The evaluation and management of meniscus tears continues to be an evolving and dynamic segment of the sports medicine world. The goal of this issue of Clinics in Sports Medicine is to keep the interested practitioner up to date on the latest procedures and technologies involving the repair of meniscus tears. This issue is written by a distinguished group of Sports Medicine specialists with expertise in various aspects of meniscus repair. The first article reviews indications for meniscus repair and the importance of meniscal preservation. The tried and true classic techniques of inside-out and outside-in suturing are updated while offering several surgical pearls. Meniscus Fixators continue to evolve and the latest generation of devices is discussed. The next few articles concern particular meniscus tear patterns that were previously routinely treated with meniscectomy, but recently the trend has been to repair. This includes tears in the posterior root as well as tears in the avascular region. Biologic enhancement of the repair site is allowing the usual indications for what is considered to be a repairable tear to be stretched. Posterior horn tears are covered in a separate article demonstrating an all-inside suture repair without fixators. The repair of the posterior root is similar to anchoring a soft-tissue meniscal allograft posteriorly. Speaking of allografts, this issue does not cover allografts, as that is a topic for a completely separate edition. Allografts generally require the complete removal of any remaining meniscal tissue prior to its replacement. Rather than sacrificing normal tissue, a new technology is currently being used by our European colleagues in which a scaffold is sutured into the meniscal defect to replace just the lost portion. This procedure is more equivalent to repairing a bucket handle tear rather than the larger operation required for an allograft. An article is devoted to this new technology and includes a discussion of the 2-year follow-up data. Although these meniscal scaffolds are not currently approved by the FDA, new trials are imminently forthcoming. Meniscus tears in children also present a special circumstance as the knees can be smaller than adults. In addition, children have more years of heavy use of their knees ahead of them, all making the need for repair more vital. Hence, a separate article is devoted to this situation. Once meniscus repairs are complete, patients need to be guided back as they progressively increase their activity in preparation for returning to sports. Most current guidelines are based on assumptions regarding weight-bearing, strengthening, and presumed milestones. This issue will hopefully change many preconceptions and provoke changes in your current postoperative aftercare. Content: Meniscal Repair. Mark D. Miller xi Preface. Peter R. Kurzweil xiii-xiv Indications for Meniscus Repair. Travis G. Maak, Peter D. Fabricant, Thomas L. Wickiewicz 1-14 Meniscal Repair Using the Inside-Out Suture Technique. Don Johnson, William M. Weiss 15-31 Meniscal Repair—Outside-In Repair. Timothy R. Vinyard, Brian R. Wolf 33-48 Meniscal Repair with the Newest Fixators—Which are Best? Eric D. Bava, F. Alan Barber 49-63 Management of Meniscus Tears that Extend into the Avascular Region. Frank R. Noyes, Sue D. Barber-Westin 65-90 Biologic Enhancement of Meniscus Repair. Laura E. Scordino, Thomas M. DeBerardino 91-100 Meniscus Root Avulsion.John M. Marzo 101-111 Posterior Horn Tears—All-Inside Suture Repair. Jin Hwan Ahn, Jae Chul Yoo, Sang Hak Lee 113-134 Meniscus Repair in Children. Cordelia W. Carter, Mininder S. Kocher 135-154 Return to Sport After Meniscal Repair. Anthony M. Barcia, Erick J. Kozlowski, John M. Tokish 155-166 Partial Meniscus Substitution with Tissue-Engineered Scaffold: An Overview Georgios Mouzopoulos, Rainer Siebold 167-181 Index 183-186
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