Meniscal Root Injuries


What is a meniscal root tear?

The meniscus is a C-shaped piece of cartilage that acts as a shock absorber between your femur (thigh bone) and your tibia (shin bone). There is a meniscus in both the medial and lateral compartments of the knee, and both have very strong attachments at their most posterior aspects, called the root attachments. These attachments are crucial to the function of the meniscus because they hold it in place, provide stability to the circumferential fibers of the meniscus, and prevent meniscal extrusion. 

Once the meniscus has been pushed out, or extruded, the underlying cartilage can start to rapidly deteriorate. The surrounding bone can frequently become inflamed, causing significant pain. In fact, it has been shown that a tear of the meniscal root is actually comparable to removing the entire meniscus itself, and exposes the cartilage to extremely large stresses. Thus, a tear of the meniscal root is considered a very serious condition.


What causes a meniscal root tear?

There are two different patient populations who commonly suffer meniscal root tears:

  • Young athletes with trauma-related injuries – This could include an injury to the ACL, PCL, and other associated ligament combinations. In these circumstances, the meniscal root is commonly torn along with the ligament, and it is recommended to perform a concurrent meniscal root repair. Failure to repair the meniscal root tear in these circumstances can lead to the development of osteoarthritis, failure of a ligament reconstruction, or other joint problems in the future.
  • Middle-age adults with everyday injuries – The consequences of a meniscal root tear appear to be much more severe in this age group. A meniscal root tear, which can occur with minor or seemingly trivial trauma, with a pop in the back of their knee with deep flexion, squatting and lifting, and other activities, can be quite severe. In this population, the rapid development of osteoarthritis or insufficiency fractures can occur.


What is the treatment for a meniscal root tear? 

Meniscal root tears are repaired whenever possible based on their importance in limiting future knee arthritis. The repair is performed with minimally invasive knee arthroscopy, and involves passing stitches into the meniscus remnant, and re-anchoring it to the bone. Surgical repair of the meniscus root has been shown to have incredibly successful outcomes by restoring the protective function of the meniscus.