Meniscus

Meniscal pathology continues to remain one of the more common etiologies for knee symptomatology in athletes and patients of all ages and activity levels. Improved understanding and treatment of meniscal injury, including repair techniques and treatment of symptomatic postmeniscectomy pain, remains a compelling interest to orthopedists and all treating health care professionals. Evolving indications and optimal techniques to carry out effective and clinically successful meniscal repair is broadening the approach to meniscal preservation. Rehabilitation following meniscal surgery remains individualized without consensus and not always evidenced-based. A more scientific approach to postoperative protocols is much needed. When all else fails, potential options for meniscal substitution with novel porous degradable scaffolds or transplantation using allograft tissue is becoming better understood with more accrued outcome data.

This special focus section is compiled to provide a state-of-the-art update on the presentation of meniscal pathology and indications for its treatment and rehabilitation. The authors have succeeded in contributing five comprehensive chapters on meniscal resection, repair, scaffolds, allograft transplantation, and rehabilitation. In the article by Weiss and Johnson, the current indications and effective resection techniques are covered, including description of the natural history of postmeniscectomy symptomatology. Goodwillie, Myers, and Sgaglione provide a concise, up-to-date review of meniscal repair methodologies, including evolving all-arthroscopic technologies as well as inside-out and outside-in techniques. Myers, Sgaglione, and Goodwillie also report on novel approaches to meniscal substitution using biodegradable scaffolds, and review indications and early clinical experience in Europe. Mascarenhas, Yanke, Frank, Butty, and Cole discuss the current state of meniscus allograft transplantation, reviewing preoperative assessment, surgical considerations, and clinical outcomes.

Finally, Cavanaugh summarizes his expert experience and evidenced-based review of current rehabilitation protocols emphasizing clear and well-delineated clinical practice guidelines.

On behalf of the Special Focus authors we wish to thank the JKS editors for this important opportunity to participate in this informative educational publication and for the privilege of sharing the information with our readership.