The function, pathology, and surgery of the meniscus

Abstract

The menisci are vital for normal function of the knee joint and appear to protect the articular surfaces. Meniscal tears are very common, although often they may be asymptomatic. The diagnosis of tears on clinical grounds alone is unreliable, but the advent of arthrography and arthroscopy has made assessment much more accurate. Care should be taken in the ascription of symptoms to minor tears so discovered. The traditional view that meniscal tears cause osteoarthritis is hard to substantiate, and torn menisci may coexist with articular cartilage in excellent condition, whereas grossly degenerate joints may contain amazingly normal menisci. Total meniscectomy is followed by abnormal stress transfer across the joint, and ultimately degenerative changes frequently occur. Partial meniscectomy will relieve mechanical symptoms while preserving a rim capable of some function. Arthroscopic meniscectomy gives excellent results rapidly and is very efficient for both the patient and the surgeon.