The meniscus

This account traces more than a century of thinking and practice around meniscus injuries, a field where treatment has repeatedly been shaped by contested scientific claims. It opens with the era when surgeons would manipulate a locked knee to free a bucket-handle or flap tear and restore movement.

The book then follows the move toward removing the damaged cartilage. Some surgeons took out the meniscus in thousands of patients and displayed the removed pieces as trophies in large glass jars. Debate followed over whether only the torn portions should be cut away or the whole meniscus removed, a position Smillie championed, since Mandic had observed a meniscus-shaped tissue reforming after complete excision. Trillat's intramural resection later preserved the stabilizing outer rim and its ligamentous and capsular attachments, protecting rotational stability.

Earlier efforts are also covered. Thomas Annandale in 1883 and Moritz Katzenstein in 1908 attempted to suture menisci back into place, with Katzenstein reporting a series of good results. In 1921, Eugen Bircher carried out the first diagnostic knee arthroscopy for internal derangement using an ordinary Jacobaeus laparoscope. The text closes by noting that the menisci's central role in knee motion, load distribution and rotational stability is now firmly established.