JOSPT Insights Ep 36: Meniscus tears—we don’t know what we don’t know, with Dr James Dreese
May 17, 2021
Orthopedic surgeon Dr. James Dreese discusses how different meniscus tears behave differently, influencing treatment choices. Topics include meniscal root attachments, ACL injuries, meniscectomy vs. repair based on tissue quality, and the importance of collaboration between physical therapists and surgeons for optimal patient outcomes.
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Meniscus Anatomy and Function
- The meniscus dissipates force across the knee joint through radial and circumferential fibers and root attachments.
- Root attachments, particularly posterior ones, play a crucial role in knee stability.
Meniscus Tears and ACL Relationship
- Posterior root tears of the lateral meniscus are commonly associated with ACL tears due to excessive internal tibial rotation.
- Medial meniscus root tears are often seen in older patients with degenerative changes and radial tears.
Meniscus Tear Types and Treatment
- Different meniscus tear types behave differently, require different treatments, and have different prognoses.
- Radial tears, which disrupt circumferential fibers, are particularly detrimental and often require repair rather than meniscectomy.