Meniscal Or Meniscus And Suture

Knee meniscus is the cushioning fibro-cartilage tissue present in between the femoral condyles and tibial plateau of knee joint. It is largely avascular in nature and suffers from a wide range of tears and injuries caused by accidents, trauma, active lifestyle of the populace and old age of individuals. Healing of meniscus is especially difficult due to their avascularity and hence requires invasive arthroscopic approaches such as surgical resection, suturing or implantation. Though various tissue engineering approaches are proposed for treatment of meniscus tears, 3D printing/bioprinting, injectable hydrogels and physical stimulation involving modalities are gaining forefront in the past decade...

BACKGROUND: Various suture configurations are available for medial meniscus posterior root tear (MMPRT) repair. The modified Mason-Allen (MMA) technique has been proposed as a refixation technique for MMPRT instead of the conventional 2 simple stitches (TSS). This is in view of its superior biomechanical characteristics. PURPOSE: To perform a systematic review and meta-analysis to compare MMA and TSS configuration techniques for MMPRT repair and identify any differences between the 2 techniques in terms of clinical outcomes, medial meniscal extrusion (MME), and postoperative healing...

BACKGROUND: To evaluate the technique of transtibial pull-out repair with tibial interference screw fixation for medial meniscus posterior root (MMPR) tear by reporting on short-term outcomes and complications. METHODS: All MMPR repairs performed between January 2019 and August 2021 (n = 70) were retrospectively screened regarding demographic data and surgical parameters. The patients were questioned for performed revision surgery, symptoms and complications...

PURPOSE: The aim of this study is to assess the dynamics of the tear site of meniscal ramp lesions, particularly considering knee flexion angles, and validate anchor fixation using an all-inside device. METHODS: Eight Thiel-embalmed paired cadaveric knees with their whole bodies were used in this study. The ramp lesions were created arthroscopically, and ramp lesion dynamics were evaluated by gradually extending the knee from 90° of knee flexion. Changes in the gap and step-off (0: no step-off; 1: cross-sectional overlap exists; and 2: tibial articular surface exposed) were evaluated at 90°, 60°, 30°, and 10° of knee flexion...

Meniscal root tears remain a common problem, with devastating biomechanical and clinical consequences. Thankfully, numerous techniques have been developed to repair the symptomatic meniscal root tear. However, rates of conversion to arthroplasty are reported to be 21% to 33% at 10 years, and persistent extrusion of the meniscus at follow-up is a known limitation of current root repair techniques. There is also growing evidence that some medial meniscal root tears may be an effect of meniscal extrusion, rather than the cause of it...

BACKGROUND: Meniscal repair is the gold standard for simple morphology tears. However, when the morphology and chronicity of the tear are less favorable, the success of the standard techniques is reduced. PURPOSE/HYPOTHESIS: To compare meniscal repair augmented by a new bioresorbable implant (Meniscus Cap) versus a traditional simple suture technique and the currently available augmented repair collagen matrix meniscus wrapping technique. It was hypothesized that the Meniscus Cap suture technique would increase ultimate failure load and less displacement during cyclic loading...

BACKGROUND: Meniscal injury is a common problem that can lead to knee pain and dysfunction. Meniscal repair and meniscectomy are two treatment approaches for meniscal injury, but the latter may increase the risk of osteoarthritis. We aimed to compare the 3-year outcomes of a new method of meniscal suturing with meniscectomy among patients with meniscal injury. METHODS: This retrospective cohort study compared meniscal repair (treatment group) and meniscectomy (control group) in patients with meniscal injury...

In the present study, 24 rabbits were firstly used to evaluate the apoptosis index and matrix degeneration after untreated adult meniscal tears. Vertical tears (0.25 cm in length) were prepared in the avascular zone of the anterior horn. Specimens were harvested at 1, 3, 6, 12 weeks postoperatively. The apoptosis index around tear sites stayed at a high level throughout the whole follow-up period. The depletion of glycosaminoglycans (GAG) and aggrecan at the tear site was observed, while the deposition of COL I and COL II was not affected, even at the last follow-up of 12 weeks after operation...

PURPOSE: To test tough gel adhesives to repair meniscus tears under relevant loading conditions and determine if they have adequate biomechanical properties to repair meniscus tears in a bovine cadaveric study. METHODS: Cyclic compression tests on 24 dissected bovine knees were performed. The tough gel adhesive was used either as an adhesive patch or as a coating bonded onto commercially available surgical sutures. Forty-eight menisci were tested in this study; 24 complete radial tears and 24 bucket-handle tears...

Medial meniscal root injury is known to cause an increase in the tibiofemoral contact pressure and results in early osteoarthritis. Several techniques have been described for transosseous suture repair. Typically, the sutures are passed through the meniscus, pulled out through a transtibial tunnel, and tied over a bone bridge, a suture button, or a screw at the anterior tibial cortex. Desired meniscus root tension may not be achieved in transosseous fixation with a suture button. The suspensory fixation technique is aimed to prevent secondary looseness in the knot attached to the button implant in the tibia and to provide the desired tension in the fixation of the button implant in different degrees of flexion of the knee...

INTRODUCTION: all-in meniscal suture devices have evolved and simplified meniscal repair. In this study we will formulate the following research questions: what is the rate of survival and failure? What are the risk factors associated with failure? And what are the functional results after meniscal repair surgery? MATERIAL AND METHODS: ambispective study from 2001 to 2021 of patients with repairable meniscal injury with all-in meniscal suture devices. The survival and failure ratio were obtained with the Kaplan-Meier test, the risk factors associated with meniscal suture failure were assessed with the logistic regression test, and the pre- and post-surgical functional results were estimated with the test...

BACKGROUND: Biomechanical assessment of meniscal repairs is essential for evaluating different meniscal suturing methods and techniques. The continuous meniscal suture technique is a newer method of meniscal repair that may have biomechanical differences compared with traditional techniques. PURPOSE: To evaluate the displacement, stiffness after cyclical loading, and load to failure for a continuous vertical inside-out meniscal suture versus a traditional vertical inside-out meniscal suture in a porcine medial meniscus...

OBJECTIVE: To summarize the clinical features, surgical methods, and prognosis of bucket-handle meniscal tears (BHMTs), and provide guidance for clinical treatment. METHODS: The clinical data of 91 BHMTs patients (91 knees), who met the selection criteria and were admitted between January 2015 and January 2021, was retrospectively analyzed. There were 68 males and 23 females. Age ranged from 16 to 58 years with an average of 34.4 years. The injury was caused by sports in 68 cases, traffic accident in 15 cases, and falls or sprains in 8 cases...

Meniscal tearing can increase the contact pressure between the tibia and femur by causing gapping of torn meniscus tissue. The aim of this study was to quantify gapping behaviour of radial and longitudinal tears and their impact on peak contact pressure and mean contact area. Twelve porcine knee joints underwent unicondylar, convertible osteotomy for exact tear application and consecutive suturing. Six tantalum marker beads were positioned along meniscus tears. The joints were preloaded with sinusoidal loading cycles ranging between 0 N and 350 N...

PURPOSE: This study aimed to investigate the graft maturation and safety of single-incision bone bridge lateral meniscus allograft transplantation (LMAT). METHODS: This study involved 35 patients who underwent LMAT between 2019 and 2020. All patients completed at least 2 years of follow-up (median 34 months; range 24-43) and underwent preoperative magnetic resonance imaging (MRI) to assess the trajectory safety of the leading suture passer and all-inside suture instrument (Fast-Fix)...

INTRODUCTION: Failure rates in meniscal suture associated to ACL reconstruction range from 10% to 26.9%, often leading to meniscectomy. In young patients, the wish to conserve the meniscus may lead to iterative suture, if the lesion allows. There are no data available for clinical results of repeat meniscal suture at the same site as the primary lesion in a stabilized knee. The immediate socioeconomic cost, compared to meniscectomy, needs to be taken into account, and benefit needs to be demonstrated...

Meniscus allograft transplantation can be successful for treatment of meniscal deficiency using a number of transplant techniques. In this Technical Note, we describe a double bone plug medial meniscus allograft transplantation technique that uses knotless all-suture anchors with cortical-button suspensory fixation. This technique maintains the reported advantages for bone-plug fixation while mitigating the risk for meniscal root damage, facilitating easier bone plug insertion and seating, expanding tensioning capabilities, and preventing soft-tissue irritation from suture knot stacks...

A ramp lesion is a specific type of tear in the meniscocapsular junction of the posterior horn of the medial meniscus, usually associated with anterior cruciate ligament (ACL) injury. Biomechanical cadaveric studies have shown that ACL injury combined with ramp lesions significantly increases anterior tibial translation and external rotation, which ACL reconstruction alone cannot completely control. Additionally, ramp lesions are sometimes associated with medial meniscal defects, especially in cases of chronic ACL deficiency after repetitive traumatic events, in which the anatomical repair of the meniscocapsular junction is infeasible...

Meniscus-related injuries are a common orthopedic challenge with an increasing incidence in the population. While the preservation of viable meniscal tissue is the preferred approach in repair strategies, complex or total traumatic lesions may require alternative therapeutic approaches such as meniscal reconstruction using allografts or engineered equivalents. Although clinical studies suggest promising outcomes with the use of acellular implants, further development is needed to improve their biological and mechanical requirements...

BACKGROUND: It is nowadays recommended to "Save the meniscus". This paradigm is based on the affirmation that an extended meniscectomy exposes to the risk of long-term secondary osteoarthritis and the global failure rate of a longitudinal tear repair remains low, whether it is the medial or lateral meniscus, with or without anterior cruciate ligament (ACL) reconstruction. However, each kind of lesion has to be studied separate. PURPOSE: The study aimed to focus on a homogeneous population of isolated repair of the bucket handle tear (BHT) of the medial meniscus (MM) in patients with stable knees to evaluate failure rate at a minimum of three years of follow-up...