Yongtao Mao · v1.1 · Published 2026.10.14 · Updated 2026.10.22
Part I. Diagnosis and Treatment Selection
Chapter 1. Meniscal Anatomy, Function, and Healing
- Vascular supply, fiber orientation, roots, and peripheral attachments
- Load transmission, hoop stress, and knee joint stability
- Tear location, tissue quality, and conditions for healing
Chapter 2. Clinical Diagnosis and Imaging Evaluation
- History, physical examination, and sources of symptoms
- True locking, painful restriction of motion, and intermittent clicking
- Indications for weight-bearing radiographs, MRI, and arthroscopy
- MRI signal, tear diagnosis, and morphologic description
- Global meniscal extrusion and displaced tear flaps
- Differentiation of cartilage injury, subchondral insufficiency fracture, and other subchondral bone changes
Chapter 3. Choosing Among Nonoperative Treatment, Repair, and Meniscectomy
- Clinical distinction between traumatic tears and degenerative lesions
- Preoperative judgment of stability, reducibility, and repairability from history and imaging
- Age, activity demands, lower-limb alignment, joint stability, and cartilage status
- Treatment benefit, risk of reoperation, and patient goals of care
Part II. Nonoperative Treatment and Surgical Indications
Chapter 4. Implementation and Reassessment of Nonoperative Treatment
- Exercise therapy, activity modification, and weight management
- Analgesic medication, intra-articular injection, and symptom control
- Follow-up of symptoms, effusion, range of motion, and functional recovery
- Causes of persistent symptoms and criteria for conversion to surgery
Chapter 5. Degenerative Meniscal Pathology
- Relationship among imaging abnormalities, knee pain, and osteoarthritis
- Comparative studies of exercise therapy, partial meniscectomy, and sham surgery
- Mechanical symptoms, trial exclusion populations, and individualized treatment decisions
- Concurrent osteoarthritis, non–root-related meniscal extrusion, and adjustment of nonoperative care
Chapter 6. Management of Acute Tears and Timing of Surgery
- Nondisplaced tears and displaced tears
- Urgency of managing the locked knee and preoperative evaluation
- Early repair, delayed repair, and chronic tears
- Effect of concomitant ligament injury on surgical timing
Part III. Surgical Methods
Chapter 7. Arthroscopic Exploration and Assessment of Repairability
- Arthroscopic exploration, tear classification, and confirmation of stability
- Tissue quality, tear zones, and consistency of judgment
- Debridement of tear edges, reduction, and intraoperative plan adjustment
- Extent of repair, suture orientation, and fixation stability
- Repair site, fixation failure, and short- to mid-term healing outcomes
Chapter 8. Meniscal Suture Techniques
- Inside-out, outside-in, and all-inside suture
- Approaches by location, instrument selection, and neurovascular protection
- Suture configuration, fixation materials, and intraoperative assessment
- Biomechanical comparisons and evidence of clinical efficacy
Chapter 9. Biological Augmentation of Meniscal Repair
- Synovial rasping, marrow stimulation, and fibrin clot
- Variability in platelet-rich plasma preparation and clinical results
- Cell-based therapies and other experimental methods
- Combined ACL reconstruction, adjunctive procedures, and attribution of treatment effects
Chapter 10. Partial Meniscectomy
- Identification of irreparable tissue and extent of resection
- Preservation of a stable residual rim and circumferential continuity
- Differences after medial versus lateral resection
- Extent of resection, short- to mid-term symptoms, and complications
Part IV. Tear Patterns and Special Populations
Chapter 11. Longitudinal Tears and Bucket-Handle Tears
- Displacement, reduction, and tissue deformation
- Extent of suture, choice of configuration, and residual instability
- Management of chronic bucket-handle tears and irreparable portions
Chapter 12. Radial Tears
- Partial and complete radial tears
- Location of non-root-zone tears, residual continuity, and load transmission
- Suture configuration, transtibial fixation, and clinical outcomes
Chapter 13. Meniscal Root Tears and Extrusion
- Etiology and concomitant injuries of medial posterior root, lateral posterior root, and anterior root tears
- Root attachment injury and near-root radial tears
- MRI findings, subchondral insufficiency fracture, and intraoperative confirmation
- Influence of lower-limb alignment, cartilage status, and osseous lesions on treatment selection
- Choice among repair, nonoperative treatment, and partial meniscectomy
- Evaluation for osteotomy or arthroplasty when repair is not appropriate
- Transtibial tunnel and suture-anchor fixation
- Centralization for meniscal extrusion and clinical evidence
- Persistent extrusion, failure, and joint degeneration after root repair
Chapter 14. Horizontal Tears, Flap Tears, Complex Tears, and Meniscal Cysts
- Tissue quality, repair, and selective resection of horizontal tears
- Displacement, incarceration, and management of vertical and horizontal flap tears
- Judgment of preservable tissue in complex tears
- Management of meniscal cysts and accompanying tears
Chapter 15. Meniscal Injury Combined with ACL Injury
- Recognition and stability of medial meniscal ramp lesions
- Exploration of posterior horn, posterior root, and other concomitant tears
- Concurrent versus staged treatment and retention of stable tears
- Timing of ACL reconstruction, knee instability, and secondary meniscal injury
- Ramp and posterior root injury in relation to rotational stability and pivot shift
- Effect of ACL reconstruction on repair outcomes and rehabilitation planning
Chapter 16. Hypermobile Lateral Meniscus and Popliteomeniscal Fascicle Injury
- Recurrent locking, conventional MRI findings, and dynamic arthroscopic assessment
- Anatomy and stabilizing structures of the popliteal hiatus region
- Repair methods, symptom improvement, and reoperation
Chapter 17. Discoid Meniscus
- Morphology, peripheral stability, and tears
- Asymptomatic discoid meniscus and symptomatic lesions
- Extent of saucerization, peripheral repair, and tissue preservation
- Retear and long-term cartilage change
Chapter 18. Meniscal Injury in Children and Adolescents
- Pediatric MRI findings and diagnostic error
- Repair potential, tissue preservation, and reinjury
- Open physes and transtibial fixation
- Sport participation, family engagement, and rehabilitation adherence
Part V. Meniscal Deficiency and Reconstruction
Chapter 19. Evaluation and Treatment of the Meniscus-Deficient Knee
- Causes of persistent pain after meniscectomy
- Influence of lower-limb alignment, joint instability, and cartilage defects on treatment selection
- Choice among nonoperative treatment, osteotomy, and cartilage repair
- Indications for combined procedures and sequencing
Chapter 20. Meniscal Allograft Transplantation
- Case selection, graft matching, and preservation
- Fixation methods, graft position, and extrusion
- Technical adjustments when combined with osteotomy, ligament, or cartilage surgery
- Symptoms, graft survival, reoperation, and return to sport
Chapter 21. Meniscal Scaffolds and Substitute Materials
- Indications for partial versus extensive defects
- Scaffolds, synthetic substitutes, and tissue-engineering approaches
- Clinical efficacy, adverse events, and duration of follow-up
- Product indications, regulatory status, and disclosure of commercial interests
Part VI. Rehabilitation, Management of Failure, and Long-term Outcomes
Chapter 22. Rehabilitation After Meniscal Surgery
- Weight-bearing, range of motion, and strengthening after partial meniscectomy
- Protective conditions and training progression after repair
- Differences after radial repair, root repair, and transplantation
- Protocol adjustment when combined with ligament or cartilage surgery
- Effusion, pain, restricted motion, and rehabilitation reassessment
Chapter 23. Home Rehabilitation After Meniscus Repair
- Individualized rehabilitation prescription and movement instruction before discharge
- Home weight-bearing, bracing, range of motion, and early training
- Adjustment of home training after radial repair, root repair, and combined procedures
- Activities of daily living, family assistance, and training progression
- Post-exercise responses, follow-up visits, and symptoms that require prompt medical attention
- Comparative evidence for home, outpatient, and remote rehabilitation
Chapter 24. Return to Sport and Prevention of Reinjury
- Return to daily activity, running, sport-specific training, and competition
- Control of effusion and pain; assessment of quadriceps strength, single-leg hop, and sport-specific movement
- Healing time, functional criteria, and sport demands
- Applicability of ACL reconstruction return-to-sport criteria in patients with meniscal injury
Chapter 25. Repair Failure, Retear, and Surgical Complications
- Definitions of failure based on reoperation, persistent symptoms, and structural nonhealing
- Differentiation of persistent symptoms, nonhealing, and new tears
- Postoperative MRI and repeat arthroscopy
- Revision suture, partial meniscectomy, and subsequent reconstruction
- Infection, thrombosis, neurovascular injury, stiffness, and device-related problems
- Subchondral insufficiency fracture after arthroscopy
- Rapid chondrolysis after lateral meniscectomy
Chapter 26. Long-term Outcomes of Meniscal Treatment
- Symptoms and function, structural healing, and reoperation
- Osteoarthritis progression, arthroplasty, and quality of life
- Comparison of outcomes after conservative treatment, repair, meniscectomy, and reconstruction
- Discordance among patient-reported outcomes, reoperation, and imaging evidence of degeneration
Appendix
- Classification of meniscal tears and Chinese–English terminology
- Preoperative assessment and operative record items
- Rehabilitation progression assessment and patient-reported outcome measures (IKDC, KOOS, Lysholm, WOMET)