The shocking truth about meniscus

The menisci of the knee are structures integral to the long term health of the knee joint. The primary function of these tissues is to distribute load across the tibiofemoral joint by increasing the congruency of the joint, thereby decreasing the resultant stress experienced by the articular cartilages. The menisci also play a secondary role in stabilizing the joint, particularly in the anterior cruciate ligament deficient knee, and also have roles in joint lubrication and proprioception. Also, an oft-cited role of this tissue is that of a shock absorber. We will review the literature supporting this shock absorption paradigm and describe the limitations and errors in the conclusions made by these studies. Consequently, we will show that the literature is inconclusive with no support for the shock absorption paradigm, which should therefore not be stated as a function of the menisci. We will describe how one of the three articles in support of this paradigm actually could be interpreted to the contrary and support the idea that the menisci may play no significant role in shock absorption at the knee at all, with the two remaining papers being inconclusive. (C) 2011 Elsevier Ltd. All rights reserved.