الفهرس 
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Abstract
IUMMAI.Y
The menisci. or semilunar cartilage. are intra-articular crescentic portions of
fibrocartilage situated at the periphery of the the upper articular surface of the tibia.
Histologically, the menisci are composed of dense. tightly woven collagen fibres with a
small amount of elastic tissue in between.
The menisci contribute to the following functions :
• Articular cartilage nutrition and joint lubrication.
• Stability of the knee.
• Movement of the knee joint.
• Shock absorption.
• Weight bearing and load distribution.
Various types of meniscal tears are encountered, although different kinds, and
sites of tear frequently coexist. Cysts and complex lesions may also present, both in
previously normal menisci and in congenitally abnormal or degenerate menisci. Meniscal
tears will produce pain, loss of movement. and instability of the joint. The relationship
of these symptoms should be recognized. A tom meniscus produces joint line tenderness,
often very localized, an effusion as well as locking. Positive McMurray and Apley
grinding test is very valuable in diagnosing meniscal lesions.
Advances in arthrography, arthroscopy, computed tomography and magnetic
resonance imaging have enabled the orthopaedic surgeon to diagnose and treat meniscal
lesions, most often without arthrotomy and the incidence of errors in diagnosis has
been reduced. However. arthroscopy is the most accurate, reliable and standard for the
detection and treatment of meniscal tears, as its diagnostic accuracy reached 90 to 96%.
The realization that the meniscus has a valuable function within the knee, even
if only the peripheral portion is present, has led to a more conservative surgical policy
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when dealing with a tear. On the other hand, arthroscopy allows a more differentiated
and conservative approach to meniscal lesions with less morbidity than the conventional
open technique.
The goal of arthroscopic meniscectomy is to remove all ruptured and offending
meniscal tissues with preservation of as much of an intaet stable rinl as is possible.No
single method of endoscopicmeniscectomy works best in every ~. One must not
think that there is any right or wrong way to perform an arthrosco~c meniscectomy.
In general, the prognosis after meniscectomy is adversely affected by the
following factors :
• Presenceof osteoarthrosis.
• Presenceof significant ligament laxity or other injuries.
• Other meniscus already removed..
• Extremes of age (poor results common in children and older people).
• Female sex.
Our results from the study of 157 cases of partial arthroscopic meniscectomy
have shown that males were more commonly affected than females. the mean age of
incidence of meniscal lesion was 29 years. the medial meniscus was more commonly
affected than the lateral one and sport injury was the commonest causative trauma
leading to meniscal injury.
Clinically. pain presented in 95’10 of cases. gtvmg way in 42% and locking in
28%. On examination, joint line tenderness had the highest score of 80’10 presentation
among our cases, followed by positive McMurray’s test (64%), then joint effusion (63%)
then positive Apley grinding test (5291».
The mean duration of joint illness among our cases at the time of the operation
was IS months. The mean operating time was 48 minutes. The mean hospital stay was
2.7 days.
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longitudinal tears were found to be the commonestmeniscal lesion followed by
flap tears then radial tears. Complex tear came the least in oc:curance.We did not
encounter any case with cystic degenerationnor post-meniscectomyrim tears.
Satisfactory results were obtained in 142 (92%) of the cases (60% w:ellent and
32%good).Age and duration of illness had a significant effect on the final end result.
On the other hand, sex and type of meniscal lesion as well as its location had no
significant effect on the final result.
Partial arthroscopic meniscectomyas described in the pmleDt study with no
intra-operative complications,only 6 (4%) minor post-operative complications(3 cases
with stitch infection and 3 cases with haemoanhrosis)and early return to normal
activity (mean, 20 days) and sports activities (mean, 8 weeks) adding to the high
percentageof its satisfactory results, make the procedureto be the treatment of choice
for a great majority of symptomaticmeniscal tears.
Finally, our results suggested to perform partial arthroscopic meniscectomyas
early as possible in symptomatic meniscal· tears with careful evaluation of older
patients.