Die mediale Meniskuswurzelläsion: Resektion, Refixation oder „leave alone“?

Posteromedial meniscal root tears (PMMRT) are generally degenerative in nature and commonly affect patients over the age of 50 years. Clinically, these injuries are highly relevant because they have a high risk of a rapidly progressing osteoarthritis; however, the treatment is a problem as the healing potential is limited due to the degenerative nature of the injury and there is often pre-existing cartilage degeneration. Both conservative treatment and partial meniscectomy have shown poor results in clinical studies, with high conversion rates to knee arthroplasty. The best results are achieved after refixation of the meniscal root, although this procedure also has its limitations and the results are not always satisfactory. A recent development in meniscal root fixation is the additive meniscus centralization, which appears to be promising at least in short-term observational studies. In patients with significant varus deformity, corrective osteotomy represents an adjunct or alternative treatment option.