APEX Knee Navigating Pearls and Pitfalls-Treatment of the Meniscus (Repairing Vertical Tears, Horizontal Tears, Root Repairs, Radial Tears)

Treatment of the Meniscus (Repairing Vertical Tears, Horizontal Tears, Root Repairs, Radial Tears)

Video Transcription

Video Summary

A panel of sports surgeons discusses meniscus preservation through several cases. A 19-year-old wrestler has a complete radial lateral meniscus tear; despite pressure to “trim it” for quicker return, the group emphasizes repair because radial tears function like root injuries and resection can create functional meniscus deficiency, especially laterally. They cite healing rates roughly 60–80% and recommend cautious return-to-sport based on strength testing and function, typically around six months, avoiding routine postoperative MRI. A chronic displaced medial bucket-handle tear in an orthopedic resident is still repaired initially to protect the joint, though it later re-tears and requires partial meniscectomy. For a 51-year-old with a medial root tear and mild varus, they support root repair even with some chondrosis, but note arthritis may still progress, sometimes leading to total knee arthroplasty. Finally, after subtotal lateral meniscectomy, meniscus allograft transplantation is favored over scaffolds in neutral alignment, but persistent symptoms with valgus may require distal femoral osteotomy and possibly revision transplant.

Asset Caption

Moderator: Nicholas A. Sgaglione, M.D.
Panel: Sanjeev Bhatia, M.D., Justin J. Mitchell, M.D., James Lee Pace, M.D.

Keywords

meniscus preservation

radial lateral meniscus tear repair

bucket-handle meniscus tear

medial meniscus root repair

meniscus allograft transplantation

distal femoral osteotomy