Meniscus tears treatment: The good, the bad and the ugly-patterns classification and practical guide

Table 1 The classification of meniscus lesions and the recommended treatment for each tear pattern

	Suggested treatment	Secondary treatment
Good lesions
Stable longitudinal tears	Repair of peripheral tears	Peripheric small tears of the lateral meniscus can be left in situ because of the low risk of subsequent meniscectomy
Small flap tears	Partial meniscectomy of small lesions in the avascular zone of the meniscus
Bad lesions
Bucket handle tears	Repair with dedicated technique according to the lesion features	Meniscectomy of isolated medial bucket handle tears must be discussed with patients
Ramp lesions	Conservative treatment should be considered as first-line for degenerative tears	Surgical treatment of degenerative tears should be considered when conservative approach failed or in presence of mechanical symptoms
Lateral posterior root tears
Degenerative tears (big flap tears, horizontal tears, complex tears)
Ugly lesions
Radial tears	Repair must be attempted aiming at preserving meniscus function	Valgus or varus osteotomy needs to be considered in case of limb malalignment
Medial posterior root tears
Anterior root tears