Thursday, October 16, 2008

A discussion on adult lateral meniscus.

Lateral meniscus induced antero-posterior translational during knee flexion is 12 mm & it contributes to the congruence of the knee joint. Meniscal lesion does not mean meniscectomy and this is particularly true for the lateral meniscus. Following are some facts from Beaufils P et al’s review:
1. The rate of joint space narrowing after lateral meniscectomy is of 40% at a follow-up of 13 years compared to 28% for the medial meniscus (symposium SFA 1996).
2. Lateral meniscectomy must be as partial as possible. Particularly, a discoid meniscus presenting a complete tear should be treated by a meniscoplasty in order to shape the meniscus in a more anatomic form than a total meniscectomy. Lateral meniscectomy is indicated in complex or horizontal cleavage, symptomatic, on stable knees. Meniscal repair is highly performed when the meniscal tear is associated to a rupture of the ACL (simultaneous reconstruction of the LCA). Postoperative outcome is different of that of a "simple" arthroscopic meniscectomy. The healing process being slow, it suits to protect the suture by a splint in the first month, and with an exclusion of sports with knee torsion during 6 months.
3. Functional results and anatomical results are good in 77% of cases (symposium of the French Society of Arthroscopy 2003) at a follow-up of 55 months.

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