Alternative Treatments for Meniscal Injuries

executed arthroscopic meniscectomy for a torn medial meniscus provided full functional restoration in more than 90% of cases, with short-term results comparable with those of open meniscectomy. In the longer term, factors such as varus malalignment and mechanical overload increase the risk of degeneration of load-bearing cartilage (Fig. 2). The buffer function of the semilunar cartilage between the femoral condyle and medial tibial plateau is lost, and the stabilising factor, the meniscal wall, is also lacking. The result is an increased anteroposterior shift of the femoral condyle in relation to the medial tibial plateau (Fig. 3). Any ligamentous laxity produced by the initial trauma will increase the degenerative changes in the loadbearing area. Even more important, but less controllable, is the magnitude of the mechanical load. This will depend on the weight of the patient and on work- and sports-related activity. The same factors also apply to older patients. The shortterm results of accurate arthroscopic meniscectomy are better than those of open total meniscectomy because of the preservation of the meniscal wall. Again, the quality of the load-bearing cartilage will determine the functional out