Save the Meniscus: A Case-Based Discussion (AANA25)-Save the Meniscus: A Case-Based Discussion on the Management of Complex Meniscal Pathology

Video Transcription

Video Summary

In a comprehensive presentation on meniscal pathology and repair techniques, experts discussed various aspects of meniscal tears and their management. Dr. Kathy Koiner highlighted the importance of preserving the meniscus due to its vital role in knee function. She emphasized that more meniscus repairs are being performed rather than meniscectomies, noting that advanced repair methods align with current trends. In cases like bucket handle tears, she advocated for a hybrid approach using both all-inside and inside-out repair techniques, depending on the specific tear characteristics.<br /><br />Dr. Adnan Sethna discussed ramp lesions, stressing the high rate of misdiagnosis and the importance of a detailed surgical evaluation to ensure proper repair. The preferred method for ramp lesions involved suture hook techniques, which showed better outcomes compared to all-inside techniques.<br /><br />Looking at root tears, the presentation emphasized the significant biomechanical implications, including loss of hoop stresses leading to arthritis. Root repair is advocated over non-operative management due to better outcomes and reduced arthritis progression. Dr. Brian Cole further discussed meniscal transplantation, emphasizing proper indications and noting that despite the lack of distinct superior techniques, meniscal allografts have shown promising long-term outcomes. He also reviewed the role of biologics in enhancing repair outcomes, suggesting that while PRP and concentrated bone marrow could improve healing rates, routine use needs further validation. The session concluded with an open Q&A, where the panelists addressed various clinical concerns, including post-operative rehabilitation protocols and treatment decisions based on individual patient needs.

Asset Caption

Mary K. Mulcahehy, M.D., FAANA | Adnan Saithna, M.D., FAANA | Katherine J. Coyner, M.D., M.B.A. | John R. Miller, M.D. | Brian J. Cole, M.D., M.B.A., FAANA

Keywords

meniscal pathology

meniscus repair

meniscectomy

bucket handle tears

ramp lesions

suture hook techniques

root tears

biomechanical implications

meniscal transplantation

biologics

post-operative rehabilitation