Meniscus—Friend or foe: Epidemiologic observations and surgical implications

The meniscus has long been appreciated as a source of knee symptoms and disability.In fact, through much of the 20 th century total meniscectomy was performed relatively frequently for patients with persistent, disabling mechanical knee symptoms.The procedure relieved mechanical symptoms but at a cost: Total meniscectomy was associated with accelerated degenerative radiographic changes, establishing the importance of the meniscus in the pathogenesis of osteoarthritis.1 -3 Biomechanical studies clarified these clinical observations.The meniscus distributes substantial mechanical load throughout the tibiofemoral joint surfaces that would otherwise be transmitted directly and focally to the weight-bearing portions of the femur and tibia.Damage to or resection of the meniscus disrupts this load sharing function, leading to excess loading of cartilage and subchondral bone and attendant changes of osteoarthritis.1 , 4 -