This 2012 narrative review consolidates meniscal basic science from literature spanning 1858-2011. It covers gross anatomy, ultrastructure, vascular and neural anatomy, biomechanics, aging changes, and MRI characteristics. The goal is a single foundational reference for understanding meniscal pathology, repair biology, and surgical decision-making.
The meniscus was described as a functionless embryonic remnant as recently as 1897, and total meniscectomy was standard treatment well into the latter half of the 20th century. Fairbank's 1948 observations of predictable post-meniscectomy arthritis launched the basic science era that this review synthesizes — and the numbers it consolidates are the reason modern orthopedics defaults to repair over resection.
When you see a medial meniscus tear in the setting of ACL deficiency, recognize that the posterior horn is doing the ACL's job. Removing it increases AP tibial translation by up to 58% at 90° flexion. Compounding instability on top of instability. Preserve it, or at minimum factor its loss into your surgical planning and postoperative counseling.
On MRI, resist the urge to chase anterior horn signal changes. A 74% false-positive rate means most of what you see there is not a surgically significant lesion. Correlate with examination and symptoms before taking the patient to the OR.
This 2012 narrative review consolidates meniscal basic science from literature spanning 1858-2011. It covers gross anatomy, ultrastructure, vascular and neural anatomy, biomechanics, aging changes, and MRI characteristics. The goal is a single foundational reference for understanding meniscal pathology, repair biology, and surgical decision-making.
The meniscus was described as a functionless embryonic remnant as recently as 1897, and total meniscectomy was standard treatment well into the latter half of the 20th century. Fairbank's 1948 observations of predictable post-meniscectomy arthritis launched the basic science era that this review synthesizes — and the numbers it consolidates are the reason modern orthopedics defaults to repair over resection.
When you see a medial meniscus tear in the setting of ACL deficiency, recognize that the posterior horn is doing the ACL's job. Removing it increases AP tibial translation by up to 58% at 90° flexion. Compounding instability on top of instability. Preserve it, or at minimum factor its loss into your surgical planning and postoperative counseling.
On MRI, resist the urge to chase anterior horn signal changes. A 74% false-positive rate means most of what you see there is not a surgically significant lesion. Correlate with examination and symptoms before taking the patient to the OR.