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Meniscal repaire

Su-Keon Lee, Bong-Seok Yang, Byeong-Mun Park, Ji-Ung Yeom, Ji-Hyeon Kim, Jeong-Seok Yu
Medial meniscal root tears have been repaired using various methods. Arthroscopic all-inside repair using a suture anchor is one of the popular methods. However, insertion of the suture anchor into the proper position at the posterior root of the medial meniscus is technically difficult. Some methods have been reported to facilitate suture anchor insertion through a high posteromedial portal, a posterior trans-septal portal, or a medial quadriceptal portal. Nevertheless, many surgeons still have difficulty during anchor insertion...
March 2018: Clinics in Orthopedic Surgery
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
Bahar Bilgen, Chathuraka T Jayasuriya, Brett D Owens
The meniscus is the most commonly injured structure in the human knee. Meniscus deficiency has been shown to lead to advanced osteoarthritis (OA) due to abnormal mechanical forces, and replacement strategies for this structure have lagged behind other tissue engineering endeavors. The challenges include the complex 3D structure with individualized size parameters, the significant compressive, tensile and shear loads encountered, and the poor blood supply. In this progress report, a review of the current clinical treatments for different types of meniscal injury is provided...
March 15, 2018: Advanced Healthcare Materials
Michael Day, Michael Ryan, Eric Strauss
The management of meniscal root injuries has changed as biomechanical studies have demonstrated the importance of meniscal integrity in load distribution across the knee joint. Meniscal injury causes altered joint mechanics, which is postulated to be related to the onset of arthrosis. Arthroscopic meniscal root repair has been shown to restore more normal joint mechanics and is considered a treatment option in the appropriately indicated patient. Short- and midterm clinical results of meniscal root repair are promising, but long-term results are yet to be established...
March 2018: Bulletin of the Hospital for Joint Diseases
Björn Friebe, Martin Richter, Susanne Penzlin, Christian Stärke, Siegfried Kropf, Christoph Lohmann, Frank Fischbach, Oliver Speck
OBJECTIVES: The aim of this study was to compare the assessment of low-grade meniscal tears and cartilage damage in ultrahigh-field magnetic resonance imaging (MRI) at 7 T to routine clinical MRI at 3 T. MATERIALS AND METHODS: This study was approved by the local ethics committee, and written informed consent was obtained from each patient. Forty-one patients with suspected meniscal damage or mild osteoarthritis (Kellgren-Lawrence score, 0-2) received 7 T as well as routine clinical 3 T consecutively...
March 8, 2018: Investigative Radiology
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
Hervé Ouanezar, William G Blakeney, Charles Latrobe, Adnan Saithna, Levi Reina Fernandes, Jean Romain Delaloye, Mathieu Thaunat, Bertrand Sonnery-Cottet
PURPOSE: Repairs of the posterior horn of the lateral meniscus can be technically challenging. In contrast to medial meniscus repairs, the capsule around the posterior segment attachment of the lateral meniscus is quite thin. This study evaluates the clinical results of an arthroscopic all-inside repair technique for unstable, vertical, lateral meniscus tears, using a suture repair placed directly into the popliteus tendon. METHODS: A retrospective analysis of prospectively collected data from the SANTI database was performed...
March 3, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Mark Phillips, Erik Rönnblad, Love Lopez-Rengstig, Eleonor Svantesson, Anders Stålman, Kalle Eriksson, Olufemi R Ayeni, Kristian Samuelsson
PURPOSE: To compare Knee Injury and Osteoarthritis Outcome Score (KOOS) and EuroQol-5D (EQ-5D) subscale scores at 2-year follow-up for patients with primary isolated ACL reconstruction with patients undergoing ACL reconstruction and simultaneous meniscal treatment in terms of either resection or repair in the Swedish National Knee Ligament Register (SNKLR). METHODS: All ACL reconstruction patients within the SNKLR at 2-year follow-up were reviewed. The KOOS and EQ-5D subscales were assessed in four distinct patient groups: isolated ACL reconstruction, ACL reconstruction + medial meniscus resection, ACL reconstruction + lateral meniscus resection, ACL reconstruction + medial meniscus repair, and ACL reconstruction + lateral meniscus repair...
February 28, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Feini Qu, Qing Li, Xiao Wang, Xuan Cao, Miltiadis H Zgonis, John L Esterhai, Vivek B Shenoy, Lin Han, Robert L Mauck
Few regenerative approaches exist for the treatment of injuries to adult dense connective tissues. Compared to fetal tissues, adult connective tissues are hypocellular and show limited healing after injury. We hypothesized that robust repair can occur in fetal tissues with an immature extracellular matrix (ECM) that is conducive to cell migration, and that this process fails in adults due to the biophysical barriers imposed by the mature ECM. Using the knee meniscus as a platform, we evaluated the evolving micromechanics and microstructure of fetal and adult tissues, and interrogated the interstitial migratory capacity of adult meniscal cells through fetal and adult tissue microenvironments with or without partial enzymatic digestion...
February 19, 2018: Scientific Reports
Bancha Chernchujit, Renaldi Prasetia
Meniscal extrusion (ME) is defined as extension of the meniscal margin by at least 3 mm beyond the tibial margin. The main purpose of meniscal root repair is to restore the anatomy and function of the meniscus. Therefore, the reduction in the ME is one of the important objective outcomes. Nevertheless, the reduced meniscal extrusion was obtained in limited patients after meniscal root repair. This technical note described the arthroscopic direct meniscal extrusion reduction as surgical tips to reduce persistent meniscal extrusion in posterior meniscal root repair...
February 14, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Satoru Atsumi, Kunio Hara, Yuji Arai, Manabu Yamada, Naoki Mizoshiri, Aguri Kamitani, Toshikazu Kubo
RATIONALE: Considering the risk of osteoarthritis following resection of a horizontally torn meniscus of the knee, repairing and preserving the meniscus as much as possible is preferred. We report 3 cases of restoration of horizontally torn menisci using a novel arthroscopic method we have called "all-inside interleaf vertical suture" that afforded preservation. PATIENT CONCERNS: The 3 patients (aged 14, 17, and 21 years) had knee pain through sports activity. DIAGNOSES: All patients had horizontal tears in the posteromedial part of the meniscus...
February 2018: Medicine (Baltimore)
Santiago Pache, Zachary S Aman, Mitchell Kennedy, Gilberto Yoshinobu Nakama, Gilbert Moatshe, Connor Ziegler, Robert F LaPrade
The posterior cruciate ligament (PCL) is the largest and strongest ligament in the human knee, and the primary posterior stabilizer. Recent anatomy and biomechanical studies have provided an improved understanding of PCL function. PCL injuries are typically combined with other ligamentous, meniscal and chondral injuries. Stress radiography has become an important and validated objective measure in surgical decision making and post-operative assessment. Isolated grade I or II PCL injuries can usually be treated non-operatively...
January 2018: Archives of Bone and Joint Surgery
Bancha Chernchujit, Renaldi Prasetia
The occurrence of posterior root tear of both the lateral and medial menisci, combined with anterior cruciate ligament rupture, is rare. Problems may be encountered such as the difficulty to access the medial meniscal root tear, the confusing circumstances about which structure to repair first, and the possibility of the tunnel for each repair to become taut inside the tibial bone. We present the arthroscopy technique step by step to overcome the difficulties in an efficient and time-preserving manner.
October 2017: Arthroscopy Techniques
S Tal Hendrix, Adam Kwapisz, Douglas J Wyland
Treatment of symptomatic meniscal tears continues to evolve as we improve our understanding of the biomechanical role of the meniscus and its long-term importance to the health of the knee joint. Suture repair of meniscal tears is challenging, yet the incidence of repairs among our colleagues continues to rise as we aim to preserve meniscal tissue. Many elements of performing a repair are tedious and difficult, including proper meniscal preparation, reduction, mattress suture placement, and fixation. The tear pattern and location present another layer of difficulty...
October 2017: Arthroscopy Techniques
Kenneth R Brooks
Horizontal cleavage and horizontal oblique meniscal tears have traditionally been treated with partial meniscectomy. Recent research has shown the deleterious long-term effects of meniscectomy in these patients regarding the development of osteoarthritis. Meniscal preservation is thus the preferred method of surgical treatment in patients with these tears. However, traditional repair techniques using inside-out sutures or suture anchor-based devices do not address the horizontally aligned nature of these particular tears and thus do not compress the meniscal tissue in the correct plane...
October 2017: Arthroscopy Techniques
Christopher Kowalski, Robert A Gallo
Although horizontal tears of the meniscus have historically been treated with partial meniscectomy due to poor vascularity within the tear, evidence suggests that repair of horizontal meniscal tears may be advantageous to partial meniscectomy. Furthermore, the addition of platelet-rich plasma has shown promise in improving meniscal healing. We present our technique of platelet-rich fibrin clot-augmented repair of horizontal cleavage meniscal tear.
October 2017: Arthroscopy Techniques
Akinobu Nishimura, Shigeto Nakazora, Naoya Ito, Aki Fukuda, Ko Kato, Akihiro Sudo
Longitudinal flexor hallucis longus (FHL) tendon tears are sometimes complicated by posterior ankle impingement syndrome (PAIS), especially in ballet dancers. In recent years, PAIS has been treated endoscopically, but it is difficult to suture FHL tendon tears endoscopically. In this report, we describe how to suture the FHL tendon endoscopically with the Meniscal Viper Repair system (Arthrex, Naples, FL). Without our endoscopic technique, when a patient is found to have a longitudinal tear of the FHL under endoscopy, we must choose to either neglect the tear or convert to an open repair...
October 2017: Arthroscopy Techniques
Ana Perez-Blanca, María Prado Nóvoa, Maximiano Lombardo Torre, Alejandro Espejo-Reina, Francisco Ezquerro Juanco, Alejandro Espejo-Baena
PURPOSE: To assess the role of suture cutout in the mechanics of failure of the repaired posterior meniscal root during the early post-operative period when using sutures of different shape. METHODS: Twenty medial porcine menisci were randomized in two groups depending on the suture shape used to repair the posterior root: thread or tape. The sutured menisci were subjected to cyclic loading (1000 cycles, (10, 30) N) followed by load-to-failure testing. Residual displacements, stiffness, and ultimate failure load were determined...
February 2, 2018: International Orthopaedics
Janosch Häberli, Laurenz Jaberg, Kathrin Bieri, Stefan Eggli, Philipp Henle
BACKGROUND: The goal of this study was to perform an in-depth analysis of the frequency and cause of secondary interventions subsequent to primary anterior cruciate ligament (ACL) repair with dynamic intraligamentary stabilization (DIS). METHODS: Between July 2009 and June 2014, 455 patients underwent DIS treatment. The minimum follow-up was 21months (mean 28months, range 21-64months). RESULTS: A total of 215 (48.2%) reinterventions were performed in 190 (42...
January 29, 2018: Knee
Hiroshi Nakayama, Ryo Kanto, Shunichiro Kambara, Kenji Kurosaka, Shintaro Onishi, Shinichi Yoshiya, Motoi Yamaguchi
Objective: To examine the clinical and functional outcomes for a series of patients who underwent meniscal repair for isolated meniscal tears focusing the study population on athletes. Methods: This study represents a case series of 46 athletes who underwent repair of isolated meniscal lesions of the knee from 2010 to 2015. Cases of discoid meniscal lesions and combined ligament injuries were excluded. The mean age of the patients was 22.9 years ranging from 12 to 50 years...
October 2017: Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology
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