Meniscus Anatomy and Meniscus injuries

Prof. Rene Verdonk, UZ Gent, Belgium talks about the meniscus issue

See Dr Allen Mishra talk about meniscus tears

What is the meniscus

The knee joint is the most complex and remarkable joint in the body. It is capable of withstanding high load and shear stresses. Integral to the knee’s functionality is the meniscus. The knee’s menisci are two half-moon, wedge shaped pieces of cartilage (the lateral and medial meniscus), acting as lubricant and elastic buffer, distributing forces evenly between the femur (upper leg) and tibia (lower leg) in the knee joint.

At least two – thirds of the meniscus is both thin and avascular (has no blood supply). About 80% of meniscal damage occurs in the avascular area where successful long-term tissue repair is not possible.
Each year, orthopedic/sports medicine surgeons treat some 1.5 million meniscal injuries in Europe and the United States alone. Many of these injuries are originally sports related from golf, skiing, soccer or other active pursuits. A sudden twist of the knee can result in a pinch or tear of the meniscus. At present, if the tear is in the non-vascularised area, there is only one surgical option and the damaged tissue is removed by performing a partial meniscectomy. This leads to a permanent reduction in the functionality of the knee joint.
When injuries occur in the vascularized area of the meniscus (about 20% of the time), it is possible to repair the tear by suturing or using fixation devices. However, treatment fails in approximately 20% of these cases within two years of the initial surgery at which stage there is no option but to remove the injured tissue.
There is overwhelming clinical evidence that removal of meniscal tissue leads to degenerative condition over time. This is followed by articular cartilage damage, often leading to painful osteoarthritis (bone and cartilage degeneration) and frequently results in a total knee replacement. There is a strong demand for products that will promote the regeneration of new meniscus tissue.