The history of meniscal-surgery

In comparison with other operative procedures, the history of meniscal-surg ery offers some particular differences. Over a long period of time injuries of the semilunar-cartilages of the knee-joint were not generally recognise d. In the 18th century only was the clinical picture roughly outlined. Ther e is evidence, that parts of the meniscus were removed much earlier than we have historic proof of. These meniscal fragments were generally mistaken f or "loose bodies" in the joints, not knowing the exact etiology. Operative interference with joints was afflicted with a Very high incidence of infect ions and thus complications. Due to this reliable standards of sterility we re imperative to obtain reproductive and satisfactory results in surgery of the knee-joint and this is why the discovery and implementation of antisep tic and aseptic principles play such an important role in joint- and, in pa rticular, in meniscal-surgery. The development of meniscal-surgery is dominated by a lenghty discussion ab out the way in which the injuries of the semilunar cartilages should be dea lt with operatively. Fundamental techniques such as fixation of the cartila ge by sutures, limited or total removal of the meniscus were established as early as 1895. Over a long period they existed concurrently and their adeq uate application remained cause for a highly controversial discussion until the end of the 20th century. Not before more detailed knowledge was gained about the exact morphology of the meniscus and the rising of arthroscopic surgery offered new surgical perspectives, it was possible to establish a w idely accepted standard of meniscal surgery.