Miniscus

Abstract

Symptomatic traumatic or degenerative irreparable meniscal lesions: radial tears larger than one third of the meniscus diameter, longitudinal tears, bucket handle tears or flap tears in the avascular (white- white) zone. Symptomatic discoid meniscus.

Restoration of a stable meniscal contour by removing the most minimal amount of the unstable meniscus.

Discoid meniscus: Arthroscopic re-contouring of the meniscus by removing the central part and eventually fixing the peripheral part to the capsule, if unstable.

• Symptom specific history: triggering event (etiology), symptomatology (pain, locking, limitation of motion, subjective instability), duration of the complaint.

• Symptom specific examination: range of motion (extension or flexion deficit with springy resistance), meniscal signs, exclusion of concomitant instability.

• X-ray of the knee in 3 views (AP, lateral and tangential patella) to exclude osseous lesions and to evaluate the degree of osteoarthritis.

• MRI to assess the meniscal lesion and the other knee intraarticular lesions.

Specific operative risks: residual symptoms, iatrogenic cartilage injury, intra-articular breakage of instruments, resulting instability, symptomatic postoperative bone marrow edema up to osteonecrosis (post meniscectomy syndrome), progression of osteoarthritis

• Supine position

• A thigh tourniquet is applied

Diagnostic arthroscopy is performed via the anterolateral portal. The operative indication is confirmed and possible concomitant lesions are assessed.