This condition may lead to increased cartilage degeneration, progressive OA and allograft failure, as mentioned in several biomechanical studies [17, 111]. The rubbery wedges of cartilage act like shock absorbers for your knee, providing cushioning for your bones and knee joint. Brignardello-Petersen R, et al. J Am Acad Orthop Surg 23(2):7176, Kwak YH, Lee S, Lee MC, Han HS (2018) Large meniscus extrusion ratio is a poor prognostic factor of conservative treatment for medial meniscus posterior root tear. PubMed Central Current research has directed its focus to meniscotibial ligaments (MTL), which stabilize on the tibial plateau and centralize the meniscus, as an additional potential causative factor for ME. Conservative treatment is recommended for tears associated with the wear and tear of age. Partial meniscectomy involves trimming away the damaged meniscus. Kneecap pain. The knee is the largest and most complex joint in the body, holding together the thigh bone, shin bone, fibula (on the outer side of the shin), and, Torn meniscus is perhaps the most common type of knee injury in which a ligament in the knee becomes lacerated, affecting stability and causing pain, Locked knee refers to an inability to either bend or straighten the knee. In fact, MAT supporters claim that it restores the biomechanical properties of the endogenous meniscus, prevents or slows cartilage damage, especially if the MAT is performed immediately, and improves long-term outcomes [17, 110, 111]. EFORT Open Rev 4(4):115120, Gonzlez-Lucena G, Gelber PE, Pelfort X, Tey M, Monllau JC (2010) Meniscal allograft transplantation without bone blocks: a 5- to 8-year follow-up of 33 patients. In a recent study by Tsujii et al., it was shown that after concurrent ACLR and meniscal repair, the lateral extrusion of the LM was correlated with its healing status. Following surgery, a doctor may advise engaging in 2030 minutes of exercise twothree times per day. Nonoperative treatment is associated with poor clinical outcomes, especially in the presence of a large ME [59], and exacerbation of OA with a higher incidence of subsequent arthroplasty over 5years of follow-up [60]. A true knee lock occurs when something in your knee joint gets stuck and. Knee Surg Sports Traumatol Arthrosc 27(2):361368, Jacob G, An S, Kumar G, Varghese J (2020) Percutaneous arthroscopic assisted knee medial collateral ligament repair. An MRI scan is the method of choice for confirming a suspected diagnosis. However, knowledge regarding the management of ME remains limited. Become a Gold Supporter and see no third-party ads. Moreover, instead of a single value, Miller et al. (2017). An MRI will confirm a suspected diagnosis. On the other hand, the suture-only technique has its own advantages and is therefore chosen by many surgeons [104, 111]. A Meta-analysis Am J Sports Med 46(9):22852290, Smith NA, Parkinson B, Hutchinson CE, Costa ML, Spalding T (2016) Is meniscal allograft transplantation chondroprotective? Here are tips on how to prepare your room and your body for a good nights sleep, and what to do if your knee pain becomes more severe. Lateral wedge insoles have been found to reduce MME and could also supplement a conservative treatment of knee OA, as they could potentially delay the degenerative process [50]. The early results of MAT are encouraging, as pain relief and improved knee function are reported [15,16,17, 62, 104,105,106,107,108,109]. Sudden twisting movements such as pivoting to catch a ball can tear the cartilage. 29(4):295301, Moon HS, Choi CH, Jung M, Lee DY, Hong SP, Kim SH (2020) Early surgical repair of medial meniscus posterior root tear minimizes the progression of meniscal extrusion: 2-year follow-up of clinical and radiographic parameters after arthroscopic transtibial pull-out repair. J Orthop Res Off Publ Orthop Res Soc 24(6):12081217, Wenger A, Englund M, Wirth W, Hudelmaier M, Kwoh K, Eckstein F et al (2012) Relationship of 3D meniscal morphology and position with knee pain in subjects with knee osteoarthritis: a pilot study. We do not endorse non-Cleveland Clinic products or services. Recovery after a meniscectomy takes 36 weeks, and recovery after a meniscus repair takes 36 months. Krych et al. Privacy OrthoInfo from the American Academy of Orthopaedic Surgeons. Two pieces of cartilage sit inside your knee, between your thighbone (femur) and shinbone (tibia). PubMed Central Theres an inner (medial) meniscus and an outer (lateral) meniscus. Another promising surgical approach for reducing the ME is the arthroscopic centralization of the extruded meniscus at the point where the capsule adjacent to the meniscus is repaired at the border of the tibial plateau [98, 101]. This procedure involves inserting a miniature camera and tiny surgical instruments through two or three small incisions in the knee to repair or trim a meniscus tear. statement and Several preoperative and intraoperative factors (Table 3) are associated with the absolute value of allograft extrusion [16, 102, 106, 109, 120]. Eur J Radiol 1(102):115124, Karpinski K, Diermeier T, Willinger L, Imhoff AB, Achtnich A, Petersen W (2019) No dynamic extrusion of the medial meniscus in ultrasound examination in patients with confirmed root tear lesion. With a surgical treatment approach, exercises are necessary for recovery. However, it remains unknown whether it is capable of delaying or modifying OA progression, and further research is warranted [32, 48, 49]. Am J Sports Med 38(8):15421548, Yanagisawa S, Kimura M, Hagiwara K, Ogoshi A (2020) Association between postoperative meniscal extrusion and clinical outcomes of the pullout fixation technique for medial meniscus posterior root tear. However, several studies showed that partial meniscectomy, particularly when the ME was profound [62, 63], failed to prevent the progression of OA, as it creates a meniscus-deficient state, and leads to significant functional impairment with high rates of arthroplasty [24, 60]. Call the offices of Dr. Brett Gilbert at (919) 788-8797 or request an appointment online, and let Dr. Gilbert help you get back to If your injury doesnt improve with RICE, NSAIDs and physical therapy, your healthcare provider may recommend arthroscopic surgery. J Orthop Res 35(8):16251633, Shefelbine SJ, Ma CB, Lee KY, Schrumpf MA, Patel P, Safran MR et al (2006) MRI analysis of in vivo meniscal and tibiofemoral kinematics in ACL-deficient and normal knees. The knee meniscus: Management of traumatic tears and degenerative lesions. For these reasons, certain contraindications have been introduced (Table 2) [102, 103, 105,106,107,108,109]. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. See this post to learn more about how a meniscus functions, As mentioned in my recent post, the majority of posterior horn tears are determined to be degenerative. Being unable to fully bend or straighten your leg. The aim is to strengthen the muscles surrounding the knee, such as the front thigh muscles, known as the quadriceps. A person should make an appointment with a doctor if they experience any of the following: A meniscus injury refers to a tear in one of the menisci within the knee. Often, athletes and people who play sports for fun suffer meniscus tears. This can provide pain relief for 2 to 4 weeks. Arthroscopy 30(11):14241429, Merkely G, Ogura T, Ackermann J, Mestriner AB, Minas T, Gomoll AH (2019) Open meniscal allograft transplantation with transosseous suture fixation of the meniscal body significantly decreases meniscal extrusion rate compared with arthroscopic technique. People who play sports (like tennis, soccer, basketball or football) that involve sudden twisting movements are most likely to tear a meniscus. WebThe outside one-third of the meniscus has a rich blood supply. Orthopaedics, University General Hospital of Alexandroupolis, St. Niarhos 1, Dragana, 68100, Alexandroupolis, Greece, Konstantinos G. Makiev,Ioannis S. Vasios&Paraskevas Georgoulas, Orthopaedics, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece, Konstantinos Tilkeridis,Georgios Drosos&Athanasios Ververidis, You can also search for this author in Most people fully recover from a torn meniscus and can get back to doing their favorite activities without knee pain. Here's what you need to know as well as a chart. Meniscal injury decreases their functional properties, resulting in degeneration of the knee joint [2]. Slowly lower the body, keeping the foot flat. Doctors may use additional clinical tests that assess range of motion in the knee from various positions. This post goes into considerable detail about managing a knee with arthritis and a complex or degenerative meniscus tear. A narrative review with focus on relevance for osteoarthritis research. Moreover, centralization of the allograft can be performed to help stabilize it on the tibial plateau; however, there are not yet sufficient data in the literature to support its benefits. Exercises Initial routine. root tear: typically radial-type tear located at the meniscal root. Surgery is a very effective way to repair a torn meniscus. Today, in general, doctors recommend conservative treatment, not surgery, when meniscus tears result from degeneration. Cite this article. Therefore, they suggested that this type of OA patient, with MME and varus malalignment with a low MPTA, could benefit primarily from an early intervention with high tibial osteotomy (HTO), thus delaying the progression of knee OA. The menisci can be torn or strained by any rotation or twisting motion that puts stress on the knee. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The inner two-thirds of the meniscus have only a limited blood supply, which is why doctors call this the white zone. 2023 Healthline Media LLC. Finally, meniscal allografts often result in extrusion, thus potentially reducing the clinical benefits of transplantation. PubMed Central 2017;25(1):76-84. Slowly raise the extended leg 12 inches from the floor and then slowly lower it back. They may also share some exercises you can do at home. Treatment with glucosamine, chondroitin sulfate and licofelone has been found beneficial in patients with knee OA and ME, as it may lead to alleviation of symptoms and reduce cartilage volume loss over time. Surgical versus conservative interventions for treating meniscal tears of the knee in adults. To address the problems of patients with meniscectomy, efforts are constantly being made to develop techniques that aim at meniscal regeneration or development of meniscal scaffolds. [53], in a retrospective review of 131 patients who had undergone arthroscopic surgery for knee OA and were followed up for 4years, found that in regard to pain relief, arthroscopic surgery was also beneficial in patients with major MME (>3mm). taking pain medications. Most people will need to perform exercises following surgery. If the tear is too big to repair, your surgeon may remove all or part of the meniscus. Diagnosis and management of meniscal injury. Most often, the meniscus tears during a sudden motion in which your knee twists while your foot stays planted on the ground. One way to reduce postoperative ME is by early intervention, specifically within 3months after the MPRT [70,71,72]. Meniscal maceration is a finding sometimes used on MRI imaging to describe the wasting away of the meniscus or cause it to become soft or separated into constituent elements. Treatment for knee meniscus tears may involve: using the rest, ice, compression, and elevation (RICE) method. This is probably why capsulodesis is so effective in minimizing extrusion. Arthrosc Tech 8(9):e941e946, Leafblad ND, Smith PA, Stuart MJ, Krych AJ (2021) Arthroscopic centralization of the extruded medial meniscus. Am J Sports Med 45(8):18641871, Novaretti JV, Astur DC, Cavalcante ELB, Kaleka CC, Amaro JT, Cohen M (2020) Preoperative meniscal extrusion predicts unsatisfactory clinical outcomes and progression of osteoarthritis after isolated partial medial meniscectomy: a 5-year follow-up study. WebDamage to the medial meniscus root, for example by a complete radial tear, destroys the ability of the knee to withstand hoop strain, resulting in contact pressure increases and kinematic alterations. The menisci are crescent-shaped, fibrocartilaginous structures that play a crucial role in the load transition and distribution of the contact forces along the tibiofemoral articulation. People who tear a meniscus often feel like something has popped in their knee at the time of the injury. Nonsurgical treatment may include interventions such as rest, exercises, and medication. The outer one-third of the meniscus has a blood supply, and so doctors refer to this area as the red zone. Acta Med Okayama 70(6):441448, Narazaki S, Furumatsu T, Tanaka T, Fujii M, Miyazawa S, Inoue H et al (2015) Postoperative change in the length and extrusion of the medial meniscus after anterior cruciate ligament reconstruction. During an arthroscopy, a small, lighted, optic tube Nevertheless, there is still controversy in the literature regarding the optimal threshold, as a few studies have proposed a value lower than 3mm [9, 10], whereas other researchers suggest that a cutoff value higher than 3mm is optimal [11,12,13]. Knee 24(6):14081413, Phua JKS, Razak HRBA, Mitra AK (2020) Arthroscopic procedures could delay the need for a subsequent knee arthroplasty in older patients with end-stage osteoarthritis. Therefore, the relative values may be significant [17]. For a simple tear here, doctors may advise a short course of rest and physical therapy to see whether spontaneous healing occurs. When will I be able to get back to full activity? Tsujii et al. Policy. However, its posterior extrusion progressed significantly regardless of the healing status [90]. Tears in this area are typically more likely to heal on their own. Furthermore, at 2-year follow-up, patients experienced significantly less pain, with improved clinical outcomes. Arthrosc Tech 9(10):e1511e1517, Tsujii A, Yonetani Y, Kinugasa K, Matsuo T, Yoneda K, Ohori T et al (2019) Outcomes more than 2 years after meniscal repair for radial/flap tears of the posterior lateral meniscus combined with anterior cruciate ligament reconstruction. Osteophyte removal>2mm at the edge of the lateral tibial plateau can reduce extrusion after lateral MAT [109, 121, 122]. WebMedial compartment osteoarthritis is a type of arthritis in your knee. Older people are likely to have meniscus damage related to degeneration from wear-and-tear. Adv Orthop. Based on these findings, they concluded that the all-inside repair of the radial tear of the LM could help maintain its dynamic behavior, thus reducing the biomechanical stress exerted on the adjacent cartilage [89]. It usually results from twisting your knee suddenly. Meniscal extrusion (ME) is a radiological finding, especially in magnetic resonance imaging (MRI) scans, for which there has been growing interest in recent years. 1. Try to rest your knee for a few days and keep pressure off it. Feel like your knee locks up or might give way underneath you. volume34, Articlenumber:35 (2022) Am J Sports Med 49(3):684692, Ichiba A, Makuya K (2012) Radial displacement of the lateral meniscus before and after anterior cruciate ligament reconstruction. Some clinical studies on its effectiveness exist, but more research is needed. WebOne of the main tests for meniscus tears is the McMurray test. Reference article, Radiopaedia.org (Accessed on 01 May 2023) https://doi.org/10.53347/rID-70702. For example: Surgery may be a meniscus repair or a trimming of the meniscus tissue, which is called a partial meniscectomy. Meniscal tear: Presentation, diagnosis and management. The concurrent ACLR with repair of the menisci has shown good clinical and functional results and less risk of reoperation during the follow-up periods [83, 87]. VA conceived the idea for the study and supervised the whole study process. Koga et al. (2012). The tear frequently occurs while playing sports. MAT is a potential surgical procedure for young, active patients with symptomatic meniscal insufficiency that does not respond to conservative treatment [102, 103]. Your healthcare provider may recommend taking a nonsteroidal anti-inflammatory (NSAID) medicine (such as ibuprofen or aspirin) to relieve pain and reduce swelling. Arthroscopy 32(7):13371345, Kim NK, Bin SI, Kim JM, Lee CR, Kim JH (2017) Meniscal extrusion does not progress during the midterm follow-up period after lateral meniscal transplantation. 60 patients were performed arthroscopic meniscus repairs Those that are caused by an injury are often the ones that can be, A meniscectomy is a procedure that repairs a torn meniscus. Healthline Media does not provide medical advice, diagnosis, or treatment. Meniscus repair involves stitching torn pieces of a meniscus back together. Hart et al. The authors did not receive funding for this study. A hip labral tear is an injury to the labrum, the soft tissue that covers the acetabulum (socket) of the hip. Arthritis (a breakdown of cartilage in the joints) can also lead to a meniscus tear. WebHip Labral Tear. Knee Surg Sports Traumatol Arthrosc. Bhan, K. (2020). Kijima et al. A physical therapist will individualize a persons exercise regimen to prevent further injury. The injury also commonly affects older people and those with arthritis in their knees. Treatment often involves OTC medications, cortisone injections, and physical therapy. Root repair is indicated when varus malalignment is minimal (<5), the cartilage wear is not advanced (Outerbridge grade 12) and it can be performed arthroscopically either with a transtibial pullout technique or with suture anchors, each with its respective advantages and disadvantages [58]. Whilst APM is one of the most commonly performed orthopaedic procedures [], meniscal repair is the treatment of choice for the young athlete with an acute meniscal tear [].Meniscal repair is most commonly performed in younger populations aged under 35 years [10, 2127] and aims to preserve the entire meniscus, without excision.The A tear can result from a trauma, such as twisting the leg, or age-related degeneration of the knee joint. However, further investigation is needed to evaluate the effect of the ACLR on the restoration of the MM function [88]. You can learn more about how we ensure our content is accurate and current by reading our. Usually you will be able to leave the hospital the same day. Mordecai SC, et al. WebACL surgery can be delayed until the child is closer to reaching skeletal maturity; however, this comes with a risk of future meniscus or cartilage injury. Currently, MPRT repair constitutes the treatment of choice, since it restores the hoop tension and the joint kinematics [65], halts the progression of OA and lowers the rate of arthroplasty [66, 67]. On the contrary, traumatic tears usually involve the lateral meniscus after an acute traumatic episode with concomitant ligamentous injury, especially anterior cruciate ligament tear, in younger patients [5]. Improper positioning of the posterior horn causes a similar deviation to the anterior horn. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. A tear in this "red" zone may heal on its own, or can often be repaired with surgery. People whose cartilage wears down (due to age or arthritis) can tear a meniscus from a motion as simple as stepping on an uneven surface. Work up slowly to more intense exercise activity. You may also get imaging tests, such as X-rays or an MRI, to assess the damage. (2018). Degenerative lesions of the knee joint are more commonly present during concurrent ACLR with meniscectomy than with intact or repaired menisci. During this procedure, the surgeon inserts a tiny camera (called an arthroscope) through a small incision into your knee. More serious meniscus tears may not heal on their own. A threshold of 3mm, which was initially introduced, is most commonly used to define a significant ME [8]. occasionally a surgery we refer to as an arthroscopy. Conservative treatment constitutes the first line of therapy in mild or moderate knee OA [46, 47]. Arthrosc Tech 6(2):e269e274, Ahn JH, Kang HW, Yang TY, Lee JY (2016) Multivariate analysis of risk factors of graft extrusion after lateral meniscus allograft transplantation. Recovery time is 6 to 8 weeks with conservative treatment. The primary site of destruction is the soft tissue fibers which couple the deep layers of the ACL to the LM and the LM to the tibial plateau. In addition, when there is ACL rupture and the preoperative extrusion of the LM is 1.1mm, the surgeon should consider the possibility of a complete posterior root tear (PRT) of the LM. Spang RC III, et al. Finally, we provide a proposed treatment algorithm based on the information retrieved from the literature that could help guide clinicians in the management of ME on the aforementioned knee pathologies (Fig. Although there is a need for longer follow-up periods, the currently available data suggest a benefit of concomitant ACLR with the repair of longitudinal, radial, posterior horn and posterior root tears of the menisci, because the combination can even better reduce their shape and extrusion [92, 98,99,100]. (ACLR+LM tear repair) demonstrated that the narrowing was only 0.04mm at 3.4years postoperatively, whereas another study showed widening of 0.1mm at 3.5years postoperatively [85, 90]. The results as to which technique is superior to the others remain controversial. Red-red tears are within the red zone, and red-white tears have central margins that extend into the white zone. These findings suggest that the tension of the graft and the excessive external rotation of the tibia are also factors that can affect the condition of the MM. Correspondence to WebThere are two general forms of treatment for meniscus tears: conservative, or nonsurgical, and surgical. 2b, c) [78,79,80,81,82]. Prepatellar bursitis is a common complaint of people who work on their knees or who engage in activities that risk blows to the knee. An inappropriate tibial tunnel may also cause extrusion of the LM. There are two main types of arthroscopic surgery for a meniscus tear: partial meniscectomy and meniscus repair. Winkler et al. Its best to see a doctor as soon as possible: Untreated meniscus tears can get worse, or pieces of the meniscus can shed into the joint. 3. This thinner cartilage can tear more easily. Meniscal tears: Current understanding, diagnosis, and management. Arthroscopy 32(10):20002008, Chernchujit B, Prasetia R (2018) Arthroscopic direct meniscal extrusion reduction: surgical tips to reduce persistent meniscal extrusion in meniscal root repair. This article outlines two types and their associated symptoms and causes. Orthop J Sports Med 4(8):2325967116663185, Van Der Straeten C, Byttebier P, Eeckhoudt A, Victor J (2016) Meniscal allograft transplantation does not prevent or delay progression of knee osteoarthritis. A torn or strained meniscus is generally treated with rest, ice, over-the-counter anti-inflammatory medicines and physical therapy. We avoid using tertiary references. Therefore, ACL rupture alone cannot cause the posterior extrusion of the MM, and the ACLR alone does not directly cause distinct damage to the MM. Here, find nine gentle exercises that may help strengthen and heal a torn meniscus. J Orthop Res Off Publ Orthop Res Soc 36(7):18941900, Kodama Y, Furumatsu T, Miyazawa S, Fujii M, Tanaka T, Inoue H et al (2017) Location of the tibial tunnel aperture affects extrusion of the lateral meniscus following reconstruction of the anterior cruciate ligament. [77] performed arthroscopic centralization of nine extruded lateral menisci with the use of suture anchors, and ME was significantly reduced in 2years of follow-up. California Privacy Statement, Finally, meniscal allograft extrusion is also associated with subchondral bone marrow lesions and cysts [2, 115]. Over time, the joint can break down. Arthroscopy 31(12):2380-2391.e2, Ren S, Zhang X, You T, Jiang X, Jin D, Zhang W (2018) Clinical and radiologic outcomes after a modified bone plug technique with anatomical meniscal root reinsertion for meniscal allograft transplantation and a minimum 18-month follow-up. Have swelling that doesnt go away with a few days of RICE and taking NSAIDs. This site should be used for informational purposes only. Magnetic resonance imaging (MRI) mid-coronal view of the right knee, where the tibial eminences are most prominent. WebArthroscopic meniscus repairs typically takes about 40 minutes. Lie on Intermediate routine. During this procedure, your doctor will remove the During the meniscus surgery, a small instrument called an arthroscope, which has a camera at its tip, is inserted into your knee. Can I make a meniscus tear worse if I run on it? Some meniscus tears require surgery to heal the meniscus and restore the knees range of motion. Several other techniques of meniscal centralization with suture anchors as well as with transtibial tunnel, with or without prior meniscal release from its capsular attachments, have also been described in technical notes (Fig. Clinical significance and management of meniscal extrusion in different knee pathologies: a comprehensive review of the literature and treatment algorithm. Physical therapy generally leads to a good outcome. Knee Surg Sports Traumatol Arthrosc 19(2):214217, Kim YS, Kang KT, Son J, Kwon OR, Choi YJ, Jo SB et al (2015) Graft extrusion related to the position of allograft in lateral meniscal allograft transplantation: biomechanical comparison between parapatellar and transpatellar approaches using finite element analysis. https://doi.org/10.1186/s43019-022-00163-1, DOI: https://doi.org/10.1186/s43019-022-00163-1. It is often used with chronic degenerative conditions although some authors also propose this term in the setting of a tear (macerated tear) 2.On imaging, it Cookies policy. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. However, efforts to standardize or optimize the treatment for MMPRT are much needed. Eur Radiol 22(1):211220, Lee DW, Jang HW, Lee SR, Park JH, Ha JK, Kim JG (2014) Clinical, radiological, and morphological evaluations of posterior horn tears of the lateral meniscus left in situ during anterior cruciate ligament reconstruction. Clinical significance and management of meniscal extrusion in different knee pathologies: a comprehensive review of the literature and treatment algorithm, https://doi.org/10.1186/s43019-022-00163-1, Anterior cruciate ligament reconstruction (ACLR), https://doi.org/10.1007/s00167-020-06363-0, https://link.springer.com/article/10.1007%2Fs00402-020-03683-1, https://doi.org/10.1186/s43019-019-0019-x, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. PubMed Associations. MNT is the registered trade mark of Healthline Media. Get useful, helpful and relevant health + wellness information, 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.merckmanuals.com/home/injuries-and-poisoning/sprains-and-other-soft-tissue-injuries/knee-sprains-and-related-injuries), (https://www.niams.nih.gov/health-topics/knee-problems#tab-overview), (https://orthoinfo.aaos.org/en/treatment/knee-arthroscopy/), (https://orthoinfo.aaos.org/en/diseases--conditions/meniscus-tears/), (https://www.physio-pedia.com/Meniscal_Repair). A doctor can do physical and imaging tests, such as an X-ray or MRI, to determine what kind of damage you have and discuss possible treatment options with you. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 24(9):29232935, Lee SM, Bin SI, Kim JM, Lee BS, Lee CR, Son DW et al (2019) Long-term outcomes of meniscal allograft transplantation with and without extrusion: mean 12.3-year follow-up study. Therefore, improvements in surgical techniques are necessary [102, 109]. a Meniscotibial ligament repair with three interconnected suture anchors, b centralization with a transtibial tunnel or c with isolated suture anchors (usually with two or three suture anchors). Am J Sports Med 42(2):327335, Shelbourne KD, Roberson TA, Gray T (2011) Long-term evaluation of posterior lateral meniscus root tears left in situ at the time of anterior cruciate ligament reconstruction.
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