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Meniscal Or Meniscus And Suture

Matthew E Gitelis, Rachel M Frank, Maximillian A Meyer, Gregory Cvetanovich, Brian J Cole
Meniscus allograft transplantation (MAT) has yielded excellent long-term functional outcomes when performed in properly indicated patients. When evaluating a patient for potential MAT, it is imperative to evaluate past medical history and past surgical procedures. The ideal MAT candidate is a chronologically and physiologically young patient (<50 years) with symptomatic meniscal deficiency. Existing pathology in the knee needs to be carefully considered and issues such as malalignment, cartilage defects, and/or ligamentous instability may require a staged or concomitant procedure...
September 2018: American Journal of Orthopedics
Andreas M Seitz, Lutz Dürselen
PURPOSE: This systematic review intends to give an overview of the current knowledge on how allografts used for the reconstruction of cruciate ligaments and menisci are integrated and specifically perform regarding their biomechanical function. METHODS: Two reviewers reviewed the PubMed and Central Cochrane library with focus on the biomechanical integration of tendon ligament and meniscus allografts. The literature search was conducted in accordance with the PRISMA statement for reporting systematic reviews and meta-analyses...
October 5, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Mathieu Thaunat, Goran Vrgoc, Padhraig F O'Loughlin, Nicolas Jan, Gilles Clowez, Jean Marie Fayard, Bertrand Sonnery-Cottet
Management of intrasubstance horizontal cleavage meniscal lesions of microtraumatic origin remains poorly defined in young patients. For grade 2 lesions resistant to conservative measures, the standard technique is debridement of the intrasubstance tear and open suture repair via a posteromedial approach. The objective of this Technical Note is to propose an arthroscopic alternative to this open technique, using an arthroscopic additional posteromedial portal. This technique facilitates an approach to the lesion via its peripheral portion without creating an iatrogenic lesion of the free edge of the meniscus, which is located in the white zone and thus exhibits limited vascularity...
September 2018: Arthroscopy Techniques
Fabian Blanke, Andreas Feitenhansl, Maximilian Haenle, Stephan Vogt
Objective The etiology of osteochondritis dissecans (OCD) is still uncertain. Recently, it has been hypothesized that instability of the anterior horn of the meniscus is an important cause for the development of a nontraumatic OCD in adolescents with good results after surgical stabilization. This case series aims to evaluate the treatment results after meniscus stabilization in adults with nontraumatic OCD. Design Ten patients with magnetic resonance imaging (MRI)-confirmed OCD of the knee joint, meniscal instability, and closed epiphyseal plates were enrolled in this study...
September 15, 2018: Cartilage
Pedro Manuel Serrano, Tiago Amorim-Barbosa, Marta Santos Silva, Ricardo Sousa
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 and continues to rise as we aim to preserve meniscal tissue. Outside-in meniscal suture techniques may involve using expensive equipment that is not readily available for immediate use in most operating rooms. Aware of the different techniques available, the authors describe a fast and reproducible technique that does not require the use of specific material or equipment...
2018: Open Access Journal of Sports Medicine
Colin M Robbins, Colin P Murphy, Blake T Daney, Anthony Sanchez, Matthew T Provencher
In recent years there has been increased attention on preserving the menisci because they perform vital roles in maintaining knee joint homeostasis. The anterolateral (AL) meniscal root is particularly vulnerable during anterior cruciate ligament reconstruction. When the AL root is iatrogenically injured, it is imperative that it is repaired in a timely fashion to prevent early-onset osteoarthritis. In this article we outline our knotless suture anchor repair for AL root tears.
August 2018: Arthroscopy Techniques
Murat Aşçi, Orhan Balta, Recep Kurnaz, Mehmet Burtaç Eren, Yunus Emre Kuyucu, Taner Güneş
INTRODUCTION: Radial meniscus tears are seen in young patients, especially with anterior cruciate ligament ruptures. Repair of complete radial meniscus tear is necessary for the meniscus functions. The most important factor for success of the meniscus repair is primary stability, but it is still unknown which technique is ideal repair technique. AIM: We developed a new suture technique named Horizontal Butterfly (HB). In this novel technique the contact between meniscal tissue and suture is more than Horizontal Loop (HL) that routinely used today...
August 14, 2018: Acta Orthopaedica et Traumatologica Turcica
Sung-Sahn Lee, Jin Hwan Ahn, Jun Ho Kim, Bong Soo Kyung, Joon Ho Wang
BACKGROUND: Previous studies have reported various healing rates (0%-100%) as evaluated by second-look arthroscopy after repair of medial meniscal root tears (MMRTs). Such variable results might provoke suspicion of the necessity for repair. Furthermore, the effect of meniscal healing on the clinical outcomes has not been reported. PURPOSE: To more precisely determine the healing rate of MMRTs repaired through the transseptal portal, which could provide objective visualization of the healed meniscus, and to identify the effect of meniscal healing on the clinical and radiological outcomes...
September 2018: American Journal of Sports Medicine
Gilbert Steinbacher, Eduard Alentorn-Geli, Manuel Alvarado-Calderón, David Barastegui, Pedro Álvarez-Díaz, Ramón Cugat
PURPOSE: To report the outcomes (subjective function, return to play, complications and reoperations) of arthroscopic all-inside meniscal fixation in a large sample of soccer players with hypermobile lateral meniscus. METHODS: Between 2010 and 2015, 55 patients undergoing surgical treatment for hypermobile lateral meniscus at Mutualidad Catalana de Futbolistas (Barcelona, Spain) were identified. Patients with open physes, associated injuries, discoid meniscus, or clinical follow-up less than 6 months were excluded...
August 11, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Ryuichi Nakamura, Masaki Takahashi, Kazunari Kuroda, Yasuo Katsuki
Medial meniscus posterior root tear (MMPRT) is now attracting increased attention as a risk factor for the development of osteoarthritis. However, the healing rate after root repair by the suture anchor technique or the pull-out technique is still low. Here we report on a technique of MMPRT repair using suture anchor combined with arthroscopic meniscal centralization and open wedge high tibial osteotomy (OWHTO). The purposes of this technique are (1) to distribute the meniscal hoop tension between the root repair site and the centralization site and (2) to reduce the load on medial meniscus by OWHTO...
July 2018: Arthroscopy Techniques
Sandra Kolaczek, Christopher Hewison, Scott Caterine, Rebecca Berardelli, Tyler Beveridge, Ben Herman, Mark Hurtig, Karen Gordon, Alan Getgood
PURPOSE: Injury or degeneration of the meniscus has been associated with the development of osteoarthritis of the knee joint. Meniscal allograft transplant (MAT) has been shown to reduce pain and restore function in patients who remain symptomatic following meniscectomy. The purpose of this study is to evaluate and compare the three-dimensional (3D) strain in native medial menisci compared to allograft-transplanted medial menisci in both the loaded and unloaded states. METHODS: Ten human cadaveric knees underwent medial MAT, utilizing soft-tissue anterior and posterior root fixation via transosseous sutures tied over an anterolateral proximal tibial cortical bone bridge...
July 24, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Adriano Marques DE Almeida, Marcelo Bordalo Rodrigues, Marcia Uchôa DE Rezende, André Pedrinelli, Arnaldo José Hernandez
Objective: To clinically and radiologically evaluate patients who received meniscal suture using the outside-in technique, comparing magnetic resonance imaging (MRI), arthro-magnetic resonance imaging (arthro-MRI), and arthro-computed tomography (arthro-CT) to evaluate the healing of meniscal sutures. Methods: We evaluated eight patients with an average follow-up of 15 months. The evaluation analyzed clinical parameters using the Lysholm and IKDC scores as well as MRI, arthro-MRI, and arthro-CT imaging...
May 2018: Acta Ortopedica Brasileira
Tomoaki Kamiya, Tomoyuki Suzuki, Hidenori Otsubo, Miki Kuroda, Takashi Matsumura, Chihiro Kubota, Toshihiko Yamashita
BACKGROUND: Hypermobile lateral meniscus (HLM) is one of the causes of knee pain and a locking sensation. It is thought that disruption of the popliteomeniscle fascicles lead to hypermobility of the lateral meniscus in adults. In cases of HLM, the posterior portion of the lateral meniscus shows forward abnormal translation with knee flexion and backward translation with knee extension. We refer to this phenomenon as paradoxical motion. The purpose of this study was to report an arthroscopic HLM stabilization and evaluate the midterm clinical outcomes...
July 13, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Gian Luca Rovesti, Veronica Devesa, Laura Bertorelli, Jesus Rodriguez-Quiros
BACKGROUND: Stifle arthroscopy has been described to have high sensitivity and specificity in the evaluation of menisci in dogs, particularly for the medial meniscus. However, the visualization of menisci can be difficult. The use of femoral distractors in human medicine has been described to simplify demanding surgical procedures, such as meniscus transplantation. In veterinary medicine, stifle distraction has been reported to facilitate access to the joint and visualization of intra-articular structures, but there are no studies reporting the use of a stifle distraction technique while performing challenging surgical procedures, such as meniscal suture, in clinical patients...
June 28, 2018: BMC Veterinary Research
Kristine M Fischenich, Hannah M Pauly, Jackson T Lewis, Travis S Bailey, Tammy L Haut Donahue
Pressure distribution of the native ovine knee meniscus was compared to a medial meniscectomy and three treatment conditions including a suture reattachment of the native tissue, an allograft, and a novel thermoplastic elastomer hydrogel (TPE) construct. The objective of this study was to assess the efficacy of a novel TPE hydrogel construct at restoring joint pressure and distribution. Limbs were loaded in uniaxial compression at 45°, 60°, and 75° flexion and from 0 to 181 kg. The medial meniscectomy decreased contact area by approximately 50% and doubled the mean and maximum pressure reading for the medial hemijoint...
June 19, 2018: Annals of Biomedical Engineering
Tamiko Kamimura, Masashi Kimura
We present a technique to implant autogenous meniscal fragments using a fibrin clot to repair a large degenerative meniscal defect. A total of 25 mL of the patient's blood is agitated for 10 minutes using a stainless steel swizzle stick in a sterile glass syringe. The elastic fibrin clot subsequently adheres to the stick in a tubular manner. Using arthroscopic debridement, native meniscal tissue is resected. The meniscal fragments are packaged into the tubular-shaped fibrin clot, and the tube is tied at both ends using 4-0 absorbable sutures...
March 2018: Arthroscopy Techniques
Somsak Kuptniratsaikul, Thun Itthipanichpong, Vanasiri Kuptniratsaikul
Medial meniscal root injury is known to cause an increase in tibiofemoral contact pressure and results in early osteoarthritis. There have been many reports on meniscal root repairing techniques, which can be categorized into 2 groups. One is transosseous suture, and the other is anchor suture repair. Both techniques show improvement in not only clinical performance, but also radiographic finding. However, the meniscal root repair procedure must be performed by experienced physicians. Most techniques require a posteromedial portal, which takes time and may even complicate the procedure...
May 2018: Arthroscopy Techniques
Maurice Balke, Ralph Akoto, Christoph Offerhaus, Juergen Hoeher
The biomechanical consequences of a tear of the posterior root of the medial meniscus are comparable to that of a complete meniscectomy. The integrity of the meniscal roots is crucial to enable the important function of load sharing and shock absorption. An untreated root tear leads to extrusion and loss of function of the meniscus causing early degenerative arthritis of the respective knee compartment. Meniscal root repair can be achieved by 2 main techniques: indirect fixation using pullout sutures through a transtibial tunnel with extracortical fixation and direct fixation using suture anchors...
May 2018: Arthroscopy Techniques
Jay M Patel, Andrzej Brzezinski, Deep A Raole, Michael G Dunn, Charles J Gatt
BACKGROUND: Meniscal lesions represent one of the most common intra-articular knee injuries. Meniscus replacement devices are needed to restore load distribution and knee stability after meniscectomy. Fixation of these devices is crucial to the generation of hoop stresses and the distribution of loads in the joint. PURPOSE: To evaluate 2 different fixation techniques (suture endobutton and interference screw) for implantation of a novel meniscus device. STUDY DESIGN: Controlled laboratory study...
July 2018: American Journal of Sports Medicine
Giles Heilpern, Jo Stephen, Simon Ball, Andrew Amis, Andy Williams
PURPOSE: Recently, it has been recognized that meniscocapsular ('ramp') lesions of the posterior one-third of the medial meniscus frequently occur during injuries causing ACL rupture, and that these lesions are easily missed at arthroscopy. Furthermore, it is clear that these lesions are biomechanically significant, adding to the deficits caused by ACL rupture, and that their repair can reverse this. The efficacy of an all inside repair technique has been questioned by some authors and by those who advocate a suture shuttle technique via an accessory posteromedial portal...
August 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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