GC230 Knee Sport Injuries: Part 3
Knee sport injuries (Part 3) covers posterior cruciate ligament (PCL) injuries, posterolateral corner injuries, and multi-ligament knee injuries, focusing on their mechanisms, diagnosis, and surgical management in athletes.
Knee Sport Injuries – Part 3: Meniscus Tear ("Traumatic" vs "Degenerative")
Lecture Map
This lecture is exclusively about meniscus tears — arguably the single most common intra-articular knee injury you will encounter in orthopaedic practice. The overarching clinical message is deceptively simple but exam-critical: not all meniscus tears are the same, and the distinction between a traumatic tear (healthy tissue injured acutely → potential to heal → consider repair) and a degenerative tear (pre-existing pathology → low/no healing potential → conservative first, meniscectomy if needed) drives every management decision.
1. To understand the anatomy and function of meniscus 2. To learn the symptoms and signs of meniscus tear 3. How to establish the diagnosis of meniscus tear 4. To understand the principle of management of meniscus tear 5. To be able to differentiate "traumatic meniscus tear" from "degenerative meniscus tear"
This is Part 3 of a 6-part GC 230 Knee Sport Injuries series. Part 1 covers introductory concepts and ligament injury; Part 2 covers ACL/PCL in depth; Part 3 (this one) covers meniscus tears; Parts 4–6 cover cartilage injury, extensor mechanism injury, and patellofemoral instability [2]. The meniscus topic connects to knee osteoarthritis (GC 228) because meniscectomy accelerates OA, and degenerative meniscal tears are incidental findings in OA knees.
Core Concepts & Mechanisms (First Principles)
Two pieces of fibrocartilage inside the knee joint, situated between the femoral condyle and tibial plateau. [1]
- Shape: Semi-lunar (crescent) when viewed from above; triangular in cross-section. [1]
- Types: Medial meniscus (larger, more C-shaped, more firmly attached to the capsule and deep MCL → less mobile → more commonly torn) and lateral meniscus (more circular, more mobile, bears more load).
Why this matters: The meniscus is not just a "cushion". It is an engineering structure that converts axial compressive loads into circumferential "hoop stresses", dramatically enlarging the contact area between the round femoral condyle and the flat tibial plateau. Without it, point-loading destroys articular cartilage → OA.
Aneural, Avascular (relative), Alymphatic [1]
This "triple-A" characteristic explains:
- Aneural: Meniscus tears themselves don't always produce pain. Pain comes from capsular tethering or secondary synovitis. This is why some degenerative tears are asymptomatic.
- Avascular: The blood supply arrives from the periphery only (branches of medial, lateral, and middle genicular arteries through the perimeniscal capillary plexus) [1]. The central part has no direct blood supply — it's nourished by synovial fluid diffusion.
- Alymphatic: Limited inflammatory/immune response → limited intrinsic healing capacity.
Red-Red zone (R-R): the peripheral 3–4 mm of meniscus is vascular and is capable of healing. Red-White zone (R-W): limited blood supply, healing is still possible. White-White zone (W-W): no blood supply in the central portion of meniscus with low chance of healing. [1]
| Zone | Location | Blood Supply | Healing Potential | Surgical Implication |
|---|---|---|---|---|
| R-R (Red-Red) | Peripheral 3–4 mm | Good (vascular) | High — capable of healing | Meniscus repair (suture) |
| R-W (Red-White) | Middle third | Limited | Moderate — healing still possible | Repair or partial meniscectomy (case-dependent) |
| W-W (White-White) | Central/inner third | None | Low/None | Partial meniscectomy (no point repairing tissue that won't heal) |
High Yield — Vascular Zones Dictate Surgery
The vascular zone of the tear is the single most important factor determining whether you repair or resect. Peripheral tears (R-R zone) = repair. Central tears (W-W zone) = meniscectomy. This is tested repeatedly because it tests whether you understand the biological rationale for treatment choice.
Collagen (20%): over 90% is Type I collagen [1]
- Peripheral one-third: Fibers arranged circumferentially ( > 95%) → provides tensile stiffness (circumferential stiffness ~110 MPa).
- Inner one-third: More radially oriented collagen fibers → radial stiffness ~10 MPa (much lower).
- Why circumferential arrangement matters: When axial load is applied, the meniscus wants to extrude radially. The circumferential collagen resists this extrusion, converting compressive force into hoop stress. If the circumferential fibers are disrupted (e.g., radial tear), load transmission is catastrophically lost — functionally equivalent to a total meniscectomy.
Proteoglycans with GAGs (1%): GAGs are negatively charged and allow water to bind. Water (70%): provides low compressive stiffness (0.1% of circumferential tensile property), allows expansion under compressive force → suitable for shock absorption during loading. [1]
Why this matters: The meniscus is designed to be "squishy" in compression (thanks to water/GAGs) but strong in tension (thanks to collagen). This dual property makes it an ideal load-spreader and shock absorber.
- Cells: Fibrochondrocytes, fibroblasts, and cells of the superficial zone [1]. These are the cells responsible for whatever limited repair/remodeling the meniscus can achieve.
Load transmission: Medial meniscus bears 50% of the load across medial compartment; Lateral meniscus bears 70% of the load across lateral compartment [1]
Account for 50% load transmission in extension and 85% in flexion [1]
| Function | Mechanism | Clinical Consequence of Meniscectomy |
|---|---|---|
| Load transmission | Increases contact surface area → reduces contact pressure ("chondral protection") | Point loading → accelerated cartilage wear → OA |
| Shock absorption | Viscoelastic deformation (water + GAGs) | Loss of cushioning |
| Joint stabilization | Secondary stabilizer (especially medial meniscus as secondary restraint to anterior tibial translation with ACL deficiency) | Increased instability in ACL-deficient knee |
| Lubrication | Distributes synovial fluid across articular surfaces | Increased friction |
| Nutrition | Helps distribute nutrients to avascular articular cartilage | Cartilage degeneration |
The two horns (anterior and posterior) of meniscus are attached to the tibia through the insertional ligament (ROOT of meniscus) [1]
"Hoop stress" develops within the meniscus because of the intact ROOTs and the circumferentially running collagen fibers, facilitating load transmission across the joint [1]
From first principles: When you push down on the meniscus (axial load), it tries to squeeze outward radially. The intact roots anchor the meniscus to the tibia at both ends, and the circumferential collagen acts like a hoop on a barrel. Together, they resist extrusion and convert the axial load into circumferential tension (hoop stress). This is how load is transmitted across the joint.
Clinical Pearl — Root Tears
A meniscal root tear (detachment of the insertional ligament) is functionally equivalent to a total meniscectomy because it destroys the ability to generate hoop stress. The meniscus simply extrudes under load. This is why root tears are catastrophic and should be repaired if possible. Students commonly forget that root integrity is just as important as meniscal body integrity.
Symptoms and Signs of Meniscus Tear
Mechanical pain, Swelling (delayed onset), Locking, Giving way [1]
| Symptom | Explanation |
|---|---|
| Mechanical pain | Worsened by twisting/pivoting; pain at joint line. Not inflammatory in nature (no morning stiffness pattern). |
| Swelling (delayed onset) | Key discriminator from ACL tear. ACL tear → immediate swelling (haemarthrosis from vascular ligament). Meniscus tear → delayed swelling (hours–days) because meniscus is relatively avascular → effusion is from synovial irritation, not hemorrhage. |
| Locking | A displaced meniscus fragment physically blocks joint motion. True locking = mechanical block (not just pain-limited ROM). |
| Giving way | Knee "buckles" — due to reflex quadriceps inhibition when the torn fragment catches, or pain-mediated instability. |
Exam Trap — Swelling Timing
Immediate swelling (within 2 hours) = haemarthrosis = think ACL tear (vascular structure bleeds immediately). Delayed swelling (hours to next day) = effusion from reactive synovitis = think meniscus tear (avascular structure doesn't bleed much). This is a classic MCQ discriminator.
Pain can occur: [1]
- At the time of injury
- 1–2 months post-injury
- At the time of locking
- After the development of secondary osteoarthritis of joint
This timeline is important because it explains why some patients present late. A small tear may be tolerable initially, then becomes symptomatic weeks later when the fragment becomes more mobile, or years later when OA develops.
Joint line tenderness, Effusion (fluid shift test), Reduced range of motion (both active and passive), Provocative signs (e.g., McMurray test, Apley grinding test) [1]
| Sign | How to Perform | What It Tests | Limitations (from lecture) |
|---|---|---|---|
| Joint line tenderness | Palpate along medial/lateral joint line | Localizes which meniscus is torn | Non-specific; can occur with OA, collateral ligament injury |
| Effusion | Fluid shift test (milk test, patellar tap) | Detects intra-articular fluid | Non-specific |
| Reduced ROM | Both active and passive | Mechanical block (if passive extension is blocked → displaced bucket-handle tear) | |
| McMurray test | Flex knee, externally rotate foot + extend knee (medial meniscus); internally rotate + extend (lateral meniscus). Positive = palpable click/pain at joint line | Meniscus tear | Low specificity as a diagnostic test in acute injury; low sensitivity as a screening test in chronic situation [1] |
| Apley grinding test | Patient prone, knee 90° flexed. Compress tibia into knee + rotate. Positive = pain | Meniscus tear (compression) vs ligament injury (distraction) | Same limitations as McMurray |
Key Lecture Point — Provocative Tests Have Limitations
Provocative tests (McMurray, Apley grinding) have low specificity in acute injury (many things hurt in an acutely injured knee) and low sensitivity in chronic situations. [1] Do NOT rely on a negative provocative test to rule out a meniscus tear. Clinical diagnosis alone is insufficient — you need imaging.
Establishing the Diagnosis
The lecture provides a detailed table comparing three types of "locking" — this is extremely high yield because SAQs love asking you to differentiate:
| Feature | Acute Locking | Intermittent Locking | Loose Body |
|---|---|---|---|
| Pathology | Displaced bucket-handle tear of meniscus | Displaceable meniscus tear or loose body (LB, usually bony) | Loose body (usually bony in nature) |
| Preceding injury | Usually yes | Yes or no | Usually no |
| Locking position | Inability to fully extend the knee passively | Can be in any position of knee flexion | Can be in any position of knee flexion |
| Duration of locking | Persistent | Transient | Transient |
| Cause of pain | Tethering of capsule by the meniscus fragment that remains attached to the capsule | Tethering of capsule by the meniscus fragment that remains attached to the capsule | Increase in pressure at the subchondral bone resulting from the impingement of the LB within the joint |
Why Acute Locking Blocks Extension Specifically
A bucket-handle tear is a longitudinal tear where the central portion flips over like a bucket handle into the intercondylar notch. This displaced fragment physically blocks the knee from reaching full extension — hence the inability to fully extend passively. The fragment is tethered to the capsule, so it pulls on the capsule → pain. This is an urgent indication for surgery.
X-ray: usually unremarkable [1] Important in ruling out other differential diagnoses [1]
Why X-ray first: Even though X-ray won't show the meniscus (soft tissue), it rules out fractures, loose bodies, OA changes, osteochondral defects. The lecture says "usually remarkable" in one slide but this is clearly a transcription error — context and the other slide confirm "usually unremarkable" [1].
DIAGNOSIS is made by either MRI or arthroscopy [1]
- MRI: Non-invasive gold standard for meniscus tear diagnosis. High sensitivity and specificity (> 90%). Shows tear morphology (horizontal, vertical, radial, bucket-handle, complex), location (R-R, R-W, W-W zone), and associated pathology.
- Diagnostic arthroscopy: Direct visualization. Historically the gold standard but invasive. Now reserved for therapeutic purposes (repair/meniscectomy) with MRI used for diagnosis.
Four management options: [1]
| Option | Indication | Key Points |
|---|---|---|
| Non-operative / Observation | Asymptomatic; symptoms mild and compatible with acceptable function | Understand that the lesion may progress over time |
| Meniscectomy | No or low potential for healing, even if surgical repair is attempted; symptomatic | Loss of meniscus tissue after meniscectomy will lead to accelerated osteoarthritis of the joint |
| Meniscus Repair | The repaired meniscus tissue has the potential to heal | Reported rate of successful healing is only 80–85%, even in well-selected cases |
| Meniscus Transplant | Reserved for symptomatic cases with significant loss of meniscus tissue | Not available in Hong Kong due to the lack of a sizeable fresh meniscus allograft bank |
High Yield — Management Algorithm
Step 1: Is the patient symptomatic? → If no, observe (even if MRI shows a tear). Step 2: If symptomatic, is the tear in a zone with healing potential (R-R or R-W) AND is the tissue healthy (traumatic, not degenerative)? → If yes, repair. Step 3: If the tear is in the W-W zone OR the tissue is degenerative → meniscectomy (as conservative as possible — partial meniscectomy to preserve maximum tissue). Step 4: If significant meniscal tissue is already lost → consider transplant (though not available in HK).
Why preserve the meniscus? Because meniscectomy → loss of load distribution → increased contact pressure → accelerated cartilage wear → early-onset OA. This is a well-established consequence (Fairbank's changes on X-ray: joint space narrowing, osteophyte formation, subchondral sclerosis). Every effort should be made to repair rather than resect, especially in young patients.
From the supporting Maksim Surgery Notes [3]:
- Conservative preferred for < 1 cm meniscal tear: RICE, analgesics, rehabilitation.
- Operative indications: failed conservative treatment, bucket-handle tear, associated ligament injury, locked knee.
- Meniscal repair with suture: indicated if outer 1/3 (good vascular supply), vertical tear.
- Partial meniscectomy: indicated if inner 1/3 (e.g., radial tear, horizontal tear).
- Complications of knee arthroscopy: damage to saphenous nerve and vein, peroneal nerve, popliteal vessels [3].
Traumatic vs Degenerative Meniscus Tear — The Core Distinction
This is the central teaching point of the entire lecture. Expect an SAQ or MCQ directly on this.
The meniscal tissue is healthy before the onset of symptoms [1] Hence, there is potential for healing if it is repaired promptly [1] Always associated with a significant injury history [1] Onset of first symptoms is always acute [1] Symptoms are mainly related to the instability of the torn meniscus, including pain and locking [1]
In the acute setting:
Can present with "acute locking" (loss of terminal passive extension due to persistently displaced meniscus fragment blocking joint extension) and joint effusion [1] Provocative tests are limited because they are non-specific and nearly always positive in an acutely injured knee (regardless of whether there is a meniscus tear or not) [1]
In the subacute setting:
Symptoms of "intermittent locking" (due to a displaceable meniscus tear) may occur; symptoms occur when the meniscus tear is displaced and pain disappears after the dislodged meniscus fragment is reduced [1] Physical signs (including joint line tenderness, effusion, positive McMurray test or Apley grinding test) are always present, but once again are non-specific [1]
Surgical repair should be attempted as soon as possible in order to preserve the meniscus [1]
The tear may occur in a meniscus with pre-existing pathology (such as degeneration of meniscus, untreated chronic "traumatic" meniscus tear, or a developmental problem, such as a discoid meniscus) [1] Hence, there is NO or LOW potential of healing, even if surgical repair is attempted [1]
The tear may happen even if there is no injury; or after insignificant injury; or after significant knee injury [1] Onset of symptoms can be acute or insidious [1]
Primary degenerative meniscal lesions are more frequent in men than women; and occur in the fourth and fifth decades of life [1]
First-line management for degenerative meniscus tear should be conservative treatment [1] Meniscectomy can be considered for symptomatic patients who have undergone adequate non-operative treatment [1]
Critical Caveat:
Degenerated meniscus, including degenerative meniscus tears, are very common incidental findings on MRI in patients suffering from osteoarthritis of the knee [1] In patients suffering from concomitant osteoarthritis of the knee, patients' symptoms may or may not be related to the meniscus lesion [1] Caution should be exercised against the treatment of "incidental" meniscus lesions found on MRI in patients who have no symptoms of locking [1]
Exam Trap — Don't Operate on Incidental MRI Findings
An elderly patient with knee OA gets an MRI showing a meniscus tear. This does NOT automatically mean the meniscus tear is causing their symptoms. Many OA patients have degenerative meniscal tears that are asymptomatic. Operating on an incidental tear in an OA knee (arthroscopic meniscectomy) has been shown in multiple RCTs to be no better than sham surgery or conservative management. The lecture explicitly warns against this.
| Feature | Traumatic | Degenerative |
|---|---|---|
| Meniscal tissue quality | Healthy before injury | Pre-existing pathology (degeneration, discoid meniscus, chronic tear) |
| Healing potential | Yes — repair if possible | No/Low — even if repaired |
| Injury history | Always significant | None, insignificant, or significant |
| Symptom onset | Always acute | Acute or insidious |
| Age group | Typically younger (sports injuries) | 4th–5th decade (40s–50s) |
| Sex predominance | No specific (sports-related) | More frequent in men |
| Key symptom | Locking (acute or intermittent) | May have intermittent locking or just pain |
| First-line management | Early surgical repair (preserve meniscus) | Conservative treatment (physio, analgesics) |
| Role of meniscectomy | Only if repair is not possible (W-W zone) | For symptomatic patients who fail conservative Rx |
| Associated conditions | ACL tear (unhappy triad), other sport injuries | OA knee, discoid meniscus |
Clinical Approach Summary
- Mechanism: Twisting injury? Contact sport? Trivial injury? No injury?
- Onset: Acute (traumatic) vs insidious (degenerative)
- Symptoms: Pain pattern (mechanical?), swelling (timing of onset — immediate vs delayed), locking (true locking vs pseudolocking from pain), giving way
- Past history: Previous knee injuries, knee OA, previous meniscus surgery
- Age & activity level: Young athlete vs middle-aged/elderly sedentary patient
- Functional demands: Drives management decisions
- Look: Effusion, quadriceps wasting, alignment (varus/valgus)
- Feel: Joint line tenderness (medial vs lateral — localizes the affected meniscus)
- Move: Active and passive ROM — specifically check for loss of terminal passive extension (acute locking from bucket-handle tear)
- Special tests: McMurray test, Apley grinding test — but remember their limitations in both acute and chronic settings
- Assess for associated injuries: ACL (Lachman test, anterior drawer, pivot shift), MCL/LCL (valgus/varus stress), patellofemoral joint
- X-ray knee (AP, lateral, skyline): First-line. Usually unremarkable for isolated meniscus tear. Rules out fractures, OA, loose bodies.
- MRI knee: Definitive non-invasive investigation. Shows tear morphology, location, associated injuries.
- Diagnostic arthroscopy: Direct visualization. Now largely replaced by MRI for diagnosis; reserved for therapeutic arthroscopy.
- Conservative: For asymptomatic/mild degenerative tears, and as first-line for all degenerative tears
- Surgical repair: For traumatic tears in vascular zones (R-R, R-W) in patients with healing potential → repair ASAP
- Partial meniscectomy: For tears in W-W zone, degenerative tears failing conservative Rx, irreparable tears
- Meniscus transplant: For significant meniscal loss with symptoms; not available in HK
- Meniscectomy leads to accelerated OA — patient must understand this trade-off
- Repaired meniscus: 80–85% healing rate, requires protected rehabilitation (limited weight-bearing and ROM restrictions for weeks)
- Degenerative tears: explain that MRI findings may not correlate with symptoms; surgery is not always the answer
Exam Intelligence
- MCQ: "What is the most appropriate next investigation for a patient with mechanical knee pain and joint line tenderness?" → MRI
- MCQ: "Which zone of the meniscus has the best healing potential?" → R-R (Red-Red) zone, peripheral 3–4 mm
- SAQ: "Differentiate traumatic from degenerative meniscus tear" → Use the comparison table
- SAQ: "A 25-year-old footballer has acute locking of the knee after a twisting injury. What is the most likely diagnosis and management?" → Displaced bucket-handle tear → urgent meniscal repair
- MCQ: "Which meniscus bears more load?" → Lateral meniscus (70% of lateral compartment load)
- MCQ/SAQ: "What is the consequence of meniscectomy?" → Accelerated OA (loss of chondral protection, increased contact stress)
| Trap | Correct Understanding |
|---|---|
| "McMurray test is diagnostic for meniscus tear" | No — low specificity in acute injury, low sensitivity in chronic setting. Diagnosis is by MRI or arthroscopy. |
| "All meniscus tears need surgery" | No — asymptomatic/mild tears can be observed; degenerative tears start with conservative treatment. |
| "Meniscus tear in an OA knee should be operated on" | No — degenerative tears are often incidental findings on MRI. Don't treat the MRI, treat the patient's symptoms. |
| "Immediate swelling = meniscus tear" | No — immediate swelling = haemarthrosis = think ACL tear. Meniscus tear causes delayed effusion. |
| "Acute locking can be in any position" | No — acute locking from a bucket-handle tear specifically causes inability to fully extend passively. Intermittent locking and loose body locking can be in any position. |
| "Meniscal repair always works" | No — even in well-selected cases, only 80–85% healing rate. |
| Feature | ACL Tear | Meniscus Tear | Collateral Ligament Tear |
|---|---|---|---|
| Mechanism | Pivot/deceleration | Twist with foot planted | Valgus (MCL) or varus (LCL) force |
| Swelling timing | Immediate (haemarthrosis) | Delayed (effusion) | Variable |
| Key symptom | Instability/giving way | Locking | Pain on specific stress direction |
| Key sign | Lachman +ve, anterior drawer +ve | Joint line tenderness, McMurray | Valgus/varus stress test laxity |
| Imaging | MRI (gold standard) | MRI (gold standard) | MRI if severe; often clinical |
Integration with Related Lecture Material
The "unhappy triad" (O'Donoghue's triad) = ACL tear + MCL tear + medial meniscus injury [3]. When you see an ACL tear, always assess for meniscus injury. ACL reconstruction without addressing a concomitant meniscus tear leads to poor outcomes. Additionally, in the ACL-deficient knee, the medial meniscus acts as a secondary restraint to anterior tibial translation → it is at increased risk of tearing in chronic ACL deficiency.
Meniscectomy → loss of load distribution → Fairbank's changes → progressive OA. The 2025 Fourth Summative MCQ Q48 tests this concept: effective and evidence-supported treatment of knee OA includes knee replacement and (controversially) paracetamol, but NOT arthroscopic debridement or glucosamine [4].
The management framework from Part 1 applies: "Definitive management depends on whether the injured tissue can heal and whether it can restore normal function if allowed to heal" [2]. For meniscus:
- Can heal (traumatic, peripheral tear) → non-op or repair
- Cannot heal (degenerative, central tear) → observation or meniscectomy
Relevant Past Paper Questions
2025 Fourth Summative MCQ Q48 [4]:
"A 68-year-old lady suffered from left knee mechanical pain for 3 years. X-ray of the left knee showed reduced joint space in the medial compartment with marginal osteophyte formation. Which of the following is an effective and evidence-supported treatment of knee osteoarthritis? A. Arthroscopic debridement B. Glucosamine C. Knee replacement D. Paracetamol"
Correct Answer: C. Knee replacement
Rationale: This question directly relates to the lecture's warning against treating incidental meniscal lesions in OA knees with arthroscopic debridement. Multiple RCTs (MOSAIC trial, Sihvonen et al.) have shown arthroscopic debridement/meniscectomy is no better than sham surgery for OA knees. Glucosamine has no strong evidence. Paracetamol has limited efficacy for OA. Knee replacement is the definitive evidence-supported treatment for end-stage OA. Note: The lecture's point about caution against treating "incidental" MRI meniscal lesions in OA patients directly supports why answer A is wrong.
(No other directly relevant meniscus-specific questions were identified in the indexed past papers. The lecture content is more likely to appear as part of composite orthopaedic MCQs or SAQs testing the broader knee injury series.)
High Yield Summary
Meniscus Anatomy: Two fibrocartilage crescents between femoral condyle and tibial plateau. Aneural, avascular (relative), alymphatic. Blood supply from periphery only via genicular arteries → perimeniscal capillary plexus. Three vascular zones: R-R (peripheral, heals), R-W (middle, may heal), W-W (central, won't heal).
Function: Load transmission (medial 50%, lateral 70% of compartment load; 50% in extension, 85% in flexion), shock absorption, secondary stabilization, lubrication, cartilage nutrition. Hoop stress mechanism depends on intact roots and circumferential collagen.
Symptoms: Mechanical pain, delayed-onset swelling, locking, giving way. Pain can occur at injury, 1–2 months post-injury, at locking, or with secondary OA.
Signs: Joint line tenderness, effusion, reduced ROM, McMurray/Apley tests (low specificity acutely, low sensitivity chronically).
Diagnosis: X-ray (rule out other pathology) → MRI (definitive) or arthroscopy.
Management: Non-operative (asymptomatic/mild) → Meniscus repair (traumatic, vascular zone, 80–85% success) → Meniscectomy (non-healable tears, symptomatic; warn about accelerated OA) → Transplant (significant loss, not in HK).
Traumatic vs Degenerative: Traumatic = healthy tissue, significant injury, acute onset, healing potential, repair ASAP. Degenerative = pre-existing pathology, 4th–5th decade, no/low healing potential, conservative first. Don't operate on incidental degenerative tears in OA knees.
Active Recall - Lecture Notes
GC230 Knee Sport Injuries: Part 2
Continuation of knee sport injuries covering conditions such as meniscal tears, collateral and cruciate ligament injuries, and associated soft tissue damage resulting from athletic activities.
GC230 Knee Sport Injuries: Part 4
Knee sport injuries Part 4 covers posterior cruciate ligament (PCL) injuries and posterolateral corner injuries, including their mechanisms, clinical assessment, and management principles.