Meniscal pathology, instability, and ligament reconstruction in arthroscopy

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Over the past year, several articles have documented the sequelae of various forms of meniscectomy. Although both partial meniscectomy and total meniscectomy increase the risk for degenerative arthritis, total meniscectomy patients, especially children, fare significantly worse. Numerous articles demonstrate the critical role that anterior cruciate ligament stability plays in the status of the meniscus. Research in meniscal transplantation further elucidates the role of host cellular repopulation of grafts. Recent studies support clinical observations that most posterior cruciate ligament injuries occur with the knee flexed and a posterior force applied on the tibial tubercle. In addition, the effects of varus internal and external tibial torque on the anterior cruciate ligament and the posterior cruciate ligament have been documented after sectioning of the posterolateral corner. Perhaps the most important advancement is tibial placement of the anterior cruciate ligament graft posterior to the intersection of the roof of the intercondylar notch.

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