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Abstract

The menisci (Fig. 3.1) are two crescent-shaped fibrocartilaginous structures that are found within each knee between the femoral condyles and the tibial plateau. Earlier, they were considered as functionless remnants of a leg muscle [1]. In 1942, Murray [2] stated that “when the knee joint is opened on the anterior aspect and the suspected cartilage appears normal, its removal can be undertaken with confidence if the diagnosis of a posterior tear has been arrived at clinically prior to the operation. A far too common error is shown in the incomplete removal of the injured meniscus.” Currently the menisci are critical to the function of the knee joint and have important roles in providing shock absorption, stability and joint lubrication.

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References

  1. Sutton JB. Ligaments: their nature and morphology. London: M. K. Lewis; 1987.

    Google Scholar 

  2. Mc Murray TP. The semi lunar cartilages. Br J Surg. 1942;29:407–14.

    Article  Google Scholar 

  3. Gardner E, O’Rahilly R. The early development of the knee joint in staged human embryos. J Anat. 1968;102:289–99.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Mc Dermott LJ. Development of the human knee joint. Arch Surg. 1943;46:705.

    Article  Google Scholar 

  5. Whillis J. The development of the synovial joint. J Anat (Lond). 1940;74:277–83.

    CAS  Google Scholar 

  6. Smillie IS. The congenital discoid meniscus. J Bone Joint Surg. 1948;30-B:671.

    Google Scholar 

  7. Nathan PA, Cole SC. Discoid meniscus. A clinical and pathologic study. Clin Orthop Relat Res. 1969;64:107–13.

    CAS  PubMed  Google Scholar 

  8. Young RB. The external semilunar cartilage as a complete disc. In: Cleland J, Macke JY, Young RB, editors. Memoirs and memoranda in anatomy. London: Williams and Norgate; 1889.

    Google Scholar 

  9. Watanabe M, Takeda S, Ikeuchi H. Atlas of arthroscopy. Tokyo: Igaku-Shoin; 1978. p. 88.

    Google Scholar 

  10. Monllau JC, Leon A, Cugat R, Ballester J. The innervation of the human meniscus. Arthroscopy. 1998;14:502–4.

    Article  CAS  PubMed  Google Scholar 

  11. Good CR, Green DW, Griffith MH, Valen AW, Widmann RF, Rodeo SA. Arthroscopic treatment of symptomatic discoid meniscus in children: classification, technique, and results. Arthroscopy. 2007;23:157–63.

    Article  PubMed  Google Scholar 

  12. Clark CR, Ogden JA. Development of the menisci of the human knee joint. J Bone Joint Surg Am. 1983;65:538–47.

    Article  CAS  PubMed  Google Scholar 

  13. Herwig J, Egner E, Buddecke E. Chemical changes of human knee joint menisci in various stages of degeneration. Ann Rheum Dis. 1984;43:635–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Eyre DR, Wu JJ. Collagen of fibrocartilage: a distinctive molecular phenotype in bovine meniscus. FEBS Lett. 1983;158:265–70.

    Article  CAS  PubMed  Google Scholar 

  15. Bullough PG, Munuera L, Murphy J, et al. The strength of the menisci of the knee as it relates to their fine structure. J Bone Joint Surg. 1970;52B:564–7.

    Google Scholar 

  16. Fithian DC, Kelly MA, Mow VC. Material properties and structure function relationships in the menisci. Clin Orthop Relat Res. 1990;252:19–31.

    Google Scholar 

  17. Renstrom P, Johnson RJ. Anatomy and biomechanics of the menisci. Clin Sports Med. 1990;9:523.

    CAS  PubMed  Google Scholar 

  18. Rath E, Richmond JC. The menisci: basic science and advances in treatment. Br J Sports Med. 2000;34(4):252–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Arnoczky SP, Warren RF. Microvasculature of the human meniscus. Am J Sports Med. 1982;10(2):90–5.

    Article  CAS  PubMed  Google Scholar 

  20. King D. The function of the semilunar cartilages. J Bone Joint Surg. 1936;18-B:1069–76.

    Google Scholar 

  21. Fukubayashi T, Kurosawa H. The contact area and pressure distribution patter of the knee. A study of normal and osteoarthritic knee joints. Acta Orthop Scand. 1980;51:871–9.

    Article  CAS  PubMed  Google Scholar 

  22. Walker PS, Erkman MJ. The role of the menisci in force transmission across the knee. Clin Orthop Relat Res. 1975;109:184–92.

    Article  Google Scholar 

  23. Johnson DL, Swenson TM, Livesay MS. Insertion site anatomy of the human menisci: gross, arthroscopic and topographical anatomy as a basis for meniscal transplantation. Arthroscopy. 1995;11:386.

    Article  CAS  PubMed  Google Scholar 

  24. Last RJ. Some anatomical details of the knee joint. J Bone Joint Surg Br. 1948;30:683.

    Google Scholar 

  25. Last RJ. The popliteus muscle and the lateral meniscus. J Bone Joint Surg Br. 1950;32:93.

    Google Scholar 

  26. Dickason JM, Del Pizzo W, Blazina ME. A series of 10 discoid medial menisci. Clin Orthop. 1992;168:75.

    Google Scholar 

  27. Schonholtz GJ, Koenig TM, Prince A. Bilateral discoid medial menisci: a case report and literature review. Arthroscopy. 1993;9:315.

    Article  CAS  PubMed  Google Scholar 

  28. Dickhaut SC, DeLee JC. The discoid lateral meniscus syndrome. J Bone Joint Surg Am. 1982;64:1068.

    Article  CAS  PubMed  Google Scholar 

  29. Ikeuchi H. Arthroscopic treatment of the discoid lateral meniscus: technique and long term results. Clin Orthop. 1983;176:225.

    Google Scholar 

  30. Washington III ER, Root L, Liener UC. Discoid lateral meniscus in children: long term follow up after excision. J Bone Joint Surg Am. 1995;77:1357.

    Article  PubMed  Google Scholar 

  31. Nielse AB, Yde J. Epidemiology of acute knee injuries: a prospective hospital investigation. J Trauma. 1991;31:1644–8.

    Article  Google Scholar 

  32. Hede A, Jensen DB, Blyme P. Epidemiology of meniscal lesions in the knee: 1215 open operations in Copenhagen 1982–84. Acta Orthop Scand. 1990;61:435–7.

    Article  CAS  PubMed  Google Scholar 

  33. Drosos GI, Pozo JL. The causes and mechanisms of meniscal injuries in the sporting and non sporting environment in an unselected population. Knee. 2004;11:143–9.

    Article  CAS  PubMed  Google Scholar 

  34. Poehling GG, Ruch DS, Chabon SJ. The landscape of meniscal injuries. Clin Sports Med. 1990;9:539–49.

    CAS  PubMed  Google Scholar 

  35. Hegedus EJ, Cook C, Hasselblad V. Physical examination tests assessing a torn meniscus in the knee: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2007;37:541–50.

    Article  PubMed  Google Scholar 

  36. Meserve BB, Cleland JA, Boucher TR. A meta analysis examining clinical test utilities of assessing meniscal injury. Clin Rehabil. 2008;22:143–61.

    Article  PubMed  Google Scholar 

  37. Terry GC, Tagert BE, Young MJ. Reliability of the clinical assessment in predicting the cause of internal derangements of the knee. Arthroscopy. 1995;11:568–76.

    Article  CAS  PubMed  Google Scholar 

  38. Fu F. Master techniques in orthopaedic surgery; sports medicine. 3rd ed. Lippincott William Wilkins; Philadelphia, USA. 2010.

    Google Scholar 

  39. Cooper DE, Arnoczky SP, Warren RF. Meniscal repair. Clin Sports Med. 1991;10(3):529–48.

    CAS  PubMed  Google Scholar 

  40. Anderson AF, et al. Interobserver Reliability of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Classification of Meniscal Tears. Am J Sports Med. 2011;39(5):926–32.

    Article  PubMed  Google Scholar 

  41. Guermazi A, et al. Medial posterior meniscal root tears are associated with development or worsening of medial tibiofemoral cartilage damage: the multicenter osteoarthritis study. Radiology. 2013;268(3):814–21.

    Article  PubMed  PubMed Central  Google Scholar 

  42. LaPrade CM, James EW, Cram TR, et al. Meniscal root tears: a classification system based on tear morphology. Am J Sports Med. 2015;43(2):363–9.

    Article  PubMed  Google Scholar 

  43. LaPrade CM, Foad A, Smith SD, et al. Biomechanical consequences of a nonanatomic posterior medial meniscal root repair. Am J Sports Med. 2015;43(4):912–20.

    Article  PubMed  Google Scholar 

  44. Papalia R, Vasta S, Franceschi F, et al. Meniscal root tears: from basic science to ultimate surgery. Br Med Bull. 2013;106:91–115.

    Article  CAS  PubMed  Google Scholar 

  45. Fairbank TJ. Knee joint changes after meniscectomy. J Bone Joint Surg Br. 1948;30:664–70.

    Google Scholar 

  46. Baratz ME, Fu F, Mengato R. Meniscal tears: the effect of meniscectomy and of repair on intraarticulaar contact areas and stress in the human knee: a preliminary report. Am J Sports Med. 1986;14:270–5.

    Article  CAS  PubMed  Google Scholar 

  47. Tapper EM, Hoover NW. Late results after menisectomy. J Bone Joint Surg Am. 1969;51:517–26.

    Article  CAS  PubMed  Google Scholar 

  48. Hsieh HH, Walker PS. Stabilizing mechanisms of the loaded and unloaded knee joint. J Bone Joint Surg Am. 1976;58:87–93.

    Article  CAS  PubMed  Google Scholar 

  49. Levy MI, Torzilli PA, Warren RF. The effect of medial meniscectomy on anterior-posterior motion of the knee. J Bone Joint Surg Am. 1982;64:883–8.

    Article  CAS  PubMed  Google Scholar 

  50. Hollis JM, Pearsall AW, Niciforos PG. Change in meniscal strain with anterior cruciate ligament injury and after reconstruction. Am J Sports Med. 2000;28:700–4.

    Article  CAS  PubMed  Google Scholar 

  51. Insall JN, Scott WN. Surgery of the knee. 4th ed. Churchill Livingstone. Elsevier, Philadelphia, USA. 2006.

    Google Scholar 

  52. McMurray TP. The semilunar cartilages. Br J Surg. 1942;29:407–14.

    Article  Google Scholar 

  53. Fairbanks TJ. Knee joint changes after menisectomy. J Bone Joint Surg Br. 1948;30:664–70.

    Google Scholar 

  54. Kruger-Franke M, Siebert CH, Kugler A, et al. Late results after arthroscopic partial medial meniscectomy. Knee Surg Sports Traumatol Arthrosc. 1999;7:81–4.

    Article  CAS  PubMed  Google Scholar 

  55. Johnson RJ, Kettelkamp DB, Clark W, Leaverton P. Factors affecting late results after menisectomy. J Bone Joint Surg Am. 1974;56:719–29.

    Article  CAS  PubMed  Google Scholar 

  56. Jareguito JW, Elliot JS, Leitner T, et al. The effects of partial lateral menisectomy in an otherwise normal knee: a retrospective review of functional, clinical and radiographic results. Arthroscopy. 1995;11:29–36.

    Article  Google Scholar 

  57. Burks RT, Metcalf MH, Metcalf RW. Fifteen year follow up of arthroscopic partial menisectomy. Arthroscopy. 1997;13:673–9.

    Article  CAS  PubMed  Google Scholar 

  58. Dehaven KE. Decision making factors in the treatment of meniscus lesions. Clin Orthop. 1990;252:49–54.

    Google Scholar 

  59. Newman AP, Daniels AU, Burks RT. Principles and decision making in meniscal surgery. Arthroscopy. 1993;9:33–51.

    Article  CAS  PubMed  Google Scholar 

  60. Barber FA. Meniscus repair: results of an arthroscopic technique. Arthroscopy. 1987;3:25–30.

    Article  CAS  PubMed  Google Scholar 

  61. Jorgensen U, Sonne-Holm S, Lauridsen F, et al. Long term follow up of menisectomy in atheletes. A prospective longitudinal study. J Bone Joint Surg Br. 1987;69(1):80–3.

    CAS  PubMed  Google Scholar 

  62. Horibe S, Shino K, Nakata K, et al. Second look arthroscopy after meniscal repair: a review of 132 menisci repaired by an arthroscopic inside out technique. J Bone Joint Surg Br. 1995;77:245–9.

    CAS  PubMed  Google Scholar 

  63. Rubman MH, Noyes FR, Barber-Westin SD. Arthroscopic repair of meniscal tears that extend into the avascular zone. A review of 198 single and complex tears. Am J Sports Med. 1999;26:87–95.

    Google Scholar 

  64. Ranalletta M, Rossi W, Paterno M, et al. An arthroscopic study in anterior cruciate ligament deficient knees. Arthroscopy. 2007;23(3):275–7.

    Article  PubMed  Google Scholar 

  65. Gill SS, Diduch DR. Outcomes after meniscal repair using the meniscus arrow in knees undergoing concurrent anterior cruciate ligament reconstruction. Arthroscopy. 2002;18:569–77.

    Article  PubMed  Google Scholar 

  66. Lozano J, Ma C, Cannon W. All inside meniscal repair: a systematic review. Clin Orthop Relat Res. 2006;455:134–41.

    Article  Google Scholar 

  67. Beasley L, Armfield RD, West RV, et al. Medial meniscus root tears: an unsolved problem- demographic, radiographic and arthroscopic findings. Pittsburgh Orthop J. 2005;16:155.

    Google Scholar 

  68. Habata T, Uematsu K, Hattori K, et al. Clinical features of the posterior horn tear in the medial meniscus. Arch Orthop Trauma Surg. 2004;124:642–5.

    Article  CAS  PubMed  Google Scholar 

  69. Milachowski KA, Weismeier K, Wirth CJ. Homologous meniscal transplantation. Experimental and clinical results. Int Orthop. 1989;13:1–9.

    Article  CAS  PubMed  Google Scholar 

  70. Aglietti P, Buzzi R, Bassi PB. Arthroscopic partial menisectomy in the anterior cruciate ligament deficient patient. Am J Sports Med. 1988;16:597–602.

    Article  CAS  PubMed  Google Scholar 

  71. Rijk PC. Meniscal allograft transplantation – part I : background, results, graft selection and preservation, and surgical considerations. Arthroscopy. 2004;20:728–43.

    Article  PubMed  Google Scholar 

  72. Siegel MG, Robert CS. Meniscal allografts. Clin Sports Med. 1993;12:59–80.

    CAS  PubMed  Google Scholar 

  73. Brown KL, Cruess RL. Bone and cartilage transplantation in orthopaedic surgery. A review. J Bone Joint Surg Am. 1982;64:270–9.

    Article  CAS  PubMed  Google Scholar 

  74. Jackson DW, Windler GE, Simon TM. Intraarticular reaction associated with the use of freeze-dried, ethylene oxide-sterilized bone-patella tendon-bone allografts in the reconstruction of the anterior cruciate ligament. Am J Sports Med. 1990;18:1–11.

    Article  CAS  PubMed  Google Scholar 

  75. Hamlet W, Liu SH, Yang R. Destruction of a cryopreserved meniscal allograft: a case for acute rejection. Arthroscopy. 1997;13:517–21.

    Article  CAS  PubMed  Google Scholar 

  76. Khoury MA, Goldberg VM, Stevenson S. Demonstration of HLA and ABH antigens in fresh and frozen human menisci by immunohistochemistry. J Orthop Res. 1994;12:751–7.

    Article  CAS  PubMed  Google Scholar 

  77. Bos GD, Goldberg VM, Zika JM, Heiple KG, Powell AE. Immune responses of rats to frozen bone allografts. J Bone Joint Surg Am. 1983;65:239–46.

    Article  CAS  PubMed  Google Scholar 

  78. Stevenson S. The immune response to osteochondral allografts in dogs. J Bone Joint Surg Am. 1987;69:573–82.

    Article  CAS  PubMed  Google Scholar 

  79. Chen MI, Branch TP, Hutton WC. Is it important to secure the horns during lateral meniscal transplantation? A cadaveric study. Arthroscopy. 1996;12:174–81.

    Article  CAS  PubMed  Google Scholar 

  80. Paletta Jr GA, Manning T, Snell E, Parker R, Bergfeld J. The effect of allograft meniscal replacement on intraarticular contact area and pressures in the human knee: a biomechanical study. Am J Sports Med. 1997;25:692–8.

    Article  PubMed  Google Scholar 

  81. Alhalki MM, Howell SM, Hull ML. How three methods for fixing a medial meniscal autograft affect tibial contact mechanics. Am J Sports Med. 1999;27:320–8.

    CAS  PubMed  Google Scholar 

  82. Verdonk R, Kohn D. Harvest and conservation of meniscal allografts. Scand J Med Sci Sports. 1999;9:158–9.

    Article  CAS  PubMed  Google Scholar 

  83. Wilcox TR, Goble EM, Doucette SA. Goble technique of meniscus transplantation. Am J Knee Surg. 1996;9:37–42.

    CAS  PubMed  Google Scholar 

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Correspondence to Ashok Rajgopal MS, Mch(Orth), FRCS .

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Rajgopal, A., Vasdev, A. (2016). Meniscus Surgery. In: Parker, D. (eds) Management of Knee Osteoarthritis in the Younger, Active Patient. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48530-9_3

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