Contemporary Diagnostic and Therapeutic Strategies for Knee Meniscal Injuries: A Review

Abstract

Meniscal injuries represent one of the most prevalent and clinically consequential musculoskeletal conditions encountered in orthopaedic and sports medicine practice, affecting a broad demographic spectrum ranging from young competitive athletes to elderly patients with degenerative joint disease. The menisci fulfil indispensable biomechanical roles within the tibiofemoral joint, including load transmission, shock absorption, stabilisation, and lubrication, and their preservation is increasingly recognised as fundamental to the long-term health of the knee. Over the past two decades, the management of meniscal injuries has undergone significant evolution, driven by robust clinical trial evidence that has challenged longstanding surgical conventions and redirected practice towards conservative, tissue-preserving approaches. This review critically appraises current knowledge across the full spectrum of meniscal injury, encompassing pathoanatomy, tear classification, clinical diagnosis, imaging assessment, and the complete range of therapeutic strategies from structured rehabilitation to arthroscopic intervention, allograft transplantation, biological augmentation, and emerging tissue engineering technologies. Particular attention is given to randomised controlled trials demonstrating the equivalence of exercise-based rehabilitation to arthroscopic partial meniscectomy for degenerative tears, and to the growing evidence base supporting meniscal repair as the preferred surgical strategy for appropriate lesions. The roles of platelet-rich plasma, mesenchymal stem cell therapy, scaffold-based implants, and three-dimensional bioprinting in meniscal regeneration are reviewed alongside the current limits of the clinical evidence. The article identifies critical gaps in knowledge and proposes future research priorities to guide practice in this rapidly advancing field.