The most controversial topics on meniscal repair and transplantation, in an intense debate between Dr. Jorge Chahla, from Rush University, Chicago, and Dr. Pablo Gelber, from ICATME-Dexeus and Hospital Sant Pau in Barcelona. The topics both experts discussed about were:
Radial Meniscal Tears: Should They Be Repaired?
Meniscal sutures: Should biology be enhanced?
Meniscal Sutures: Vertical or Horizontal?
Meniscal transplant: with bone block or without bone block?
Meniscal transplant: only in postmeniscectomy syndrome?
In recent years, some meniscal lesions that had been previsouly went unnoticed were described. They were called hidden lesionsof the meniscus. If you do not have a high suspicion and knowledge of these injuries, they can go unnoticed, generating great frustration in the patient and the professional because they can not solve out this injury. This video presents the case of a first division professional soccer player who had meniscal-like pain but the MRI´s report ruled out any injury, and for that reason he was treated conservatively for 3 months, without any improvement. But the patient had a meniscal ramp injury, which is one of the types of hidden lesions of the meniscus.
Meniscal transplantation with the only-suture technique (no bony attachment) is used to replace the medial meniscus of the knee although it is also possible to use it to replace the lateral meniscus. It requires a careful and delicate arthroscopic technique.
Standard meniscal resection is still commonly performed. However it should be used only when the meniscal tissue is not repairable, because the meniscus has an important role the biomechanics of the knee.
Meniscal repair is crucial to maintain the normal functioning of the knee in the short and long term when a meniscus is torn. It requires a great knowledge of the arthroscopic techniques and a correct understanding of the multiple possible lesions.