Acute Isolated Meniscal Pathology
Publication Date: June 10, 2024
Last Updated: June 25, 2024
Summary of Recommendations
PHYSICAL EXAMINATION
Physical examination, including joint line tenderness, the McMurray test, and the Thesally test, can effectively diagnose acute meniscal tears and may yield more accurate results when combined. (Moderate)
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ADVANCED IMAGING
MRI is the preferred imaging modality to diagnose acute meniscal tears because of its high accuracy, while CT arthrography or ultrasound can be used, particularly when MRI is not available or is contraindicated. (Strong)
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JOINT DEGENERATION
When indicated in the treatment of acute meniscal tear, surgery should preserve as much functional meniscal tissue as possible to mitigate patient risk for osteoarthritis. (Moderate)
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SURGICAL INTERVENTION AFTER NON-OPERATIVE TREATMENT
Patients with acute meniscal tear who have failed conservative treatment may have better outcomes from surgical intervention within 6 months of injury. (Limited)
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MENISCUS REPAIR
Meniscus repair can improve patient outcomes compared to partial meniscectomy in acute isolated meniscal tears with healing potential. (Limited)
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BIOLOGICAL ENHANCEMENT
Bone Marrow Venting or Platelet Rich Plasma can be considered in patients with acute isolated meniscal tears undergoing surgical repair to improve outcomes. (Moderate)
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INDICATIONS FOR ACUTE SURGICAL INTERVENTION
In the absence of sufficient evidence, it is the opinion of the workgroup that patients with a displaced or displacing acute meniscal tear, particularly those restricting knee range of motion, can benefit from acute surgical intervention. (Consensus)
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INDICATIONS FOR ACUTE SURGICAL INTERVENTION
In the absence of sufficient evidence, it is the opinion of the workgroup that patients with a symptomatic acute meniscal tear who could benefit from a repair should be considered for early surgical intervention. (Consensus)
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PHYSICAL THERAPY
In the absence of sufficient evidence, it is the opinion of the workgroup that physical therapy/rehabilitation may benefit patients with an acute isolated meniscal tear undergoing non-operative treatment or recovering from meniscal surgery. (Consensus)
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SURGICAL REPAIR TECHNIQUE
It is the opinion of the workgroup that, when performing repair of acute isolated meniscal tears, surgeons may favor the inside out technique to reduce the risk of repair failure in certain tear patterns or all inside techniques to reduce the risk of other complications. (Consensus)
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The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.
Title
Acute Isolated Meniscal Pathology
Authoring Organization
American Academy of Orthopaedic Surgeons
Publication Month/Year
June 10, 2024
Last Updated Month/Year
June 25, 2024
Country of Publication
US
Document Objectives
This clinical practice guideline is based on a systematic review of published studies examining the management of acute meniscal tears.
Target Patient Population
Individuals who are suspected of or have been diagnosed by a trained healthcare provider with an acute isolated meniscal tear
Target Provider Population
Orthopaedic surgeons and other healthcare providers managing patients with acute meniscal tears
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Ambulatory, Outpatient, Operating and recovery room
Intended Users
Nurse, nurse practitioner, physical therapist, physician, physician assistant
Scope
Assessment and screening, Treatment, Management, Rehabilitation
Diseases/Conditions (MeSH)
D000072600 - Meniscus
Keywords
Meniscal Pathology, meniscal tears
Source Citation
American Academy of Orthopaedic Surgeons Management of Acute Isolated Meniscal Pathology Evidence-Based Clinical Practice Guideline. https://www.aaos.org/ampcpg Published June 10, 2024