Vol. 9, Issue 4, Part A (2025)

Meniscal tears are among the most frequently encountered intra-articular knee injuries, affecting both athletic and non-athletic populations across a wide age spectrum. Advances in arthroscopic techniques and improved understanding of meniscal biomechanics have shifted treatment paradigms from routine meniscectomy toward preservation-oriented strategies. However, the decision to repair or simply manage meniscal tears arthroscopically remains controversial, particularly in cases involving degenerative tears, stable peripheral lesions, or asymptomatic findings. While meniscal repair offers theoretical advantages in maintaining joint biomechanics and reducing long-term osteoarthritic changes, not all tear patterns are amenable to repair, and unnecessary intervention may expose patients to avoidable risks and prolonged rehabilitation. This review explores the role of simple arthroscopic management approaches, including partial meniscectomy and selective non-repair strategies, in the treatment of meniscal tears. Emphasis is placed on tear morphology, vascular zone involvement, patient age, activity level, and associated ligamentous injuries as critical determinants guiding treatment decisions. Recent clinical evidence suggests that appropriately selected patients can achieve favorable functional outcomes without formal meniscal repair, particularly when tears are stable, degenerative, or located in avascular regions. Furthermore, emerging data question the universal application of repair techniques, highlighting comparable short- to mid-term outcomes between repair and non-repair strategies in select scenarios. By critically examining current evidence, this article aims to clarify whether all meniscal tears truly require repair or if simpler arthroscopic interventions can provide equivalent clinical benefits. Understanding these distinctions is essential for optimizing patient outcomes, minimizing surgical morbidity, and preserving knee joint health. The findings support an individualized, evidence-based approach to meniscal tear management rather than a one-size-fits-all repair philosophy.