Journal of Joint Surgery and Research (Dec 2023)
Meniscus repair and centralization: Preserving meniscus function
Abstract
Purpose: Meniscus injury and meniscus extrusion cause meniscus dysfunction, which then leads to the initiation and progression of knee osteoarthritis. Meniscus preservation surgery therefore plays an important role in preventing long-term cartilage degeneration. The purpose of this paper was to review the current information about meniscus preservation surgeries, such as meniscal repair and centralization. Methods: We reviewed recent articles related to meniscus preservation surgery. We compiled sections for some special meniscus pathologies, including ramp lesion, discoid lateral meniscus, degenerative meniscus tear, posterior root tear, and meniscus extrusion. Results: Reoperation rates are higher after meniscal repair compared with arthroscopic partial meniscectomy; however, long-term follow-up studies have demonstrated better clinical outcomes and less severe degenerative changes for meniscal repair than for partial meniscectomy. Therefore, meniscal repair should be considered the first option for any meniscus injury when surgical intervention is necessary. Posterior root tears of the meniscus substantially affect meniscal hoop function and accelerate cartilage degeneration and accompanying meniscus extrusion. Therefore, surgical repair should be considered as early as possible. A centralization procedure has been developed to reduce meniscus extrusion and improve meniscus hoop function. Long-term follow-up should also be considered essential for the prevention of osteoarthritis. Conclusions: Meniscus preservation surgery provides satisfactory clinical outcomes at short- and mid-term follow-up. Further understanding of meniscus pathology and continued development of surgical techniques will improve the outcomes of meniscus preservation surgery. The long-term efficacy of these procedures should also be confirmed to validate this treatment strategy for meniscus dysfunction.
