The menisci are fibrocartilages which have mainly the function to uniformly distribute the dynamic load that is transmitted from the femur onto the tibia during joint function; they also increase the congruence of the articular bones, and therefore increase the stability of the joint, both during walking and running, and in anti-gravitation terms.
Total removal of the menisci in conventional surgery is not to be done anymore because it causes early osteoarthritis deformities of the knee, while the selective removal of small arthroscopic meniscal injuries caused by trauma or degenerative changes allow a more physiological healing with rapid functional recovery.
In severe meniscal lesions in young sportsmen meniscal suture in selected cases retains most of the function of the meniscus without the need for donor meniscal transplant.
In patients not so young when meniscal cartilage is severely damaged and articular bones result still in good condition meniscal transplantation offers valid perspectives to make tibiofemoral surfaces last longer; anyway if this is current scientific trend, nonetheless our clinical trend remains is to conserve patient’s meniscal residues as much as possible.
Although ten years ago it was believed that the good condition and, if necessary, restoration of the central pivot (Acl and Pcl) was crucial to delay the onset of arthritis of the knee, currently the meta-analysis of long-term results of nowadays most common and accepted knee surgery (athroscopic menisci treatment, combined or not with anterior or posterior cruciate ligament reconstruction, etc.) has convinced us that in order to maintain over time a joint in acceptable quality, it is essential and central to maintain the function of menisci.