Semilunar cartilage refers to the medial crescent-like shape or lateral cartilages of the knee joint between the femur and the tibia. In this case, the involved joint is the knee.

Indications for removal of the semilunar cartilage may include: disease, such as arthritic degenerative diseases; trauma; congenital anomalies; cysts; infection or metabolic disorders.

Signs and symptoms may include: effusion or increased production of synovial fluid; pain; swelling; inflammation; popping sensation; locking; giving way sensation; instability; inability to bear weight; or catching sensation.

Tests which are carried out include: physical examination, and range of motion tests such as McMurrays sign. In addition, contrast arthrogram, magnetic resonance imaging (MRI), or arthroscopy may be done to confirm a diagnosis.

A partial or complete meniscectomy may be indicated for certain congenital disorders. Surgical removal of only damaged areas may be indicated to preserve as much healthy meniscus as possible. Routine total removal of the meniscus is obsolete. In the early postoperative period, physical therapy may be initiated to restore range of motion and muscle strength. Medication for pain or inflammation may be given.

There may be immobility for a limited period after surgery. The development of osteoarthrosis or avascular necrosis is possible. The need for rehabilitation may be prolonged.

• The rating schedule for musculoskeletal was updated on February 7, 2021. Protection still does apply and should be considered with existing evaluations (38 CFR 3.951(a)).

• Evaluation of a knee disability under 38 CFR 4.71a, DC 5257, DC 5260, or 5261 does not, as a matter of law, violate 38 CFR 4.14.or preclude separate evaluation of a meniscal disability of the same knee under

  • 38 CFR 4.71a, DC 5258 (dislocated semilunar cartilage), or

  • 38 CFR 4.71a, DC 5259 (symptomatic removal of semilunar cartilage).

  • A repaired meniscal tear (s/p partial meniscectomy) is not directly synonymous with 38 CFR 4.71a, DC 5259. Therefore, it is most appropriate to rate the disability analogous to whichever code most closely approximates the current symptoms.

  • Evaluation of the same manifestation under multiple diagnoses is prohibited under 38 CFR 4.14.  Thus, when all the symptoms of the meniscal disability are used to support elevation of an evaluation under 38 CFR 4.71a, DC 5260/5261 or assignment of an evaluation under 38 CFR 4.71a, DC 5257, a separate evaluation cannot be assigned under 38 CFR 4.71a, DC 5258/5259.

• Also, please refer to the GC opinion (VAOGCPREC9-98) dated August 1998, which held:

  • DC 5259 requires consideration of sections 4.40 and 4.45 because removal of the semilunar cartilage may result in complications producing loss of motion. Depending on the nature of the foot injury, DC 5284 may involve limitation of motion and therefore require consideration under sections 4.40 and 4.45.

• None.