REVIEW   

Minerva Ortopedica e Traumatologica 2017 June;68(2):81-90

DOI: 10.23736/S0394-3410.17.03805-X

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

An evidence-based approach to the diagnosis and treatment of meniscal root tears

Evan W. JAMES, Adam M. JOHANNSEN, Mark E. CINQUE, Jorge CHAHLA, Robert F. LAPRADE ✉

Steadman Philippon Research Institute, Vail, CO, USA

The purpose of this review was to summarize recent advances in the diagnosis and treatment of meniscus root tears. Over the past decade, meniscal root tears have become increasingly recognized as a significant source of pain and disability. Meniscal root tears are often caused by chronic degenerative changes or acute trauma to the knee. When left untreated, root tears lead to meniscal extrusion, increased contact pressures and decreased contact areas on the articular cartilage, and rapidly progressive osteoarthritis. Meniscal root repairs may be performed in active individuals with mild to no osteoarthritis. Biomechanical studies have shown that anatomic root repairs result in decreased contact stresses and increased contact areas on the articular cartilage. While multiple root repair techniques have been described, the authors’ preferred technique is a two tunnel transtibial pullout repair that allows for reduction of the root under direct arthroscopic visualization. Short and mid-term outcome studies show improvement in pain and function. Additional studies are needed to investigate the long-term outcomes, particularly with respect to the slowing of the progression of knee osteoarthritis, in patients following meniscal root repair.

KEY WORDS: Menisci, tibial - Ligaments - Osteoarthritis, knee