Save the meniscus.

摘要

In last month's editorial, we argued that prompt operative intervention reduces long-term osteoar-thritis after knee anterior cruciate ligament tear. While the surgical focus of that editorial was early ACL reconstruction, the obvious subtext was preventing osteoarthritis by preserving the meniscus. One doesn't need to be a detective to read between the lines of the February editorial: Save the meniscus. Patients with nonoperatively treated ACL tears develop meniscal tears, and "meniscectomy is an adverse event."Of course, in the 21st century, when we use the term "meniscectomy," we refer to arthroscopic partial meniscectomy. We have known since the time of Fairbank that total meniscectomy results in knee degenerative arthritis over time. Today, the very idea of total meniscectomy seems barbaric and, as arthroscopic surgeons, a core belief is that by removing only the torn portion of the meniscus while sparing healthy meniscal tissue, using minimally invasive arthroscopic intervention, we preserve knee joint function while minimizing the progression of arthritis.