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The Meniscus

The Meniscus The management of meniscus lesions is an unbelievable story of so-called scient- cally based, controversial treatment, covering a time span of more than 120 years, including: * The time when a locked knee was manipulated in order to reduce a bucket-handle or a fap tear back into place to restore motion. * The time when famous surgeons excised the meniscus in thousands of patients and kept the resected specimens as trophies in large glass jars. * The time of animated discussions on whether either partial meniscectomy, only removing the ruptured parts, should be performed or total meniscectomy, as ad- cated by Smillie, because some meniscus-shaped semilunar tissue regeneration had been shown by Mandic after complete removal. * The time when the next milestone was reached as Trillat introduced intramural resection, which preserved the circular stabilizing fbrous rim with its menis- ligamento-capsular attachments to the tibia and femur, to maintain more rotational knee stability. Prior to these mainstream meniscal resection treatments, pioneering work had been done by Thomas Annandale in 1883 and Moritz Katzenstein in 1908, who sutured the menisci back into place, with the latter achieving a series of good results. In 1921, Eugen Bircher was the frst to perform a diagnostic knee arthroscopy for internal knee derangement, just using a standard Jacobaeus laparoscope! Nowadays, the fundamental importance of the menisci to normal knee function, e.g., motion, load distribution, and rotational stabilization, is scientifcally acknowledged.
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Table of Contents

Basic Science.- Ontogeny-Phylogeny.- Anatomy.- Histology-Ultrastructure-Biology.- Biomechanics.- Synthesis.- Meniscal Lesions: Classification.- Traumatic Lesions: Stable Knee, ACL Knee.- Degenerative Lesions-Meniscal Cyst.- Meniscus and Osteoarthritis.- Synthesis.- Preoperative Clinical Examination and Imaging.- Clinical Examination: Standard X-Rays.- MRI, MR-arthrography and CT-arthrography.- Bone Scan.- Synthesis.- Technique.- Meniscectomy: Medial-Lateral.- Meniscal Repair: Biomechanics.- Meniscal Repair: Technique.- Meniscal Repair: Enhancement of Healing Process.- Meniscal Cysts.- Rehabilitation.- Synthesis.- Postoperative Evaluation.- Functional and Objective Scores. Quality of Life.- Postoperative Imaging: X-Rays, Arthro CT, Arthro MRI.- Results.- Meniscectomy: Global Results-Complications.- Meniscal Repair: Intra- and Postoperative Complications.- Meniscal Repair: Results.- Indications: Adults.- Traumatic Meniscal Lesions in a Stable Knee: Masterly Neglect, Meniscectomy, Repair.- Traumatic Lesions, ACL Knee: Masterly Neglect, Meniscectomy, Repair.- Degenerative Meniscal Lesions in a Stable Knee.- Lavage, Debridement, and Osteoarthritis.- Synthesis.- Meniscal Lesions in Children.- Classification: Discoid Meniscus, Traumatic Lesions.- Discoid Meniscus: Histology.- Technique of Meniscoplasty and Meniscal Repair in Children.- Meniscus Lesions in Children-Indications and Results.- Synthesis.- Post-meniscectomized Knee.- Postoperative Osteonecrosis of the Condyle: Diagnosis and Management.- Management of Early and Late Failure of Lateral Meniscus.- Synthesis.- Meniscal reconstruction- Allograft.- Basic Science.- Organization: Type of Grafts, Conservation, Regulation.- Meniscal Allograft: French Organization.- Open Technique.- Arthroscopic Technique Without Plugs.- Arthroscopic Technique with Bone Plugs.- Results and Indications.- Meniscal Reconstruction - Substitutes.- Menaflex (TM) Collagen Meniscus Implant: Basic Science.- Collagen Meniscus Implant: Technique and Results.- Actifit, Polyurethane meniscus implant: basic science.- Polyurethane Meniscus Implant: Technique.- Synthesis.- The Future.- The Future.- Conclusion.- General Conclusion.


From the reviews: "The editors have done something no one else has done - created one of the most comprehensive treatises on meniscus injuries ever compiled. ... This is a wonderful reference that will be of particular value for non-European surgeons ... . great value to residents and fellows in training as well as researchers performing cutting-edge research on meniscus pathologies. ... should be part of every organizational orthopedic library and will be a welcome read for any orthopedic surgeons who perform meniscal surgery. I strongly recommend it." (Mark R. Hutchinson, Doody's Review Service, September, 2010)

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