Surgical options for meniscal replacement.

Abstract

As a result of biologic issues and technical limitations, repair of the meniscus is indicated for unstable, peripheral vertical tears; most other types of meniscal tears that are degenerative, significantly traumatized, and/or located in an avascular area of the meniscus are managed with partial meniscectomy. Options to restore the meniscus range from allograft transplantation to the use of synthetic technologies. Recent studies demonstrate good long-term outcomes from meniscal allograft transplantation, although the indications and techniques continue to evolve and the long-term chondroprotective potential has yet to be determined. Several synthetic implants, none of which has US Food and Drug Administration approval, have shown some promise for replacing part or all of the meniscus, including the collagen meniscal implant, hydrogels, and polymer scaffolds.