Long Live the MeniscusDoctors are rethinking the treatment of meniscal tears. The meniscus is a horseshoe-shaped piece of cartilage on both sides of the knee joint. It acts as a shock absorber and lubricates the joint. It also helps support the knee and keeps it steady and stable.
In the past, injury to the meniscus usually required surgery to remove it. Today's doctors know how important it is to save the meniscus whenever possible. The decision to treat a meniscal tear is more complicated now. The doctor must look at the patient's anatomy and the injury itself to decide on the best treatment.
Most meniscus tears are one of two types. A healthy meniscus can tear from trauma to the knee. And in older adults, tears in an aging, damaged meniscus can occur from normal forces. In either case, damage to nearby ligaments often occurs along with the meniscal tear. If more than one structure is torn, surgery to repair the damage is more likely to be needed.
The exact method of repair depends on the size, location, and direction of the tear. Most surgery for the meniscus is done on an outpatient basis. The doctor uses an arthroscope to see inside the joint. This slender tool is inserted into the knee joint. There is a tiny TV camera on the end that allows the doctor to see the meniscus and make repairs.
Not all meniscal tears need to be repaired. Some don't cause symptoms or problems and can be left alone. They may even heal on their own. For tears that do need repair, a wide variety of surgical methods may be used. The exact surgery depends on the knee structure and type of tear present.
Patrick E. Greis, MD, et al. Meniscal Injury: I. Basic Science and Evaluation. In Journal of the American Academy of Orthopaedic Surgeons. May/June 2002. Vol. 10. No. 3. Pp. 168-176.
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