Meniscus or semilunar cartilage is a pair of cartilaginous tissue present in the knee between the thigh and leg bones. Their main function of the menisci is one of load transmission.The menisci also play a role in knee stability. They deepen the socket of the tibia to better conform to the ovoid shape of the femoral condyles; the menisci act as secondary stabilizers in the anterior cruciate ligament-deficient knee. The meniscus also has a role in joint lubrication, which significantly reduces the coefficient of friction in the knee. It has been known that more than 50% of the body’s weight is transmitted through these and loss of all or part of a meniscus increases point loading and results in premature wear of the knee due to altered mechanical forces. The menisci are now recognized to be integral parts of the knee and not the vestigial and dispensable remains of evolution as once thought.Meniscal preservation is therefore advantageous, particularly in the younger age group.
Meniscal tears are a common and important source of knee dysfunction, particularly in younger, active individuals who place significant demand on their knees. Over the last two decades, there has been an improvement in surgical techniques to assess and treat meniscal pathology and have led to a shift towards preservation of the menisci. Meniscal preservation includes leaving small or partial tears, partial menisectomy and meniscus repair techniques. It is crucial to preserve as much functional meniscus as possible. Repair of a torn meniscus restore the loading profiles of the joint and the ability of the meniscus to absorb hoop stress and eliminate joint space narrowing, possibly decreasing the risk of degenerative disease.
Arthroscopically assisted repair has become the accepted treatment of meniscus tears in recent years. Arthroscopy provides easier access to the knee, reduces operating time, and avoids the risks of open surgery. Techniques of arthroscopic repair of the meniscus include inside-out repairs, outside-in repairs, and all-inside repairs.
Dr (Prof) Raju Vaishya represented India in a recently held cadaveric workshop at National University Hospital, Singapore. In this unique workshop, various techniques of meniscal repair were discussed and practiced.