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Background <p>Degenerative meniscal lesions (DML) are one of the most frequent findings of knee joints in old age and usually develop without significant trauma. They predominantly affect the medial meniscus (MM) and often exhibit complex or horizontal tear patterns. From a&#xa0;pathophysiological perspective there is a&#xa0;bidirectional relationship: on the one hand degenerative joint changes promote the development of meniscal lesions and on the other hand these lesions can accelerate the progression of osteoarthritis. Posterior medial meniscal root tears (PMMRT) are of particular clinical relevance as they are biomechanically equivalent to a&#xa0;functional meniscectomy, resulting in increased joint stress and accelerated osteoarthritis progression.</p> Material and Methods <p>The diagnostics are primarily based on the patient’s medical history and clinical examination. Imaging techniques should only be used when justified by the indications. The coronal leg axis must also be considered, as bony misalignment can increase joint stress and substantially affect the prognosis. For isolated DML conservative treatment is the primary therapeutic approach. Arthroscopic partial meniscectomy (APM) offers no advantage over this approach and should only be used for cases involving irreparable tear patterns and mechanical blockages. Meniscus-preserving procedures are also becoming increasingly more important in cases of degenerative lesions and can be effectively employed in selected cases.</p> Results <p>For PMMRT meniscal root refixation is the preferred treatment, as conservative and resection procedures are associated with poorer clinical outcomes. A&#xa0;key prognostic factor is postoperative meniscal extrusion, which can be reduced through measures such as centralization. In cases of pronounced varus deformities (≥ 5°) corrective osteotomy around the knee should be considered the primary treatment as isolated meniscus treatment is insufficient in these cases.</p> Conclusion <p>Overall, the treatment and determination of the indications for DML require a&#xa0;therapeutic approach tailored to the individual patient and the patient-specific outcome factors.</p>

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Degenerative Meniskusläsionen

  • 期刊论文

  • 发表日期：

    2026年5月29日

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  • Julius M. Wehrmann,
  • Sebastian Leutheuser,
  • Oliver Swietek

摘要

Background

Degenerative meniscal lesions (DML) are one of the most frequent findings of knee joints in old age and usually develop without significant trauma. They predominantly affect the medial meniscus (MM) and often exhibit complex or horizontal tear patterns. From a pathophysiological perspective there is a bidirectional relationship: on the one hand degenerative joint changes promote the development of meniscal lesions and on the other hand these lesions can accelerate the progression of osteoarthritis. Posterior medial meniscal root tears (PMMRT) are of particular clinical relevance as they are biomechanically equivalent to a functional meniscectomy, resulting in increased joint stress and accelerated osteoarthritis progression.

Material and Methods

The diagnostics are primarily based on the patient’s medical history and clinical examination. Imaging techniques should only be used when justified by the indications. The coronal leg axis must also be considered, as bony misalignment can increase joint stress and substantially affect the prognosis. For isolated DML conservative treatment is the primary therapeutic approach. Arthroscopic partial meniscectomy (APM) offers no advantage over this approach and should only be used for cases involving irreparable tear patterns and mechanical blockages. Meniscus-preserving procedures are also becoming increasingly more important in cases of degenerative lesions and can be effectively employed in selected cases.

Results

For PMMRT meniscal root refixation is the preferred treatment, as conservative and resection procedures are associated with poorer clinical outcomes. A key prognostic factor is postoperative meniscal extrusion, which can be reduced through measures such as centralization. In cases of pronounced varus deformities (≥ 5°) corrective osteotomy around the knee should be considered the primary treatment as isolated meniscus treatment is insufficient in these cases.

Conclusion

Overall, the treatment and determination of the indications for DML require a therapeutic approach tailored to the individual patient and the patient-specific outcome factors.