Preserving the Meniscus: Modern Strategies from Biology to Reconstruction

The meniscus is now recognized as a critical load-sharing, stabilizing and chondroprotective structure, and its loss is closely linked to early osteoarthritis. Over the past decade, the field has moved from routine resection to a preservation-first philosophy. Advances in root repair, ramp lesion recognition, biologic augmentation, alignment correction and transplantation have changed what is possible. Yet evidence remains scattered across subspecialty literature, and key populations, particularly children and adolescents, and key decisions, such as when resection is still appropriate, are rarely addressed together.This Research Topic brings together original research, reviews and technical contributions that cover the full pathway of modern meniscus care. We aim to build a coherent, evidence-based reference for orthopedic and surgical practice, and to identify where robust data are still missing.We welcome contributions on, but not limited to:Meniscus foundations: Anatomy, vascularity, cell biology, healing biology and biomechanics, including load transmission, kinematics and the consequences of meniscal deficiency.Discoid meniscus: Diagnosis, imaging, classification (including instability patterns), saucerization and repair strategies, and outcomes of this congenital variant.Pediatric and adolescent meniscus injury: Age-specific diagnosis, treatment selection, healing potential, return to sport and rehabilitation, including physeal and growth considerations.Meniscus root tears: Biomechanical consequences, transtibial and suture anchor repair techniques, augmentation, and clinical and radiographic outcomes.Meniscus repair techniques: Current and emerging approaches to preserve tissue, including all-inside, inside-out and outside-in methods, biologic augmentation, and repair of complex or degenerative tears.Ramp lesions: Recognition, imaging, associated ACL injury and instability, and repair strategies. We treat these as more than an isolated meniscus injury.Mechanical alignment and meniscus preservation: The role of osteotomy and guided growth in protecting repaired or reconstructed menisci.Partial meniscectomy: Does it still have a role? Indications, long-term outcomes versus repair and nonoperative care, and decision-making in degenerative tears.Segmental meniscal transplantation: Novel techniques for reconstructing segmental defects, and early and mid-term results.Meniscus allograft transplantation: Indications, surgical techniques, graft selection and processing, and long-term survivorship and outcomes. Topic editors: Jason G Ina, Joseph T Featherall Source: https://www.frontiersin.org/research-topics/86965/preserving-the-meniscus-modern-strategies-from-biology-to-reconstruction