Sports Medicine, Arthroscopy and Soft-Tissue Injuries
Core rules
- Meniscal tears: preserve tissue when possible; red–red zone peripheral tears may repair, while unstable mechanical symptoms may need meniscectomy.
- ACL rupture causes instability; reconstruction is considered for active patients, but rehabilitation and graft choice are shared decisions.
- Shoulder instability is assessed by direction, degree and associated labral or bone loss; recurrent dislocation with glenoid bone loss changes surgery.
- Rotator cuff disease ranges from tendinopathy to full-thickness tears; examination and imaging guide non-operative versus repair.
- Return to sport depends on strength, pain, function and sport-specific criteria, not time alone.
Worked example
A 22-year-old footballer pivots and feels a pop with immediate swelling. Reasoning: suspect ACL rupture, examine for instability and associated meniscal injury, obtain MRI, begin prehabilitation, and discuss reconstruction plus graft options. Delay return until strength and neuromuscular control meet criteria.
Traps
Do not repair every meniscal tear. Do not ignore bone loss in recurrent shoulder dislocation. Do not clear an athlete by calendar date.
Key points are listed separately.