AANA24 Knee All-Access Pass-GENERAL SCIENTIFIC SESSION: Knee Joint Preservation (Main Stage)

Video Transcription

Video Summary

The session focused on knee joint preservation, encompassing surgical techniques and debates around meniscus repair, cartilage lesions, and biologic treatments. Dr. Henry Burke emphasized the importance of repairing meniscus ramp lesions during ACL reconstruction to improve stability and healing, describing all-inside suture techniques and the necessity of addressing both superior and inferior parts of the tear for optimal outcomes. Dr. Mary Mulcahy discussed management of bucket handle meniscus tears, comparing inside-out versus all-inside repair; both yield similar clinical outcomes, with all-inside techniques offering shorter operative times but higher implant costs.<br /><br />Dr. Lutul Farrow reviewed horizontal cleavage tears, supporting partial meniscectomy of the inferior leaf to preserve tissue and reduce pain, especially in older patients, while noting repair is safe and possibly preferable in younger patients. Dr. David Flanagan championed repair of lateral posterior radial meniscus tears, highlighting the biomechanical deleterious effects of such tears and superior outcomes of repair over meniscectomy.<br /><br />In contrast, Simon Gertz argued for prudence, cautioning that repair is not always warranted and emphasizing individualized treatment decisions. Dr. Brian Cole shared insights on cartilage repair decision-making, endorsing a nuanced, patient-specific approach. Burt Mandelbaum highlighted the critical impact of bone marrow lesions on cartilage health and joint preservation strategies including core decompression and biologics.<br /><br />Dr. Don Buford reviewed biologic injections for cartilage lesions, noting no currently proven therapies regenerate hyaline cartilage but some, like PRP and bone marrow concentrate, can reduce symptoms and slow progression. A debate between Dr. Jaishan Dragoo advocating treatment of incidental chondral lesions during ACL reconstruction and Dr. Armando Vidal advocating observation underscored controversy in managing these lesions.<br /><br />Finally, Dr. Aaron Kritsch showcased meniscus root repair with centralization techniques to reduce extrusion and improve outcomes. Overall, the session emphasized the evolving evidence supporting meniscus preservation, tailored cartilage treatments, and cautious use of biologics for joint preservation.

Asset Caption

Introduction by Moderators: Lutul D. Farrow, M.D., Elizabeth G. Matzkin, M.D.

Keywords

knee joint preservation

meniscus repair

ACL reconstruction

cartilage lesions

biologic treatments

meniscus ramp lesions

bucket handle meniscus tears

horizontal cleavage tears

bone marrow lesions

meniscus root repair