This 1980 narrative review by O'Donoghue lays out how to diagnose and surgically manage meniscal injury. It emphasizes clinical history and physical exam over imaging. It reflects the pre-arthroscopic era standard of open total meniscectomy.
Read this paper as a historical snapshot, not a treatment guide. It captures the pre-arthroscopic mindset where total meniscectomy by open arthrotomy was standard and repair was viewed with skepticism.
The anatomy it teaches is still board-relevant: the medial meniscus is firmly anchored and tears with medial sprains, while the lateral meniscus is more mobile because of its looser attachment and the popliteal hiatus.
The author's own observation that a load-bearing meniscus wears out and drives osteoarthritic joint-space narrowing is exactly the reasoning that later overturned his surgical preference. Modern practice does the opposite of what he recommends: we preserve and repair meniscal tissue whenever possible because total meniscectomy accelerates arthritis.
The durable clinical pearls are the exam points: joint-line tenderness localizes the tear, and absence of locking does not rule out a meniscal injury.
This 1980 narrative review by O'Donoghue lays out how to diagnose and surgically manage meniscal injury. It emphasizes clinical history and physical exam over imaging. It reflects the pre-arthroscopic era standard of open total meniscectomy.
Read this paper as a historical snapshot, not a treatment guide. It captures the pre-arthroscopic mindset where total meniscectomy by open arthrotomy was standard and repair was viewed with skepticism.
The anatomy it teaches is still board-relevant: the medial meniscus is firmly anchored and tears with medial sprains, while the lateral meniscus is more mobile because of its looser attachment and the popliteal hiatus.
The author's own observation that a load-bearing meniscus wears out and drives osteoarthritic joint-space narrowing is exactly the reasoning that later overturned his surgical preference. Modern practice does the opposite of what he recommends: we preserve and repair meniscal tissue whenever possible because total meniscectomy accelerates arthritis.
The durable clinical pearls are the exam points: joint-line tenderness localizes the tear, and absence of locking does not rule out a meniscal injury.