Function, post-traumatic sequelae and current concepts of management of knee meniscus injuries: a review article.

Long thought to be expendable or insignificant for function, the menisci may well be very important structures in the knee joint. Menisci are of critical importance from the standpoint of stability, shock absorption, load transmission, and lubrication, and also play a role in preventing synovial impingement, and in defining the endpoints of flexion and extension. In the wake of meniscectomy, certain predictable time-related events afflict the joint, i.e., instability and degenerative arthrosis. These eventualities are less pronounced following partial resection, and lend credence and support to the concept of subtotal meniscectomy. Meniscal surgery has taken on new dimensions with the advent of arthroscopy, which permits initial sparing and continued observation of meniscal lesions of questionable significance, as well as low morbidity partial resection in trained hands. The efficacy of meniscoplasty vis-à-vis suturing of peripheral tears is noteworthy. Present evidence suggests that traditional meniscectomy is best reserved for those lesions which do not lend themselves to partial resection, and should be combined with advancement of the corresponding capsuloligamentous complex and perhaps in some cases, even by dynamic tendon transfers.