Approach to meniscal tears in anterior cruciate ligament reconstruction

The important functions of the meniscus are well-established and provide the rationale for meniscus repair. Because the best healing rates for mensical repair occur in knees undergoing concomitant ACL reconstruction, aggressive attempts at meniscus repair should be considered during ACL reconstruction, in particular in young patients. Similar results have been documented using the outside-in, inside-out, and all inside techniques. Medial meniscus repair should be considered because it is established that absence of the medial meniscus results in higher forces in the ACL graft. Meniscus transplantation is considered in the setting of meniscus deficiency due to previous meniscectomy or a large irrepairable meniscus tear. In particular, medial meniscus transplantation should be considered during revision ACL reconstruction in the medial meniscus-deficient knee.