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Meniscus allograft

Jae-Young Park, Tae-Joon Cho, Myung Chul Lee, Hyuk-Soo Han
A case of anterior cruciate ligament (ACL) reconstruction with meniscal repair in an osteogenesis imperfecta patient is reported. A 24-year-old female with osteogenesis imperfecta type 1a suffered from a valgus extension injury resulting in tear of ACL and medial meniscus. She underwent an arthroscopic-assisted ACL reconstruction and medial meniscus repair. Meniscal tear at the menisco-capsular junction of the posterior horn of medial meniscus was repaired with three absorbable sutures via inside-out technique...
March 20, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Michael A Zacchilli, Amos Z Dai, Eric J Strauss, Laith M Jazrawi, Robert J Meislin
The meniscus plays a vital role in knee biomechanics, and its physical absence or functional incompetence (e.g., irreparable root or radial tear) leads to unacceptably high rates of joint degeneration in affected populations. Meniscal allograft transplantation has been used successfully to treat patients with postmeniscectomy syndrome, and there is early laboratory and radiographic evidence hinting at a potential prophylactic role in preventing joint degeneration. We present a technique for lateral meniscal allograft transplantation using the CONMED Meniscal Allograft Transplantation system...
December 2017: Arthroscopy Techniques
Darren de Sa, Ajaykumar Shanmugaraj, Melissa Weidman, Devin C Peterson, Nicole Simunovic, Volker Musahl, Olufemi R Ayeni
The all-inside technique (AIT) for anterior cruciate ligament reconstruction (ACLR) is gaining popularity as a more anatomic, less invasive, technique with the potential for more rapid recovery. This systematic review aims to critically assess components of the technique, its safety profile, outcomes, and complications. PUBMED, EMBASE, and MEDLINE were searched for studies discussing primary ACLR using the AIT. Article screening, quality assessment, and data abstraction were completed in duplicate, and a minimal clinically important difference (MCID) was used to frame the descriptive results in a clinically significant context...
February 8, 2018: Journal of Knee Surgery
Timothy B Pekari, Kevin C Wang, Eric J Cotter, Nicholas Kusnezov, Brian R Waterman
The purpose of this investigation is to report on trends over time in the treatment of meniscal pathology among military orthopaedic surgeons, as well as to evaluate the impact of patient demographics and concomitant procedure on the type of meniscal procedure performed. We performed a retrospective analysis of all active-duty United States military servicemembers who underwent a meniscal procedure from 2010 to 2015 within the Military Health System. Patient demographics and surgical variables were extracted from the electronic medical record...
March 7, 2018: Journal of Knee Surgery
Ahmed Mahmoud, James Young, Joanne Bullock-Saxton, Peter Myers
PURPOSE: To evaluate the survivorship of meniscal allograft transplantations (MATs), their clinical outcomes, and to compare the effect of perioperative cartilage status on survivorship. METHOD: A consecutive series of MATs with a minimum postsurgical time of 4 years were included from a prospectively collected database from 2001 to 2015. Mechanical failure was defined as transplant removal or knee arthroplasty. The effect of peri-operative cartilage status on survivorship was analyzed using a Kaplan-Meier analysis...
February 23, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Christian Stärke, Christoph Hubertus Lohmann, Sebastian Kopf
Development of meniscus replacements requires in-depth knowledge of the material properties and biomechanical behavior of the native meniscus. The compressive properties are of particular interest in this context, which are often assessed with indentation tests. However, those tests are usually done on isolated tissue specimens ex situ, which could have a significant impact on the results. It was, therefore, the goal of the study to assess the stiffness of the meniscus tissue in situ in porcine specimens and to compare it to that of artificial substitutes...
February 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Ya-Dong Zhang, Shu-Xun Hou, Hong-Bin Zhong, Yi-Chao Zhang, Dian-Zhong Luo
The present study describes a novel all-arthroscopic technique for medial and lateral meniscal allograft transplantation (MAT). Surgical instruments were specifically designed to assist in the all-arthroscopic approach for MAT. The bone plug attachment technique, either the arthroscopic-assisted or all-arthroscopic approach, attaches bone plugs to the anterior and posterior horns. In the present study, two sets of surgical implements were designed: One to produce bone plugs of predefined sizes in the anterior and posterior horns of the allograft meniscus (bone plug implements) and a second to create bone tunnels in the receptor tibial plateau to hold the bone plugs (bone tunnel implements)...
March 2018: Experimental and Therapeutic Medicine
Dhong Won Lee, Jung Ho Park, Kyu Sung Chung, Jeong Ku Ha, Jin Goo Kim
The efficacy of meniscus allograft transplantation (MAT) for the meniscus-deficient knee has been widely recognized as being excellent in terms of pain relief and functional improvement. Lateral MAT is usually performed with the bone bridge technique that uses a bone bridge connecting the anterior and posterior horns of an allograft. The slot position for the meniscal graft insertion is of great importance with the bone bridge technique, especially in the key-hole method. The purpose of this Technical Note is to describe lateral MAT using the key-hole technique in which an allograft with a bone bridge carved to accommodate the key-hole-shaped slot is properly secured to the slot...
October 2017: Arthroscopy Techniques
Bryan M Saltzman, Eric J Cotter, Jeffrey P Stephens, Gregory L Cvetanovich, Brett Madden, Kevin Wang, Adam B Yanke, Brian J Cole
BACKGROUND: The association between preoperative tibial subchondral bone marrow lesion (BML) patterns and outcomes after isolated meniscus allograft transplantation (MAT) are unknown. PURPOSE: To determine (1) if a superior classification means exists (ie, high interrater reliability [IRR]) for grading tibial subchondral BML before isolated MAT and (2) whether quality and/or severity of preoperative tibial subchondral BML patterns was associated with clinical outcomes and/or failure rates after isolated MAT...
January 1, 2018: American Journal of Sports Medicine
M Bergovec, M Smerdelj, F Bacan, S Seiwerth, D Herceg, M Prutki
Synovial sarcoma (SS) is a rare mesenchymal tumor, accounting less than 10% of soft tissue sarcomas. We report a case of intraarticular SS mimicking nodular synovitis and lateral meniscus rupture. Due to clinical and radiological presentation, arthroscopic synovectomy was performed, and histology confirmed nodular synovitis. After four years the lesion recurred and new arthroscopic biopsy was performed, revealing a monophasic SS with SYT/SSX1 translocation. Repeated histology of the first specimen confirmed appearance of a nodular synovitis microscopically, with no morphological criteria for a sarcoma, but molecular analysis showed positive SYT/SSX1 translocation...
January 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Eric J Cotter, Rachel M Frank, Brian R Waterman, Kevin C Wang, Michael L Redondo, Brian J Cole
Surgical strategies for knee joint preservation are numerous, with the procedure(s) of choice for a given patient dependent on the status of the articular cartilage, meniscus, overall alignment, and ligamentous stability. For patients with large, isolated, osteochondral defects of the articular cartilage of the femoral condyle, osteochondral allograft transplantation (OCA) is often performed in an effort to reduce pain and improve function. Similarly, for appropriately indicated patients with symptomatic meniscus deficiency, meniscus allograft transplantation (MAT) is an excellent surgical solution...
October 2017: Arthroscopy Techniques
Dhong Won Lee, Jung Ho Park, Kyu Sung Chung, Jeong Ku Ha, Jin Goo Kim
The meniscal allograft transplantation (MAT) has been reported to be an effective treatment in terms of pain relief and functional improvement in symptomatic meniscus-deficient knee. The medial MAT is usually performed with the bone plug technique or soft tissue fixation for root fixation. We describe medial MAT with modified bone plug technique that permits easy passage of posterior bone plugs and facilitates bone-to-bone healing. With this method, an anterior bone plug with a long cylindrical shape is prepared, and the posterior bone plug is prepared with a flat bone shell containing a cancellous portion...
August 2017: Arthroscopy Techniques
Jarret M Woodmass, Nick R Johnson, Bruce A Levy, Michael J Stuart, Aaron J Krych
Lateral meniscus tears are commonly encountered by orthopaedic surgeons. Despite efforts to repair and preserve the meniscus, meniscectomy is occasionally required to treat irreparable tears. The resulting lateral meniscus deficiency leads to increased tibiofemoral contact pressures and ultimately early osteoarthritic changes in the knee. Lateral meniscal allograft transplant (LMAT) has been proposed as a way to restore the lateral meniscus-deficient knee to its native form. Although several techniques for LMAT have been proposed, osseous fixation has demonstrated increased stability, improved outcomes, and improved long-term survival...
August 2017: Arthroscopy Techniques
Patrycja Mickiewicz, Michał Walczak, Michał Łaszczyca, Damian Kusz, Zygmunt Wróbel
BACKGROUND: There are many different methods of meniscal allograft measurements, which depend on individual tissue bank procedures. Due to the lack of a standardised method of dimensioning, measurement results may vary between individual cases. Consequently, allograft may be mismatched to the patient's knee anatomy. The purpose of this study was to measure four meniscal dimensions - two standard and two specific - and then compare them between sexes. METHODS: Fourteen cadaveric lateral menisci (seven male and seven female) were scanned using a microtomography scanner...
January 15, 2018: Knee
Daniel J Kaplan, Sergio A Glait, William E Ryan, Michael J Alaia, Kirk A Campbell, Eric J Strauss, Laith M Jazrawi
Over recent years, appreciation for the critical role of the meniscus in joint biomechanics has led to an emphasis on meniscal preservation. Meniscal allograft transplant (MAT) is a promising biological solution for the symptomatic young patient with a meniscus-deficient knee that has not developed advanced osteoarthritis. As surgical techniques are refined and outcomes continue to improve, it is vital to consider the utility of such procedures and offer a straightforward approach to MAT. This article and accompanying video provide a step-by-step tutorial on how to perform a MAT using the bridge and slot technique, its key pearls and pitfalls as well as the relevant advantages and disadvantages of MAT...
December 2017: Arthroscopy Techniques
Rachel M Frank, Simon Lee, Eric J Cotter, Charles P Hannon, Timothy Leroux, Brian J Cole
BACKGROUND: Osteochondral allograft transplantation (OCA) is often performed with concomitant meniscus allograft transplantation (MAT) as a strategy for knee joint preservation, although to date, the effect of concomitant MAT on outcomes and failure rates after OCA has not been assessed. PURPOSE: To determine clinical outcomes for patients undergoing OCA with MAT as compared with a matched cohort of patients undergoing isolated OCA. STUDY DESIGN: Control study; Level of evidence, 3...
January 1, 2018: American Journal of Sports Medicine
Mingxue Chen, Shuang Gao, Pei Wang, Yan Li, Weimin Guo, Yu Zhang, Mingjie Wang, Tongguang Xiao, Zengzeng Zhang, Xueliang Zhang, Xiaoguang Jing, Xu Li, Shuyun Liu, Quanyi Guo, Tingfei Xi
Meniscus is a fibrocartilaginous organ to redistribute stress and enhance the stability of knee joint. Meniscus injury is common and still a formidable challenge to orthopedic surgeons. Surgical techniques and allograft transplantation were primary approaches to meniscus repair, but with intrinsic limitations in clinical practice. Tissue engineering is the most promising method to repair meniscus at present. Electrospinning is a method to fabricate fibers in small scale. With different materials and parameters, electrospinning materials could have different mechanical properties, porosity, and orientation, which could mimic architectural features and mechanical properties of native meniscus...
January 8, 2018: Journal of Biomaterials Science. Polymer Edition
Jarret M Woodmass, Michael P O'Malley, Aaron J Krych, Patrick J Reardon, Nick R Johnson, Michael J Stuart, Bruce A Levy
PURPOSE: To (1) assess clinical outcomes of revision multiligament knee injury (MLKI) reconstruction at a minimum of 2 years' follow-up and (2) present a standardized treatment algorithm used in treating revision MLKI patients. METHODS: A retrospective review of our institution's MLKI database was performed to identify all patients who underwent revision MLKI reconstructions (≥2 ligaments reconstructed) after implementation of a standardized treatment algorithm in 2000 and had a minimum of 2 years' follow-up...
December 19, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Robert A Magnussen, James R Borchers, Angela D Pedroza, Laura J Huston, Amanda K Haas, Kurt P Spindler, Rick W Wright, Christopher C Kaeding, Christina R Allen, Allen F Anderson, Daniel E Cooper, Thomas M DeBerardino, Warren R Dunn, Brett A Lantz, Barton Mann, Michael J Stuart, John P Albright, Annunziato Amendola, Jack T Andrish, Christopher C Annunziata, Robert A Arciero, Bernard R Bach, Champ L Baker, Arthur R Bartolozzi, Keith M Baumgarten, Jeffery R Bechler, Jeffrey H Berg, Geoffrey A Bernas, Stephen F Brockmeier, Robert H Brophy, Charles A Bush-Joseph, J Brad Butler, John D Campbell, James L Carey, James E Carpenter, Brian J Cole, Jonathan M Cooper, Charles L Cox, R Alexander Creighton, Diane L Dahm, Tal S David, David C Flanigan, Robert W Frederick, Theodore J Ganley, Elizabeth A Garofoli, Charles J Gatt, Steven R Gecha, James Robert Giffin, Sharon L Hame, Jo A Hannafin, Christopher D Harner, Norman Lindsay Harris, Keith S Hechtman, Elliott B Hershman, Rudolf G Hoellrich, Timothy M Hosea, David C Johnson, Timothy S Johnson, Morgan H Jones, Ganesh V Kamath, Thomas E Klootwyk, Bruce A Levy, C Benjamin Ma, G Peter Maiers, Robert G Marx, Matthew J Matava, Gregory M Mathien, David R McAllister, Eric C McCarty, Robert G McCormack, Bruce S Miller, Carl W Nissen, Daniel F O'Neill, Brett D Owens, Richard D Parker, Mark L Purnell, Arun J Ramappa, Michael A Rauh, Arthur C Rettig, Jon K Sekiya, Kevin G Shea, Orrin H Sherman, James R Slauterbeck, Matthew V Smith, Jeffrey T Spang, Steven J Svoboda, Timothy N Taft, Joachim J Tenuta, Edwin M Tingstad, Armando F Vidal, Darius G Viskontas, Richard A White, James S Williams, Michelle L Wolcott, Brian R Wolf, James J York
BACKGROUND: Articular cartilage health is an important issue following anterior cruciate ligament (ACL) injury and primary ACL reconstruction. Factors present at the time of primary ACL reconstruction may influence the subsequent progression of articular cartilage damage. HYPOTHESIS: Larger meniscus resection at primary ACL reconstruction, increased patient age, and increased body mass index (BMI) are associated with increased odds of worsened articular cartilage damage at the time of revision ACL reconstruction...
December 1, 2017: American Journal of Sports Medicine
Justin J Mitchell, Mark E Cinque, Grant J Dornan, Lauren M Matheny, Chase S Dean, Brad Kruckeberg, Gilbert Moatshe, Jorge Chahla, Robert F LaPrade
PURPOSE: The purpose of this study was to evaluate the differences in intra-articular pathology, demographic characteristics, and radiographic characteristics of the knee associated with primary anterior cruciate ligament reconstruction (ACLR) versus revision ACLR at the time of initial presentation with either a native anterior cruciate ligament tear or an anterior cruciate ligament graft tear. Secondarily, we aimed to investigate risk factors for concomitant medial and lateral meniscal tears and cartilage injuries at the time of ACLR...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
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