APEX Foundations in Arthroscopy Basic Lectures-Meniscal Injury: Resection, Repair, and Root Tears

Video Transcription

Video Summary

This comprehensive lecture on meniscus tears covers anatomy, diagnosis, and surgical repair techniques crucial for residency training. The meniscus is vital for knee function—outer meniscal zones are well vascularized, aiding healing, while central zones have limited blood supply, affecting repair decisions. Meniscus tears are common knee injuries; preserving meniscal tissue helps prevent arthritis progression. Proper patient evaluation includes symptom inquiry, physical exam maneuvers, and imaging like detailed X-rays and MRI, where true tears show specific signals extending to meniscus surfaces.<br /><br />Tears are categorized as acute or degenerative, with various shapes (radial, vertical, bucket handle) influencing treatment strategy. Repair success depends on tear location, vascularity (red-red, red-white, white-white zones), tear pattern, and patient factors. Techniques include inside-out (gold standard, requiring assistance), outside-in (for anterior tears), and all-inside repairs—with the latter being quick but costly. Special attention is given to posterior root tears, linked to arthritis, which need aggressive repair via sutured bone tunnels. Proper surgical approach ensures protection of nerves and vessels.<br /><br />The lecture emphasizes tailored treatment based on anatomy and healing potential, cautioning against unnecessary repairs that risk complications. Meniscus preservation remains key, balanced with realistic expectations about healing, repair complexity, and patient outcomes. Hands-on lab practice will solidify these surgical techniques.

Asset Caption

Brian E. Walczak, D.O., Ph.D.

Keywords

meniscus tears

knee anatomy

meniscus repair techniques

vascular zones

diagnosis and imaging

surgical approaches

meniscus preservation