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Meniscal tear

Russell Chapin
In the postmeniscectomy or meniscal repair setting, there is overlap between expected postoperative change and findings of a re-torn meniscus, particularly increased T1-weighted or proton density signal contacting the articular surface. Protocol selection and accurate diagnosis requires knowledge of meniscal tear treatment, the expected postoperative appearance, and criteria for re-tear. Criteria for meniscal re-tear on MR imaging are high T2-weighted signal reaching the articular surface, abnormal meniscal morphology not explained by the surgery, or a displaced fragment...
November 2018: Radiologic Clinics of North America
Andrew N Pike, Jeanne C Patzkowski, Craig R Bottoni
Anterior cruciate ligament (ACL) ruptures are commonly associated with meniscal and articular cartilage injuries, and the presence of these defects influences both short- and long-term outcomes. Multiple variables are predictive of this pathology including time from injury, age, and sex. Revision ACL reconstructions demonstrate higher rates of chondral injury than primary reconstructions. Menisci are important secondary stabilizers of the knee in the setting of ACL deficiency, and specific tear types are more consistently associated with ACL injury...
October 12, 2018: Journal of the American Academy of Orthopaedic Surgeons
William E Ridley, Hao Xiang, Jason Han, Lloyd J Ridley
No abstract text is available yet for this article.
October 2018: Journal of Medical Imaging and Radiation Oncology
Omar M Albtoush, Marius Horger, Fabian Springer, Jan Fritz
The Segond fracture is a tibial avulsion injury of the insertion of the middle third of the lateral capsular ligament that is typically associated with anterior cruciate ligament and meniscal tears. The classically assigned mechanism of injury is a combination of internal rotation and varus stress. We report two cases of Segond fractures that presented with a variant pattern including osseous avulsion injuries of the medial collateral ligament at the femoral origin, anterior cruciate ligament tear, and pivot shift-type osseous contusion pattern, suggesting an alternative mechanism of injury that includes dominant valgus stress and external rotation components...
September 11, 2018: Clinical Imaging
Bertrand Sonnery-Cottet, Cesar Praz, Nikolaus Rosenstiel, William G Blakeney, Herve Ouanezar, Vikram Kandhari, Thais Dutra Vieira, Adnan Saithna
BACKGROUND: Ramp lesions are characterized by disruption of the peripheral meniscocapsular attachments of the posterior horn of the medial meniscus. Ramp repair performed at the time of anterior cruciate ligament reconstruction (ACLR) has been shown to improve knee biomechanics. PURPOSE: The primary objectives of this study were to evaluate the incidence of and risk factors for ramp lesions among a large series of patients undergoing ACLR. Secondary objectives were to determine the reoperation rate for failure of ramp repair, defined by subsequent reoperations for partial medial meniscectomy...
October 11, 2018: American Journal of Sports Medicine
Bum-Sik Lee, Seong-Il Bin, Jong-Min Kim, Chang-Rack Lee, Young Hyun Choi, Young-Hee Kwon
PURPOSE: To evaluate whether fresh-frozen meniscal allograft shrinkage occurs only during the first year of the early remodeling period or progresses over the delayed period of midterm years and to determine whether these changes were associated with certain clinical and radiologic outcomes. METHODS: We retrospectively reviewed meniscal allograft transplantations (MATs) performed by 1 senior surgeon (S-I.B.) using fresh-frozen allograft from 2008 to 2013. The inclusion criteria were the patients who had midterm follow-up magnetic resonance imaging (MRI) scans between 3 and 6 years after isolated lateral MATs...
October 3, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Kelechi R Okoroha, Ravi B Patel, Omar Kadri, Toufic R Jildeh, Andrew Krause, Caleb Gulledge, Eric C Makhni, Vasilios Moutzouros
PURPOSE: The purpose of this study was to identify if abnormal tibial alignment was a risk factor for lateral meniscus posterior root tears (LMPRT) in patients with acute anterior cruciate ligament (ACL) ruptures. METHODS: The medical charts of 200 patients treated for ACL ruptures between 2013 and 2016 were retrospectively reviewed and evaluated. MRI images and reports were assessed for concurrent meniscal tears. Radiographs were reviewed for tibia vara and tibial slope angles and MRI reports identifying lateral root tears were compared to intraoperative reports to determine accuracy...
October 4, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Victor A van de Graaf, Julia C A Noorduyn, Nienke W Willigenburg, Ise K Butter, Arthur de Gast, Ben W Mol, Daniel B F Saris, Jos W R Twisk, Rudolf W Poolman
Importance: Despite recent studies suggesting arthroscopic partial meniscectomy (APM) is not more effective than physical therapy (PT), the procedure is still frequently performed in patients with meniscal tears. Objective: To assess whether PT is noninferior to APM for improving patient-reported knee function in patients with meniscal tears. Design, Setting, and Participants: Noninferiority, multicenter, randomized clinical trial conducted in 9 hospitals in the Netherlands...
October 2, 2018: JAMA: the Journal of the American Medical Association
Laith Jazrawi, Heather T Gold, Joseph D Zuckerman
No abstract text is available yet for this article.
October 2, 2018: JAMA: the Journal of the American Medical Association
Sheng-Hao Wang, Wu-Chien Chien, Chi-Hsiang Chung, Yung-Chih Wang, Leou-Chyr Lin, Ru-Yu Pan
BACKGROUND: There is increasing interest in the long-term outcomes of patients with posterior cruciate ligament (PCL) tears following conservative treatment or reconstruction. However, limited information is available regarding these results because of the relative rarity of cases and lack of long-term follow-up. PURPOSE: The goals of this study are to (1) compare the occurrence of secondary meniscal tears, osteoarthritis (OA) or subsequent total knee replacement (TKR) in patients with or without PCL injury, and (2) evaluate the potential protective effect of PCL reconstruction against long-term sequela in patients with PCL deficiency...
2018: PloS One
Abdulhamit Misir, Turan Bilge Kizkapan, Kadir Ilker Yildiz, Yavuz Arikan, Rasit Ozcafer, Engin Cetinkaya
PURPOSE: The purpose of this study was to evaluate the role of surgeons' experience with meniscal repairs and meniscectomy decisions, and to determine the factors affecting the disagreement between meniscal repairs and meniscectomy decisions. METHODS: In total, 223 patients with meniscal tears, 106 meniscal repairs, and 117 meniscectomies were included. Six orthopedic surgeons (3: > 5 years; 3: < 5 years' arthroscopy experience) were blinded, and they independently reviewed all preoperative MR images for over a month...
September 29, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
David Dejour, Marco Pungitore, Jeremy Valluy, Luca Nover, Mo Saffarini, Guillaume Demey
PURPOSE: The aim of this study was to determine patient and anatomic factors that influence anteroposterior and rotational laxity in knees with ACL tears. Based on the findings of biomechanical studies, we hypothesized that static and dynamic anterior tibial translation (ATT) as well as positive pivot shift would increase with female gender, tibial slope, and meniscal tears. METHODS: The authors prospectively collected preoperative data and intraoperative findings of 417 patients that underwent ACL reconstruction...
September 29, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Yan Liang, Enaam Idrees, Alexander R A Szojka, Stephen H J Andrews, Melanie Kunze, Aillette Mulet-Sierra, Nadr M Jomha, Adetola B Adesida
The objective of this study was to investigate whether meniscus-derived decellularized matrix (DCM) has the capacity to induce differentiation of synovial fluid-derived mesenchymal stem cells (SF-MSCs) towards a meniscus fibrochondrocyte (MFC) phenotype. The potential roles of transforming growth factor beta-3 (TGF-β3 ) and insulin-like growth factor 1 (IGF-1) in the differentiation of SF-MSCs towards an MFC phenotype were also investigated. SF-MSCs were isolated via plastic adherence cell culture from the synovial fluid of five donors (5 male, average age 34 years)...
September 26, 2018: Acta Biomaterialia
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
James Hollier, Claudia Leonardi, Linus Igbokwe, Vinod Dasa
Background: Primary care physicians often encounter patients with knee pain and are faced with the dilemma of whether to refer patients to a specialist. Meniscal tears are the most common intraarticular knee injury but are challenging to accurately diagnose because of a lack of quantitative, accurate, and easy-to-administer tests. We conducted a retrospective medical record review to evaluate whether measurement of knee range of motion (ROM) via goniometry could discriminate between healthy and meniscus-altered knees...
2018: Ochsner Journal
Yoshiki Okazaki, Takayuki Furumatsu, Shinichi Miyazawa, Yuya Kodama, Yusuke Kamatsuki, Tomohito Hino, Shin Masuda, Toshifumi Ozaki
PURPOSE: The purpose of this study was to evaluate the shape and shift of the medial meniscus before and after meniscal repair concurrent with anterior cruciate ligament (ACL) reconstruction using magnetic resonance imaging (MRI) at 90° of knee flexion. METHODS: This study included 18 patients with ACL-deficient knees without meniscus tears (group A), 11 patients with medial meniscus tears alone (group M), and 15 patients with ACL-deficient knees complicated with medial meniscus tears (group AM)...
September 24, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Brian T Feeley, Brian C Lau
Partial meniscectomy for meniscus tears is one of the most common procedures performed by orthopaedic surgeons. Much research has been done to evaluate the biomechanical consequences and clinical outcomes from meniscus débridement. Biomechanically, as the portion of the meniscus that is removed increases, greater contact pressures are experienced by the cartilage, which leads to altered knee mechanics. The use of partial meniscectomy to manage degenerative meniscus tears in knees with mild preexisting arthritis and mechanical symptoms may be beneficial; however, its routine use in the degenerative knee over physical therapy alone is not supported...
September 18, 2018: Journal of the American Academy of Orthopaedic Surgeons
Marco Bigoni, Marco Turati, Giovanni Zatti, Marta Gandolla, Paola Sacerdote, Massimiliano Piatti, Alberto Castelnuovo, Luca Rigamonti, Daniele Munegato, Silvia Franchi, Nicola Portinaro, Alessandra Pedrocchi, Robert J Omeljaniuk, Vittorio Locatelli, Antonio Torsello
The treatment of anterior cruciate ligament (ACL) injuries in children and adolescents is challenging. Preclinical and clinical studies investigated ACL repairing techniques in skeletally immature subjects. However, intra-articular bioenvironment following ACL tear has not yet been defined in skeletally immature patients. The aim of this study was to measure cytokine concentrations in the synovial fluid in adolescent population. Synovial levels of IL-1 β , IL-1ra, IL-6, IL-8, IL-10, and TNF- α were measured in 17 adolescent patients (15 boys) with ACL tears who underwent ACL reconstruction including acute (5), subacute (7), and chronic (5) phases...
2018: Mediators of Inflammation
Elizabeth M Krier, Tiffany A Johnson, Adam H Breiteneicher, Laura E Peycke, Don A Hulse
OBJECTIVE: To describe articular cartilage (AC) lesions associated with complete lateral meniscal tears in dogs. STUDY DESIGN: Observational series. ANIMALS: Seventeen dogs with arthroscopic evidence of a complete lateral meniscal tear and associated AC lesions. METHODS: Medical records of dogs with arthroscopic evidence of complete lateral meniscal tear and associated AC lesions between March 2006 and December 2017 were examined for arthroscopic findings...
September 21, 2018: Veterinary Surgery: VS
Youngjune Kim, Joong Mo Ahn, Yusuhn Kang, Eugene Lee, Joon Woo Lee, Heung Sik Kang
OBJECTIVE: The objective of our study was to evaluate the association between anterior tibial translation and injuries on the posterior horn medial meniscus (PHMM) and the integrity of the brake stop mechanism of the PHMM in the anterior cruciate ligament (ACL)-deficient knee. MATERIALS AND METHODS: This retrospective study included 85 consecutive patients with an arthroscopically confirmed complete ACL tear. Anterior tibial translation was quantitatively measured using sagittal MRI at the midpoint of the lateral femoral condyle...
September 21, 2018: AJR. American Journal of Roentgenology
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