Original Article| Volume 36, ISSUE 2, P501-512, February 2020

Degenerative Meniscus Lesions: An Expert Consensus Statement Using the Modified Delphi Technique

Published:December 31, 2019DOI:


      The purpose of this study was to perform an evidence-based, expert consensus survey using the Delphi panel methodology to develop recommendations for the treatment of degenerative meniscus tears.


      Twenty panel members were asked to respond to 10 open-ended questions in rounds 1 and 2. The results of the first 2 rounds served to develop a Likert-style questionnaire for round 3. In round 4, the panel members outside consensus were contacted and asked to either change their score in view of the group's response or argue their case. The level of agreement for round 4 was defined as 80%.


      There was 100% agreement on the following items: insidious onset, physiological part of aging, tears often multiplanar, not all tears cause symptoms, outcomes depend on degree of osteoarthritis, obesity is a predictor of poor outcome, and younger patients (<50 years) have better outcomes. There was between 90% and 100% agreement on the following items: tears are nontraumatic, radiographs should be weightbearing, initial treatment should be conservative, platelet-rich plasma is not a good option, repairable and peripheral tears should be repaired, microfracture is not a good option for chondral defects, the majority of patients obtain significant improvement and decrease in pain with surgery but results are variable, short-term symptoms have better outcomes, and malalignment and root tears have poor outcomes.


      This consensus statement agreed that degenerative meniscus tears are a normal part of aging. Not all tears cause symptoms and, when symptomatic, they should initially be treated nonoperatively. Repairable tears should be repaired. The outcome of arthroscopic partial meniscectomy depends on the degree of osteoarthritis, the character of the meniscus lesion, the degree of loss of joint space, the amount of malalignment, and obesity. The majority of patients had significant improvement, but younger patients and patients with short-term symptoms have better outcomes.

      Level of Evidence

      Level V – expert opinion.
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      Linked Article

      • Erratum
        ArthroscopyVol. 36Issue 10
        • Preview
          In the article “Degenerative Meniscus Lesions: An Expert Consensus Statement Using the Modified Delphi Technique,” published in the February 2020 issue (Arthroscopy 2020;36:501-512), the name of author Brad Gelbart was misspelled. The article has since been corrected online.
        • Full-Text
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      • Editorial Commentary: Degenerative Meniscal Tear: Sojourn to the Oracle
        ArthroscopyVol. 36Issue 2
        • Preview
          Degenerative meniscal tears are prevalent and give rise to more than 400,000 arthroscopic partial meniscectomies annually in the United States. These lesions often occur in the setting of knee osteoarthritis and are generally regarded as a component of the tissue damage (to cartilage, meniscus, bone, synovium among others) that comprises osteoarthritis. A wide array of clinicians, ranging from orthopaedic surgeons to general practitioners, regularly encounter symptomatic degenerative meniscal tears, especially among patients with knee osteoarthritis.
        • Full-Text
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