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Evidence-based rationale for treatment of meniscal lesions in athletes

Knee Surgery, Sports Traumatology, Arthroscopy volume 30, pages 1511–1519 (2022)Cite this article

Abstract

Meniscal injuries in elite athletes are a common cause of missed game time and even have the potential to be career shortening. In this patient group, care must be paid not only to the pathology, but also to a player’s contract status, time in the season, specific demands of his/her sport and position on the field, and future consequences. Successful treatment requires the clinician to understand the player’s goals and needs, communicate effectively between all stakeholders, and a have knowledge of the challenges posed by the different types of meniscal tear seen in this population. Paramount is the distinction between injuries to the medial and lateral meniscus. Deficiency of the lateral meniscus, as a result of a tear or a meniscectomy, leads to frequent early problems and inexorably to chondral degeneration thereby affecting an athlete’s ability to perform. Therefore, it is strongly recommended to repair the majority of lateral meniscal tears. Medial meniscal tears pose a more challenging treatment dilemma, as the success of partial meniscectomy in achieving reproducible, early return to play must be balanced against the long-term degenerative consequences. Many meniscal tears are correctly treated non-operatively.

Level of evidence V.

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Authors and Affiliations

  1. Houston Methodist Orthopedics and Sports Medicine, Houston, USA

    Kyle A. Borque

  2. Fortius Clinic, London, UK

    Mary Jones & Andy Williams

  3. Departamento de Ortopedia e Traumatologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil

    Moises Cohen

  4. Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY, USA

    Darren Johnson

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  1. Kyle A. Borque
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KB contributed in the drafting and editing of the paper. AW contributed in the drafting and editing of the paper. MJ contributed in the drafting and editing of the paper. MC contributed in the synthesis of the data and the editing of the paper. DJ contributed in the editing of the paper and drafting the work.

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Correspondence to Andy Williams.

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Dr. Borque, Ms. Jones, Dr. Cohen and Dr. Johnson have nothing to disclose. Mr. Williams reports grants, personal fees and other from Smith and Nephew, personal fees from Arthrex, other from Innovate Orthopaedics, and from Fortius Clinic, outside the submitted work. In addition, Mr.Williams has a patent for 'Quick Start' Interference Screw pending.

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Borque, K.A., Jones, M., Cohen, M. et al. Evidence-based rationale for treatment of meniscal lesions in athletes. Knee Surg Sports Traumatol Arthrosc 30, 1511–1519 (2022). https://doi.org/10.1007/s00167-021-06694-6

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  • DOI: https://doi.org/10.1007/s00167-021-06694-6

Keywords

  • Medial meniscus
  • Lateral meniscus
  • Meniscal tear
  • Meniscal root tear
  • Meniscal repair