Table 1

Treatment options and indications for meniscal injuries

Surgical procedureIndications
Meniscus retention (conservative treatment)
  • Asymptomatic meniscal tears and asymptomatic discoid meniscus.

  • Non-displaced stable peripheral tears measuring 10 mm or less in length that involve the outer 10%–30% of the meniscus (vascular region) and are manually displaceable by less than 3 mm.

  • Small radial tears measuring 3 mm or less.

Meniscus resection (meniscectomy)
  • Chronic tears.

  • Avascular zone involvement (inner third of the meniscus, W-W zone).

  • Complex tears.

  • Symptomatic discoid meniscus tears: saucerisation±meniscus repair.

  • Symptomatic unstable discoid meniscus: saucerisation and meniscus repair.

Meniscus repair
  • Acute tears (better before 8 weeks).

  • Peripheral vascularised zone (middle and outer third of the meniscus, R-R and R-W zones).

  • Non-damaged bucket-handle tears.

  • Stable knee.

  • Better outcomes: acute, young age; peripheral tear; longitudinal vertical tear; lateral meniscus; associated with ACL reconstruction.

  • Inside-out: posterior horn and meniscal body (mid-horn); bucket-handle tears

  • Outside-in: anterior horn and meniscal body (mid-horn).

  • All-inside: posterior horn of lateral meniscus and meniscal body (mid-horn).

Meniscus replacement (meniscal scaffold and meniscal allograft transplantation)
  • Symptomatic meniscal-deficiency knee.

  • Postmeniscectomy syndrome.

  • Neutral alignment.

  • Stable knee.

  • ACL, anterior cruciate ligament; R-R, Red–Red; R-W, Red–White; W-W, White–White.