Abstract
PurposeThe purpose of this study was to evaluate the current status of education of polish surgeons in the subject of meniscus repair possibilities. The analysis of the possible correlations between the number of knee arthroscopy procedures performed by polish surgeons and their decision whether to remove or to repair the damaged meniscus has been performed.MethodsTwo-hundred and five registered orthopedic surgeons took part in surveys. The questionnaire contained the description of 20 patients with different types of meniscus damage and three questions concerning the experience in knee arthroscopy (two questions) and a choice of the treatment method (one question). Comparisons were made between knee arthroscopy experts (> 100 arthroscopies performed per year) and non-experts (≤ 100 cases).ResultsThe questionnaire was completed by 194 knee surgeons from Poland with different levels in knee arthroscopy experience. For most cases, experts and non-experts agreed on the meniscus treatment method. Statistically significant differences in the recommended treatment between experts and non-experts were observed in 4 cases, where experts decided to repair the damage rather than to perform the meniscectomy.ConclusionsMeniscectomy remains a frequent orthopedic procedure, despite meniscal sparing having been advocated for several decades now and despite the existence of meniscus repair technique which gives good clinical outcomes—augmentation of the damaged meniscus with a collagen membrane. Polish surgeons still need education on the meniscus treatment possibilities.Level of evidenceV.
Highlights
Meniscal tears may be arthroscopically treated with resection, repair or replacement of the damaged tissue
The most important finding of the present study was that meniscectomy remains a frequent orthopedic procedure, despite meniscal sparing having been advocated for several decades and despite the existence of meniscus repair technique which gives good clinical outcomes—augmentation of the damaged meniscus with a collagen membrane [6, 11, 18]
It has been demonstrated that even patients with combined and complex meniscal tears could be treated with an "all-inside" arthroscopic suture of meniscus and augmentation with a collagen membrane technique with bone marrow blood injection. with good or very good All treated patients had a good or very good clinical outcomes after 2 [18] and 5 years [11] and they did not require reoperation
Summary
Meniscal tears may be arthroscopically treated with resection, repair or replacement of the damaged tissue. The era of meniscal preservation is based on three pillars: (i) repair of the torn meniscus whenever reasonable, (ii) non-surgical treatment of asymptomatic meniscal pathologies despite a meniscal tear according to MRI, (iii) partial meniscectomy and resection of as much as necessary and as little as possible [5]. In this regard, the most amenable tears to be repaired are acute, traumatic tears within the peripheral well-vascularized red-red zone which are longitudinalvertical in orientation [22]. The extended indications for the meniscal repair have been recommended for the subsequent clinical entities: horizontal cleavage tears in young
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