Editorial Commentary: Medial and Lateral Meniscus Root Injuries Are Distinct, and Indications for Repair May Differ: Get Down to the Root of the Problem!

Medial and lateral root injuries are different clinical entities. Medial root injuries are of a degenerative nature and frequently are associated with obesity and varus deformity. Lateral root injuries, however, are more often of traumatic origin and usually associated with injuries to the anterior cruciate ligament. There is also a biomechanical difference between the 2 injuries. In the case of medial root injuries, the loss of circular hoop tension leads to an increase in peak contact pressure. In the case of lateral root lesions, the loss of hoop stress can be compensated for by an intact meniscofemoral ligament. Nevertheless, a repair also seems to make sense on the lateral meniscus, as the posterior root also has a stabilizing effect on the knee. The most suitable technique for lateral root repair depends on the type of lesion. A transtibial pull out repair is suitable for frequent avulsion injuries (type 1). In the case of type 2 injuries, which are also common, a side-to-side suture is an option.