellowship education globally. Faculty experts Denny Stanfield, Jorge Chala, Seth Sherman, and Kevin Bonner discuss meniscal decision-making, complex tear patterns, biologic augmentation, rehabilitation, and transplant techniques.<br /><br />Seth Sherman highlights evolving evidence favoring meniscus repair over meniscectomy, citing better long-term outcomes despite historically higher reoperation rates for repairs. He discusses tear types—vertical longitudinal, horizontal cleavage, complex, and revision tears—encouraging expanded repair indications supported by recent positive healing rates, even in traditionally marginal cases. Rehab protocols are individualized, balancing weight bearing, motion, and biologic enhancements like marrow venting and platelet-rich plasma (PRP). Sherman emphasizes functional return-to-sport assessments and patient education regarding risks and benefits of repair versus resection.<br /><br />Jorge Chala elaborates on special meniscus tears including root, radial, and ramp lesions. He stresses meniscus preservation due to its critical role in knee stability, proprioception, and load transmission, noting meniscectomy's association with increased long-term osteoarthritis and mechanical failure of ACL reconstructions. Root tear repair restores hoop stresses and knee mechanics, preventing joint degeneration. Accurate diagnosis requires vigilance, especially for lateral root tears often missed on MRI. Chala outlines indication criteria, repair techniques (including MCL pie-crusting for access), and rehabilitation emphasizing non-weight bearing to protect repairs.<br /><br />Kevin Bonner reviews meniscus transplantation as a salvage procedure for young patients with symptomatic meniscal deficiency and acceptable cartilage. He compares bone plug versus soft tissue fixation methods, favoring bone plugs for superior biomechanics though both demonstrate clinical success. Transplants can improve pain and function with survivorship up to 20 years but require meticulous surgical technique and patient selection. Return to sport is possible but prolonged, weighing risks and benefits carefully.<br /><br />Interactive case discussions illustrate repair techniques, biologic augmentation, rehabilitation strategies, and decision-making complexities in challenging clinical scenarios. The panel underscores the priority of meniscus preservation whenever feasible to optimize long-term knee health, function, and injury prevention. Overall, the series provides comprehensive guidance on advancing meniscus management in sports medicine and arthroscopy.

Asset Caption

Dr. Denver T. Stanfield | Dr. Jorge Chahla | Dr. Seth L. Sherman | Dr. Kevin F. Bonner

Keywords

meniscus preservation

meniscus repair

meniscus transplantation

arthroscopy fellowship education

meniscal tear patterns

biologic augmentation

rehabilitation protocols

meniscus root tears

meniscus transplant techniques

sports medicine arthroscopy