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 challenging meniscus cases and emphasizes “save the meniscus,” especially in young athletes. A 19-year-old wrestler has an isolated lateral complete radial tear; despite pressure to “trim it” for faster return, the group argues radial tears behave like root tears and resection can create functional meniscus deficiency and long-term damage. They recommend repair (often ripstop/hybrid constructs), with return-to-contact sport guided by strength testing and usually delayed to ~6 months; they avoid routine post-op MRI to prevent misleading findings.<br /><br />A chronic displaced medial bucket-handle tear in a 29-year-old is still repaired initially; when it re-tears, meniscectomy becomes necessary, but the panel feels repair was still the right first choice.<br /><br />For a 51-year-old medial root tear with mild varus, they favor root repair even with some chondrosis, though progression may still lead to eventual total knee arthroplasty.<br /><br />A symptomatic lateral meniscus-deficient patient undergoes meniscus allograft; persistent symptoms and valgus progression highlight the importance of alignment correction (e.g., distal femoral osteotomy) alongside meniscal restoration.

Asset Caption

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

Meta Tag

Horizontal Tears 1

Meniscus 1

Radial Tears 1

Root Repairs 1

Vertical Tears 1

Keywords

meniscus preservation

radial meniscus tear repair

bucket-handle meniscus tear

medial meniscus root repair

meniscus allograft transplantation

knee alignment correction osteotomy