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Meniscus repair, meniscus allograft

Morgan H Jones, Kurt P Spindler
The Multicenter Orthopaedic Outcomes Network (MOON) is an NIH-funded prospective, longitudinal cohort of over 3,500 patients who have undergone anterior cruciate ligament reconstruction (ACLR) by 14 sports medicine surgeons at 7 academic medical centers. Patient reported outcome questionnaires (PRO's) are completed at baseline and multiple timepoints after surgery, and a nested cohort of patients return for radiographs to assess the development of joint space changes. We review the risk factors for worse patient reported outcomes, the predictors of clinically significant symptoms of post-traumatic osteoarthritis (PTOA), and the factors associated with more radiographic joint space narrowing...
July 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Yunbin Chen, Jiaxin Chen, Zeng Zhang, Kangliang Lou, Qi Zhang, Shengyu Wang, Jinhu Ni, Wenyue Liu, Shunwu Fan, Xianfeng Lin
The increasing rate of injuries to the meniscus indicates the urgent need to develop effective repair strategies. Irreparably damaged menisci can be replaced and meniscus allografts represent the treatment of choice; however, they have several limitations, including availability and compatibility. Another approach is the use of artificial implants but their chondroprotective activities are still not proved clinically. In this situation, tissue engineering offers alternative natural decellularized extracellular matrix (ECM) scaffolds, which have shown biomechanical properties comparable to those of native menisci and are characterized by low immunogenicity and promising regenerative potential...
March 31, 2017: Cell and Tissue Research
Rachel H Koh, Yinji Jin, Byung-Jae Kang, Nathaniel S Hwang
Current meniscus tissue repairing strategies involve partial or total meniscectomy, followed by allograft transplantation or synthetic material implantation. However, allografts and synthetic implants have major drawbacks such as the limited supply of grafts and lack of integration into host tissue, respectively. In this study, we investigated the effects of conditioned medium (CM) from meniscal fibrochondrocytes and TGF-β3 on tonsil-derived mesenchymal stem cells (T-MSCs) for meniscus tissue engineering. CM-expanded T-MSCs were encapsulated in riboflavin-induced photocrosslinked collagen-hyaluronic acid (COL-RF-HA) hydrogels and cultured in chondrogenic medium containing TGF-β3...
April 15, 2017: Acta Biomaterialia
Jong-Min Kim, Seong-Il Bin, Bum-Sik Lee, Nam-Ki Kim, Ju-Ho Song, Jun-Weon Choi, Chang-Rack Lee
PURPOSE: To investigate the long-term clinical results and clinical survival rate of meniscus allograft transplantation (MAT) with bone fixation. METHODS: The inclusion criteria of this study were previous MAT with bone fixation technique in our institution and minimum follow-up duration of 8 years. Potential subjects were identified using the medical records and database that was prospectively collected from December 1996 to December 2005. The exclusion criteria were diffuse International Cartilage Repair Society grade IV articular cartilage degeneration that was not treated with a concomitant or staged cartilage repair procedure...
February 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Alaina M Brelin, John-Paul H Rue
Meniscus tears are commonly encountered in the athletic population and can result in significant loss of playing time. Current treatment methods for acute tears consist of meniscectomy and meniscal repair, whereas meniscal allograft transplant is reserved as a salvage procedure for symptomatic meniscectomized patients who desire a more functional knee. This review describes the postoperative rehabilitation protocol for each procedure and evaluates the outcomes in existing literature as it pertains to the athlete...
October 2016: Clinics in Sports Medicine
Jorge Chahla, Javier Olivetto, Chase S Dean, Raphael Serra Cruz, Robert F LaPrade
The lateral meniscus plays a critical role in the stability and health of the knee. Treating patients who have undergone a total lateral meniscectomy or functional equivalent is challenging, especially young and active patients. Current literature regarding meniscal tears supports that repair should be the first surgical option. Moreover, it is recommended to preserve as much meniscal tissue as possible. In cases in which a total or functional meniscectomy is a pre-existing condition, a lateral meniscal allograft transplantation is a possible option...
April 2016: Arthroscopy Techniques
Javier Vaquero, Francisco Forriol
OBJECTIVE: the menisci are easily injured and difficult to repair. The aim of this study was to analyze the current state of meniscal surgery aimed at preserving morphology and conserving the biomechanics of the knee to prevent joint degeneration. METHODOLOGY: a search of the electronic medical literature database Medline was conducted, from The search was not limited by language. Candidate articles were identified by searching for those that included the keywords meniscus, surgery, suture, implant, allograft...
January 2016: Muscles, Ligaments and Tendons Journal
Chase S Dean, Javier Olivetto, Jorge Chahla, Raphael Serra Cruz, Robert F LaPrade
The medial meniscus is crucial for knee homeostasis. Treating patients who have undergone a subtotal or total meniscectomy, or equivalent irreparable tear pattern, can be extremely challenging, especially in young, active patients. The importance of meniscal preservation has been reported by several authors. Meniscal repair is now widely accepted as the first surgical option for treating medial meniscal tears. Moreover, current guidelines recommend preserving as much meniscal tissue as possible. Treating a symptomatic medial meniscectomized knee is challenging because of limited surgical options...
April 2016: Arthroscopy Techniques
Ji Hyun Ahn, Ho Won Kang, Tae Yeong Yang, Jang Yun Lee
PURPOSE: To identify risk factors that predict radiographic progression of osteoarthritis after meniscus allograft transplantation (MAT) using multivariate logistic regression. METHODS: Inclusion criteria were consecutive patients who underwent medial or lateral MATs from January 2005 to September 2012 by one surgeon. Exclusion criteria were lack of postoperative magnetic resonance image, loss to follow-up for a minimum of 3 years, and simultaneous surgery on articular cartilage or the anterior cruciate ligament...
December 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Dhong Won Lee, Jin Goo Kim, Jeong Ku Ha, Woo Jong Kim
The optimal treatment for combined osteochondritis dissecans (OCD) with considerable bony defect of the lateral femoral condyle (LFC) and torn discoid lateral meniscus is unclear. We present a case of a 15-year-old female who was a gymnast and had a large OCD lesion in the LFC combined with deficiency of the lateral meniscus. The patient underwent the "one-step" technique of osteoperiosteal autologous iliac crest graft and lateral meniscus allograft transplantation after a failure of meniscectomy with repair at another hospital...
June 2016: Knee Surgery & related Research
David D Lin, Natasha E Picardo, Adetola Adesida, Wasim S Khan
Meniscal injury is a common problem among sportsmen and increasingly seen in the older and more active population. The traditional treatment options include a partial meniscectomy, which provides good mechanical and pain relief to the patient. However, the focus of treatment is shifting towards repairing meniscal tears where possible and replacement of the lost meniscal tissue where appropriate. Replacement can be total or partial. Total meniscal replacement using an allograft, is usually reserved for young patients, who meet certain criteria and who have undergone several subtotal meniscectomies or a single stage total meniscectomy and are still symptomatic...
2017: Current Stem Cell Research & Therapy
Ji Hyun Ahn, Ho Won Kang, Tae Yeong Yang, Jang Yun Lee
PURPOSE: To identify risk factors that predict major graft extrusion (>3 mm in relation to the margin of the tibial plateau) on magnetic resonance imaging (MRI) after lateral meniscus allograft transplantation (MAT) using multivariate logistic regression. METHODS: In this retrospective trial, inclusion criteria were consecutive lateral MATs from January 2004 to June 2013. Exclusion criteria were the lack of postoperative MRI, loss to follow-up for minimum 2 years, and simultaneous surgery of the articular cartilage or anterior cruciate ligament...
July 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Hiroshi Ohuchi
Performing an all-inside repair or inside-out fixation for the posterior third in meniscus allograft transplantation is discussed. Less invasiveness is always important when the results are the same, and surgeons' personal experience may be a determining factor for this procedure.
February 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Bum-Sik Lee, Seong-Il Bin, Jong-Min Kim, Jae Hyan Kim, Geun-Won Han
BACKGROUND: Candidates for meniscal allograft transplantation (MAT) often already have a significant cartilage lesion when they present with a symptomatic knee. However, the level of symptoms required for MAT to be performed is poorly defined, leading to difficulties in selecting patients and the potential for further cartilage loss. PURPOSE: To evaluate if various clinical evaluation scores reflect the articular cartilage status of the lateral compartment preoperatively in symptomatic, lateral meniscus-deficient knees...
March 2016: American Journal of Sports Medicine
Bum-Sik Lee, Seong-Il Bin, Jong-Min Kim
BACKGROUND: Little is known about the degree of articular cartilage degeneration after subtotal/total lateral meniscectomy in patients who later undergo isolated lateral meniscal allograft transplantation (LMAT). It has not yet been studied whether arthritic changes as shown on radiographs were lower during the posttransplantation period than during the meniscus-deficient period. HYPOTHESIS: Articular cartilage will significantly degenerate during the meniscus-deficient period, but the progression in radiographic arthrosis is reduced after LMAT...
January 2016: American Journal of Sports Medicine
Brian C Werner, Scott Yang, Austin M Looney, Frank Winston Gwathmey
BACKGROUND: With the increasing involvement in organized athletics among children and adolescents, more anterior cruciate ligament (ACL) injuries are being recognized in the skeletally immature population. The goal of the present study is to utilize a national database to characterize the recent epidemiologic trends of ACL injuries, ACL reconstruction, and treatment of associated meniscal and chondral pathology in the pediatric and adolescent populations. METHODS: A national database was queried for ACL tear (ICD-9 844...
July 2016: Journal of Pediatric Orthopedics
Jin Zhang, Guan-Yang Song, Xing-Zuo Chen, Yue Li, Xu Li, Jun-Lin Zhou
BACKGROUND: Many studies suggest that the gamma irradiation decreases allograft strength in a dose-dependent manner. However, no study has demonstrated that this decrease in strength translates into higher failure rate in meniscal allograft transplantation (MAT). The aim of this study was to investigate the effects of gamma irradiation on macroscopic and histological alterations of transplanted meniscal tissue and joint cartilage after MAT. METHODS: Medial total meniscectomies were performed on the right knees of 60 New Zealand white rabbits...
May 20, 2015: Chinese Medical Journal
N A Smith, M L Costa, T Spalding
The anatomy and microstructure of the menisci allow the effective distribution of load across the knee. Meniscectomy alters the biomechanical environment and is a potent risk factor for osteoarthritis. Despite a trend towards meniscus-preserving surgery, many tears are irreparable, and many repairs fail. Meniscal allograft transplantation has principally been carried out for pain in patients who have had a meniscectomy. Numerous case series have reported a significant improvement in patient-reported outcomes after surgery, but randomised controlled trials have not been undertaken...
May 2015: Bone & Joint Journal
Roger Menta, Scott Howitt
Meniscal allograft transplantation (MAT) is a relatively new procedure that has gained popularity in the last couple of decades as a possible alternative to a meniscectomy to provide significant pain relief, improve function, and prevent the early onset of degenerative joint disease (DJD). As of present, evidence is limited and conflicting on the success of such procedures. In this case, a 16-year old male athlete underwent numerous surgical procedures to correct a left anterior cruciate ligament (ACL) rupture with associated medial and lateral meniscal damage that occurred as a result of a non-contact mechanism of injury...
December 2014: Journal of the Canadian Chiropractic Association
Kevin R Stone, Jonathan R Pelsis, Scott T Surrette, Ann W Walgenbach, Thomas J Turek
PURPOSE: The purpose of this study was to evaluate the efficacy of meniscus allograft transplantation in an active patient population with moderate to severe cartilage damage and the procedure's ability to allow sports participation postoperatively. METHODS: Forty-nine patients with moderate to severe cartilage damage who underwent meniscus allograft transplantation were included in this study; those with symptoms related to articular cartilage damage also underwent articular cartilage repair...
January 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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