AANA25 Knee Access Pass-GENERAL SESSION: Knee Meniscus (Main Stage)

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Video Summary

The session focused on advancements and current perspectives in meniscus preservation and treatment as of 2025. Dr. Rachel Frank emphasized the critical role of the meniscus in joint preservation, highlighting that meniscal removal leads to adverse outcomes. She advocated for saving the meniscus whenever possible, including repairing root tears even in older patients with some arthritis, as arthroscopic techniques and technology have improved. Both inside-out and all-inside repair techniques remain effective, with no major differences in outcomes, though nuances exist based on tear types and patient activity.<br /><br />Dr. Economopoulos presented data showing that patients with bone marrow edema lesions on preoperative MRI undergoing medial meniscus root repair had worse outcomes, including higher failure and conversion to total knee arthroplasty, indicating preoperative bone marrow edema as a poor prognostic factor.<br /><br />Dr. Richter discussed meniscus ramp lesions—tears at the posterior medial meniscocapsular junction—highlighting their biomechanical importance for knee stability, especially in ACL injuries. Although difficult to detect on MRI, addressing these lesions can improve outcomes.<br /><br />Dr. Brian Cole reviewed meniscus allograft transplantation, stressing appropriate indications such as symptomatic meniscus deficiency with intact cartilage. Early transplantation may be more beneficial, though it remains rare compared to meniscectomies.<br /><br />Dr. Sabrina Strickland presented technical pearls for root repair, advocating for streamlined, minimally invasive approaches, cautious patient selection, and augmentation techniques like microventing to enhance healing.<br /><br />Dr. Aaron Critch introduced meniscus centralization to address extrusion (>3mm), which correlates with poor outcomes and loss of chondroprotection. Centralization combined with root repair can restore meniscal function and improve clinical results.<br /><br />A panel discussion covered repair techniques, with a consensus favoring inside-out repair, especially for medial meniscal bucket-handle tears, and repair of meniscus root tears in appropriate patients. They underlined the importance of individualized patient care over imaging findings alone. While meniscus preservation is ideal, meniscectomy remains a valid option in certain scenarios. Overall, the session underscored evolving technology and techniques aimed at meniscus preservation to maintain joint health and function.

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Keywords

meniscus preservation

meniscus root repair

arthroscopic techniques

bone marrow edema

meniscus ramp lesions

meniscus allograft transplantation

microventing augmentation

meniscus centralization

inside-out repair technique

meniscectomy outcomes