{"id":6409,"date":"2020-02-01T09:45:11","date_gmt":"2020-02-01T08:45:11","guid":{"rendered":"https:\/\/federicogiardina.com\/2020\/02\/01\/meniscal-suture-an-alternative-to-meniscectomy\/"},"modified":"2025-10-06T17:29:41","modified_gmt":"2025-10-06T15:29:41","slug":"meniscal-suture-an-alternative-to-meniscectomy","status":"publish","type":"post","link":"https:\/\/federicogiardina.com\/en\/2020\/02\/01\/meniscal-suture-an-alternative-to-meniscectomy\/","title":{"rendered":"Meniscal Suture: an alternative to Meniscectomy?"},"content":{"rendered":"\n

Before understanding whether or not meniscectomy<\/strong> surgery is advisable, it is necessary to understand what the functions of the meniscus are. <\/p>\n\n

The meniscus of the knee joint: what is it for?<\/h2>\n\n

The meniscus<\/strong> is a fibro-cartilaginous pad present between the bony heads of joints; a typical example is the meniscus of the knee<\/strong> joint.<\/p>\n\n

Its main function is to cushion forces in the<\/strong> knee joint<\/strong> by decreasing the pressure on the cartilage. Other functions involve joint lubrication, proprioception (set of functions deputed to control position movement) and knee stability. <\/p>\n\n

\"Anatomy<\/figure><\/div>\n\n

With this in mind, we can already begin to understand how meniscectomy, previously performed very lightly in cases of MENISCUS TEAR<\/a><\/strong>, should, instead, be thought through very carefully<\/strong>, not only by the surgeon performing it, but also by the patient undergoing it.<\/p>\n\n

Arthroscopic meniscectomy: what it’s all about<\/h2>\n\n

Meniscectomy is a surgical procedure that involves the removal of part of the meniscus<\/strong> and is performed arthroscopically. The surgeon accesses the joint through two very small incisions (portals) in the anterior region of the knee, on either side of the patellar tendon. <\/p>\n\n

\"Knee<\/figure><\/div>\n\n

Through these two portals, a camera is introduced into the inside of the knee, allowing the tools used to remove the portion of the meniscus with the lesion (selective meniscectomy<\/strong>) to be seen.<\/p>\n\n

Arthroscopic selective meniscectomy: what happens after surgery<\/h3>\n\n

Arthroscopic selective meniscectomy<\/strong> is the most performed surgery by all orthopedists worldwide and remains, to date, one of the most successful operations in the short term; for the patient, it means being able to return to regular activities, including sports, within a couple of weeks.<\/p>\n\n

Studying those who underwent this surgery 15 or 20 years ago, however, we learned that cartilage, after meniscus removal, tends to wear out faster, leading to ARTROSIS<\/a><\/strong> and subsequent KNEE PROTESIS.<\/a><\/strong><\/p>\n\n

This deterioration is more likely to occur if you have an unstable knee due to a previous anterior cruciate ligament (ACL) injury, if the meniscus removed is the lateral rather than the medial, but most importantly, if the amount removed is more than 50%.<\/p>\n\n

\"Meniscectomy\"<\/figure><\/div>\n\n

If the amount of meniscus removed is large and, more importantly, if its “root” (the posterior horn) is no longer present inside the knee, cartilage wear will progress faster<\/strong>.<\/p>\n\n

The meniscal suture: some clarity<\/h2>\n\n

It was once thought that the meniscus was an anatomical structure with no healing ability. Therefore, when an injury occurred, the movable part had to be removed. Today, however, we know that the meniscus has blood vessels in its outermost portion, thanks to which it therefore has the ability to repair. <\/p>\n\n

\"\"<\/figure><\/div>\n\n

Therefore, if the injury is peripheral, that is, the area characterized by the presence of blood vessels (called the“red zone<\/strong>,” precisely), we know that if we stabilize it with an arthroscopic suture, they will most likely heal.<\/p>\n\n

\"Vascular<\/figure><\/div>\n\n

Today the imperative is to try, always, to maintain the native meniscus, even in case of rupture. Therefore, within arthroscopy, if the type of injury and the mechanical characteristics of the meniscus allow it (“red zone” or “white-red” zone), a Meniscal Suture <\/strong>will be performed rather than its removal. <\/p>\n\n

<\/figure><\/div>\n\n

Meniscal suturing allows<\/strong> us not to lose the biological functions of the knee<\/strong>; however, it presents us with two challenges: <\/p>\n\n