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J Am Acad Orthop Surg, Vol 17, No 5, May 2009, 276-283.
© 2009 the American Academy of Orthopaedic Surgeons
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Medial Meniscus Posterior Horn Avulsion

John M. Marzo, MD

Perspectives on Modern Orthopaedics articles provide an objective appraisal of new or controversial techniques or areas of investigation in orthopaedic surgery.

Dr. Marzo is Clinical Associate Professor, Department of Orthopaedics, The State University of New York, University at Buffalo, Buffalo, NY.

Neither Dr. Marzo nor a member of his immediate family has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article.

Reprint requests: Dr. Marzo, Department of Orthopaedics, The State University of New York, University at Buffalo, 160 Farber Hall, Main Street, Buffalo, NY 14214.

Avulsion of the posterior horn of the medial meniscus can occur from acute trauma or chronic degeneration, leading to meniscus extrusion, articular cartilage loss, osteophyte formation, and medial joint space narrowing. With meniscus extrusion, the meniscus is unable to resist hoop stresses and cannot shield the adjacent articular cartilage from excessive axial load. Over time, this can lead to symptomatic knee osteoarthritis. Patients typically report pain, swelling, mechanical symptoms, and general functional loss. Although nonsurgical care may relieve symptoms, it is unlikely to alter either the natural history of meniscal loss or the fate of the medial compartment. Surgical repair of posterior horn meniscal avulsion is done in an attempt to restore the anatomy and biomechanical function of the meniscus, and to slow or prevent degenerative joint disease. Meniscal transplantation is reserved for salvage situations.






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Copyright © 2009 by the American Academy of Orthopaedic Surgeons.