Meniscal Root Tears: A Missed Epidemic? How Should They Be Treated?

Knowledge about meniscal root tears and their consequences is rapidly evolving among sports medicine surgeons. Probably unrecognized for decades, the natural evolution of medial meniscal posterior root tears can resemble an imaging pattern of an avascular necrosis of the knee and therefore mistakenly were named “spontaneous osteonecrosis of the knee.” Lateral meniscal root tears commonly occur acutely with a concurrent anterior cruciate ligament tears. Conversely, medial root tears are generally more chronic and can be caused by preexisting knee degenerative changes. Meniscal root repair is recommended in patients without significant osteoarthritis to restore native knee biomechanics and to avoid the long-term deleterious effects of its absence. Several repair techniques have been reported with satisfactory outcomes and low rate of complications. This chapter will provide a comprehensive review on meniscal root tears, diagnosis, indications, and treatment options currently available.