Orthopedics Today Hawaii

Orthopedics Today Hawaii

Issue: February 2012
February 01, 2012
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Indications for meniscal repair include tear size, location and patient age

Issue: February 2012
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Donald H. Johnson, MD, FRCS(C)
Donald H. Johnson

WAILEA, Hawaii – Choosing which meniscal tears to repair depends on several key patient factors, according to a presenter here at Orthopedics Today Hawaii 2012.

“Even in the best hands, I think 20% can be repaired. The rest you have to resect,” Donald H. Johnson, MD, FRCS(C), Arthroscopy Section Editor for Orthopedics Today, said.

Indications for meniscal repair, he said, include the location/zone of the tear with the more peripheral red-on-red and red-on-white the better, short size of 1 cm to 2.5 cm, vertical tears and acute tears. Patients younger in age -- less than 40 years -- and patient factors, such as an associated ACL tear, are also indications to repair the meniscus.

Some tears can be left alone, Johnson said. These include lateral flap root tears and undisplaced stable medial/lateral meniscal tears. Additionally, short undisplaced stable medial and lateral tears can be treated with synovial abrasion alone. Short stable tears can be treated with trephination. Posterior horn avulsion and vertical tears posterior to the popliteus can be left without repair, he said.

Reference:
  • Johnson DH. Indications: To repair or not repair. Presented at Orthopedics Today Hawaii 2012, Jan. 15-18. Wailea, Hawaii.
  • Disclosure: Johnson receives royalties from Elsevier, Lippincott, WoltersKluwer and is a consultant for Arthrex and Biosyntek.

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