The meniscus has several roles that contribute to successful knee function. There is a high prevalence of acute and chronic meniscal injury. Long-term studies have documented the detrimental effects of total meniscectomy. Research has proven that the peripheral meniscus is vascularized and can heal when injured. This has led to the development of techniques for meniscal repair. Here we discuss our indications for meniscal repair. We repair selected acute and chronic longitudinal tears in the vascularized region of the meniscus. We also repair longitudinal tears near the vascular regions with fibrin clot augmentation. Complex, degenerative, and flap tears are not generally selected for repair. We recommend associated anterior cruciate ligament reconstruction when the knee is unstable. Proper patient and tear selection will result in greater success in meniscal repair. Further research is needed to determine whether repaired menisci can prevent the onset and progression of the degenerative knee changes that are common in the postmeniscectomy knee.
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