Faculty Collaboration Database

Treatment of Knee Meniscus Pathology: Rehabilitation, Surgery, and Orthobiologics. PM R 2019 Mar;11(3):292-308

Date

09/10/2018

Pubmed ID

30195704

DOI

10.1016/j.pmrj.2018.08.384

Scopus ID

2-s2.0-85060488934 (requires institutional sign-in at Scopus site)   50 Citations

Abstract

The meniscal tear treatment paradigm traditionally begins with conservative measures such as physical therapy and referral for operative management for persistent or mechanical symptoms. As a result, the partial meniscectomy is performed more than any other orthopedic procedure in the United States. This treatment paradigm has shifted because recent literature has supported the attempt to preserve or repair the meniscus whenever possible given its importance for the structural integrity of the knee joint and the risk of early osteoarthritis associated after meniscus excision. Choosing an appropriate management strategy depends on multiple factors such as patient demographics and location of the tear. Physical therapy remains a first-line treatment for knee pain secondary to meniscus tear and should be pursued in the setting of acute and chronic knee pain. Furthermore, there is a growing amount of evidence showing that elderly patients with complex meniscus tears in the setting of degenerative arthritis should not undergo arthroscopic surgery. Direct meniscus repair remains an option in ideal patients who are young, healthy, and have tears near the more vascular periphery of the meniscus but it is not suitable for all patients. Use of orthobiologics such as platelet-rich plasma and mesenchymal stem cells have shown promise in augmenting surgical repairs or as standalone treatments, although research for their use in meniscal tear management is limited.

Author List

Chirichella PS, Jow S, Iacono S, Wey HE, Malanga GA

Author

Hannah E. Wey MD Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adipose Tissue
Arthroscopy
Exercise Therapy
Humans
Mesenchymal Stem Cell Transplantation
Orthopedic Procedures
Physical Therapy Modalities
Platelet-Rich Plasma
Tibial Meniscus Injuries