5. Dr. Elizabeth Matzkin: Management of Meniscus Tears - Part I

On today’s episode we’re focusing on meniscus tears with Dr. Elizabeth Matzkin, Orthopedic Surgeon at Brigham and Women’s Hospital and Chief of Women’s Sports Medicine. We have some great articles for you today that really contribute well this conversation on how to best manage various types of meniscus tears across different age groups.Dr. Matzkin specializes in sports medicine, knee and shoulder surgery. She is an attending surgeon and Chief of Women’s Sports Medicine at Brigham and Women’s Hospital . Dr. Matzkin earned her MD from Tulane Medical School. She completed her orthopedic residency at the University of Hawaii and then went on to complete a fellowship in sports medicine at Duke. Dr. Matzkin currently serves as a team physician for the U.S. Women’s National Soccer Team, U.S. Paralympics Soccer Team, U.S. Women’s National Hockey Team, and is the head team physician of Stonehill College. She is passionate about the care of female athletes and has dedicated much of her research to focusing on sex differences in musculoskeletal medicine. The first paper is from the April issue of AJSM, titled Long-term National Trends of Arthroscopic Meniscal Repair and Debridement. It is a descriptive epidemiology study specifically looking at ABOS case collections. For our listeners that may not know what that means, orthopedic surgeons in their first year of practice are required to prospectively record their cases over a 6 month period and submit those to the American Board of Orthopedic Surgery for evaluation. So, this data is thought to be a good surrogate for the current state of orthopedic education, and can highlight the newest shifts in treatment. Wasserburger et al found that, over the past 10 years, the rate of meniscus debridement has steadily decreased while the rate of meniscus repair has increased. Younger patient age and treatment by a sports medicine surgeon were associated with a higher likelihood of repair.We then focus specifically on meniscus root tears and review the publication Outcomes of Arthroscopic All-Inside Repair Versus Observation in Older Patients with Meniscus Root Tears from the April 2020 issue of AJSM. Dragoo and colleagues at Stanford described their technique for all-inside meniscus root repair using a side-to-side reduction suture between the posterior horn and remaining posterior root tissue, followed by a mattress suture to tether the meniscus to the posterior capsule, thereby reinforcing the repair. The authors showed improved functional outcomes and decreased rate of total knee replacement compared to non-op treatment of root tears in patients with moderate arthritis.