This clinical guide provides a special focus on the normal meniscal mechanism, body and function. Meniscal pathology and therapy are depicted in detail, followed by the presentation of long-term experience of meniscal transplantation and a look into the future of meniscal surgery.

During the last few decades, as the management of meniscal trauma has evolved, and knowledge gained on meniscal function, the orthopaedic surgeon has attempted to preserve the meniscus whenever possible. Arthroscopic meniscal repair has become the treatment of choice when the tear is located in the peripheral rim. Partial meniscectomy has become limited to such an extent that the deleterious effect of total meniscectomy is avoided. Meniscal allograft replacement, which has been available for the last two decades, is used when the patient is confronted with a painful total meniscectomy. Future research and experiments may suggest that partial meniscal replacement might be indicated in the presence of a painful knee compartment after failed meniscal repair or partial meniscectomy.

Basic Science

Ontogeny-Phylogeny
Anatomy
Histology-Ultrastructure-Biology
Biomechanics
Synthesis
Meniscal Lesions: Classification
Traumatic Lesions: Stable Knee, ACL Knee
Degenerative Lesions-Meniscal Cyst
Meniscus and Osteoarthritis
Synthesis
Preoperative Clinical Examination and Imaging
Clinical Examination: Standard X-Rays
MRI, MR-arthrography and CT-arthrography
Bone Scan
Synthesis
Technique
Meniscectomy: Medial-Lateral
Meniscal Repair: Biomechanics
Meniscal Repair: Technique
Meniscal Repair: Enhancement of Healing Process
Meniscal Cysts
Rehabilitation
Synthesis
Postoperative Evaluation
Functional and Objective Scores. Quality of Life
Postoperative Imaging: X-Rays, Arthro CT, Arthro MRI
Results
Meniscectomy: Global Results-Complications
Meniscal Repair: Intra- and Postoperative Complications
Meniscal Repair: Results
Indications: Adults
Traumatic Meniscal Lesions in a Stable Knee: Masterly Neglect, Meniscectomy, Repair
Traumatic Lesions, ACL Knee: Masterly Neglect, Meniscectomy, Repair
Degenerative Meniscal Lesions in a Stable Knee
Lavage, Debridement, and Osteoarthritis
Synthesis
Meniscal Lesions in Children
Classification: Discoid Meniscus, Traumatic Lesions
Discoid Meniscus: Histology
Technique of Meniscoplasty and Meniscal Repair in Children
Meniscus Lesions in Children-Indications and Results
Synthesis
Post-meniscectomized Knee
Postoperative Osteonecrosis of the Condyle: Diagnosis and Management
Management of Early and Late Failure of Lateral Meniscus
Synthesis
Meniscal reconstruction- Allograft
Basic Science
Organization: Type of Grafts, Conservation, Regulation
Meniscal Allograft: French Organization
Open Technique
Arthroscopic Technique Without Plugs
Arthroscopic Technique with Bone Plugs
Results and Indications
Meniscal Reconstruction - Substitutes
Menaflex (TM) Collagen Meniscus Implant: Basic Science
Collagen Meniscus Implant: Technique and Results
Actifit, Polyurethane meniscus implant: basic science
Polyurethane Meniscus Implant: Technique
Synthesis
The Future
The Future
Conclusion
General Conclusion.