What is meniscus preservation and why does it matter?

The menisci are now recognised to be integral parts of the knee and not the vestigial and dispensable remains of evolution as once thought.

Because the meniscus was thus thought to be a trivial structure, tears in the meniscus often meant that the surgeon simply cut away the torn part or removed the meniscus altogether. But we now know that the meniscus is a very significant structure within the knee.

meniscus and bones of kneeThe meniscus or semilunar cartilage is a paired structure composed of cartilaginous tissue. It is situated in the knee between the thigh and leg bones. The main function of the menisci (plural) is one of load transmission. The menisci also play a role in knee stability. They deepen the socket of the tibia to better conform to the ovoid shape of the femoral condyles; they act act as secondary stabilisers in the anterior cruciate ligament-deficient knee. The meniscus also has a role in joint lubrication, which significantly reduces the coefficient of friction in the knee.

 

Key Takeaway

More than 50% of the body’s weight is transmitted through the menisci. Loss of all or part of a meniscus increases point loading and results in premature wear of the knee due to altered mechanical forces.​ Meniscal tears are a common and important source of knee dysfunction, particularly in younger, active individuals who place significant demand on their knees.

 

Meniscus Preservation

Over the last two decades, there has been an improvement in surgical techniques to assess and treat meniscal pathology and have led to a shift towards preservation of the menisci.

Meniscal preservation includes leaving small or partial tears, performing partial menisectomy where appropriate, and meniscus repair techniques. It is crucial to preserve as much functional meniscus as possible. Repair of a torn meniscus restore the loading profiles of the joint and the ability of the meniscus to absorb hoop stress and eliminate joint space narrowing, possibly decreasing the risk of degenerative disease.​

 

Author

Dr Raju Vaishya

Knee Surgeon

Dr Raju Vaishya is an orthopaedic surgeon who specialises in total joint replacement and arthroscopic surgery of several joints, and particularly the knee.

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