Meniscus Tear: Pathology, Incidence, and Management

Abstract

Meniscus tears are a common orthopedic pathology and planning a single, effective treatment is challenging. The diagnosis of meniscal tears requires detailed history-taking, physical examinations, special diagnostic tests, and most likely magnetic resonance imaging (MRI) to confirm the lesion. A good understanding of the meniscal structure including vascularity, zones, function, and affected movements with associated symptoms plays a crucial role in establishing an optimal management plan. A careful assessment of the patient's characteristics, comorbidities, post-repair rehabilitation, and patient's overall function and satisfaction are also important for ideal management. While conservative management is commonly implemented and the only option for certain patients, partial meniscectomy remains to be the most performed treatment procedure. However, partial meniscectomy is no longer the first-line therapy due to the limitation of certain patient characteristics and side effects in the long run. Instead, meniscal repair has been shown to have better long-term outcomes and is therefore recommended for all tears, especially for young patients with acute traumatic lesions. Tissue engineering has been of high interest in the current research with promising therapeutic results. This review critically evaluates and compares the management of meniscal tears with surgical versus comprehensive management using the current literature.

Keywords: arthroscopy; degenerative; meniscectomy; meniscus tear; repair; trauma.

Figure 1. Menisci anatomy viewed in situ on the tibia

Note. Image from Bryceland JK et al. (2017) [6]

Figure 2. Different types of meniscus tears

Note. Image from Karia M et al. (2019) [1]

Figure 3. Sagittal MRI of posterior horn medial meniscus horizontal tear

Note. Image from Bhan K (2020) [2] MRI: magnetic resonance imaging