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Meniscal Repair
Advances in the understanding of the role of the human meniscus in the transmission of forces across the knee joint and as a secondary stabilizer to pathologic motion have led to increased efforts to repair meniscal injuries. The meniscus provides a significant role in load bearing and shock absorption across the tibiofemoral joint by increasing the surface area for load transmission. Tears of the meniscus have been associated with progression of articular cartilage disease visable on imaging and arthroscopy, and a strong correlation exists between meniscectomy and the increased risk of developing radiographic signs of knee osteoarthritis. The primary goal in meniscal preservation surgery is to protect the articular cartilage from the changes in joint contact pressures seen with meniscal deficiency. Much of our philosophy in meniscal repairs is driven by more than 20 years of experience with meniscal transplantation and the rapid symptomatic deterioration of the meniscus-deficient athlete. We approach all meniscal tears as being potentially repairable and are increasingly aggressive about preserving the maximum amount of meniscal tissue with decreasing patient age.