The menisci and articular cartilage: a life-long fascination

Abstract

The menisci and articular cartilage of the knee have a close embryological, anatomical and functional relationship, which explains why often a pathology of one also affects the other. Traumatic meniscus tears should be repaired, when possible, to protect the articular cartilage. Traumatic articular cartilage lesions can be treated with success using biological treatment options such as microfracture or microdrilling, autologous chondrocyte transplantation (ACT), or osteochondral transplantation (OCT) depending on the depth and area of the lesion. Degenerative cartilage and meniscus lesions often occur together, and osteoarthritis is already present or impending. Most degenerative meniscus lesions should be treated first conservatively and, after failed conservative treatment, should undergo arthroscopic partial meniscus resection. Degenerative cartilage lesions should also be treated conservatively initially and then surgically; thereby treating the cartilage defect itself and also maintaining the axis of the leg if necessary. Tears of the meniscus roots are devastating injuries to the knee and should be repaired e.g. by transtibial re-fixation. The clinical role of ‘ramp’ lesions of the meniscus is still under investigation. Cite this article: EFORT Open Rev 2020;5:652-662. DOI: 10.1302/2058-5241.5.200016

Early Low-Grade Knee Osteoarthritis in Sheep (Ovis aries) after 6-Weeks of Total Unilateral Meniscectomy: A Radiographic Evaluation

“…A number of previous studies have confirmed the role of meniscus in load transmission, shock absorption, nutrition, lubrication and stability in the knee joint (Innes et al 2004;Beveridge et al 2011;Veronesi et al 2020). Patients without intact meniscus slowly develop KOA, beginning with articular cartilage fibrillation, cleft formation and narrowing of joint space (Kopf et al 2020). Animal models of meniscectomy have also been shown to have post-traumatic osteoarthritis (OA) confirmed through radiological evaluation (Teeple et al 2013;Lampropoulou-Adamidou et al 2014;Kuyinu et al 2016).…”

Tratamento das lesões condrais no joelho

“…This allows the surgical treatment of any anatomical abnormality placing the patient at risk of recurrent dislocation or increased stress on the patellar facets. 9 10 11 …”

Meniscal repair: The current state and recent advances in augmentation

“…Degenerative tears are often observed with other articular pathologies or are within aging joints that complicate the healing process and reduce the possibility of successful repair 137,138 . Typically treated conservatively first with physical therapy and, as a last resort, with partial meniscectomy, 139‐141 the long‐term prognosis of these injuries is bleak. Additionally, degenerative menisci have likely experienced significant matrix loss and aberrant cellular behavior; thus, to save the meniscus in these case, fortification and stabilization techniques 142,143 may better restore healthy meniscus function when combined with repair.…”