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Meniscectomy

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https://www.readbyqxmd.com/read/28903016/arthroscopic-meniscectomy-for-degenerative-meniscal-tears-reduces-knee-pain-but-is-not-cost-effective-in-a-routine-health-care-setting-a-multi-center-longitudinal-observational-study-using-data-from-the-osteoarthritis-initiative
#1
Jan J Rongen, Tim M Govers, Pieter Buma, Maroeska M Rovers, Gerjon Hannink
OBJECTIVES: It is disputed whether arthroscopic meniscectomy is an (cost-) effective treatment for degenerative meniscus tears in day-to-day clinical practice. The objective of this study was to assess the cost-effectiveness of arthroscopic meniscectomy in subjects with knee osteoarthritis, in routine clinical practice, while taking into account the increased risk for future knee replacement surgery. We compared cost-effectiveness of arthroscopic meniscectomy compared to no surgery. DESIGN: - We used a state transition (Markov) simulation model to evaluate the cost-effectiveness of arthroscopic meniscectomy compared to no surgery in subjects with knee osteoarthritis (age range 45- 79 years)...
September 10, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28893426/outcomes-after-double-bundle-anterior-cruciate-ligament-reconstruction
#2
Ji Hyun Ahn, Ho Won Kang, Kug Jin Choi
PURPOSE: To identify the risk factors predicting unsatisfactory postoperative clinical outcomes after double-bundle (DB) anterior cruciate ligament (ACL) reconstruction using multivariate logistic regression. METHODS: Inclusion criteria were consecutive DB ACL reconstructions from January 2006 to September 2012 with a minimum 3-year follow-up. Exclusion criteria included (1) a delay to surgery from initial injury of more than 4 years (210 weeks); (2) contralateral knee pathology; (3) the lack of postoperative 3-dimensional computed tomography; (4) single-bundle ACL reconstruction; (5) revision ACL reconstruction; (6) meniscus allograft transplantation after total or subtotal meniscectomy; (7) multiple ligament surgeries...
September 8, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28888902/a-small-molecule-inhibitor-of-the-wnt-pathway-sm04690-as-a-potential-disease-modifying-agent-for-the-treatment-of-osteoarthritis-of-the-knee
#3
Vishal Deshmukh, Haide Hu, Charlene Barroga, Carine Bossard, Sunil Kc, Luis Dellamary, Joshua Stewart, Kevin Chiu, Maureen Ibanez, Melinda Pedraza, Tim Seo, Long Do, Shawn Cho, Joseph Cahiwat, Betty Tam, Jeyanesh R S Tambiah, John Hood, Nancy E Lane, Yusuf Yazici
OBJECTIVES: Osteoarthritis (OA) is a degenerative disease characterized by loss of cartilage and increased subchondral bone within synovial joints. Wnt signaling affects the pathogenesis of OA as this pathway modulates both the differentiation of osteoblasts and chondrocytes, and production of catabolic proteases. A novel small molecule Wnt pathway inhibitor, SM04690, was evaluated in a series of in vitro and in vivo animal studies to determine its effects on chondrogenesis, cartilage protection and synovial-lined joint pathology...
September 6, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28888901/oral-administration-of-undenatured-native-chicken-type-ii-collagen-uc-ii-diminished-deterioration-of-articular-cartilage-in-a-rat-model-of-oa
#4
Cedo M Bagi, Edwin R Berryman, Steve Teo, Nancy E Lane
OBJECTIVE: The aim of this study was to determine the ability of undenatured native chicken type II collagen (UC-II) to prevent excessive articular cartilage deterioration in a rat model of osteoarthritis (OA). METHODS: Twenty male rats were subjected to partial medial meniscectomy tear (PMMT) surgery to induce OA. Immediately after the surgery ten rats received vehicle and another ten rats oral daily dose of UC-II at 0.66 mg/kg for a period of 8 weeks. In addition ten naïve rats were used as an intact control and another 10 rats received sham surgery...
September 6, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28887704/-indication-and-limitations-of-meniscus-replacement
#5
REVIEW
C Stärke, S Kopf, R Becker
BACKGROUND: Meniscal lesions are among the most important musculoskeletal disorders and are the most common indication for knee joint arthroplasty. However, the structural integrity and function is rarely retained, and a loss of tissue results. Thus, there is a huge demand for meniscal replacement options. CURRENT PROCEDURES: Autografts were used in the past but did not fulfill expectations. Meniscus allografts have been developed to be a viable treatment option...
September 8, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28884106/understanding-posterior-meniscal-roots-lesions-from-basic-science-to-treatment
#6
REVIEW
Raphael Serra Cruz, Marcio Balbinotti Ferrari, Leonardo Metsavaht, Robert F LaPrade
The variability of symptoms and the fact that they are not easily recognized in imaging studies make the diagnosis and treatment of posterior meniscal roots lesions a challenging task to the orthopedist. In recent years, a more precise understanding of the anatomy and biomechanical impair of the knee joint in these cases has enabled great advances in therapeutic approaches. Well-documented studies have shown that the repair of these lesions presents superior functional and clinical improvement when compared with meniscectomy...
June 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28873348/management-of-traumatic-meniscal-tear-and-degenerative-meniscal-lesions-save-the-meniscus
#7
REVIEW
P Beaufils, N Pujol
Meniscectomy remains one of the most frequent orthopedic procedures, despite meniscal sparing having been advocated for several decades now. Incidence is excessive in the light of scientifically robust studies demonstrating the interest of meniscal repair or of non-operative treatment for traumatic tear and of non-operative treatment for degenerative meniscal lesions. It is high time that the paradigm shifted, in favor of meniscal preservation. In traumatic tear, and most particularly longitudinal vertical tear in vascularized zones, repair shows a high success rates in terms of recovery time, functional outcome and cartilage protection...
September 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28865577/saucerization-versus-complete-resection-of-a-symptomatic-discoid-lateral-meniscus-at-short-and-long-term-follow-up-a-systematic-review
#8
REVIEW
Dallas M Smuin, Richard D Swenson, Aman Dhawan
PURPOSE: To evaluate the surgical outcomes of symptomatic discoid menisci after total meniscectomy, saucerization, and suture repair of tears of a discoid meniscus at short- and long-term follow-up. METHODS: A systematic review was conducted using the Pubmed and ScienceDirect databases in adherence with Preferred Reporting Items of Systematic Reviews and Meta-Analysis guidelines. Short- and long-term follow-up were defined as an average follow-up of <4 years and >4 years, respectively...
September 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28854771/discoid-medial-meniscus-tear-with-a-literature-review-of-treatments
#9
In Soo Song, Jun Bum Kim, Jong Keun Lee, Byeong-Seop Park
The present study reports our experience of treating four cases of symptomatic discoid medial meniscus, three of which were bilateral. We performed partial meniscectomy with a four-portal technique using a knife leaving a 6 mm peripheral margin after confirmation of magnetic resonance imaging findings. Clinical results were assessed at the end of 2-year follow-up using the Knee Injury and Osteoarthritis Outcome Score and a visual analogue scale. We obtained satisfactory clinical results without recurrence of the symptoms in all cases...
September 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28852795/-meniscal-lesion-pre-osteoarthrotic-condition-of-the-knee-joint
#10
REVIEW
L Goebel, J Reinhard, H Madry
BACKGROUND: A close relationship between meniscal damage and articular cartilage exist. Likewise, (partial) meniscectomy may lead to the development of osteoarthritis (OA). OBJECTIVES: With a special emphasis on therapeutic consequences for orthopaedic surgeons, the structural and functional relationship between meniscal tears/extrusion and cartilage loss, and/or the effect of meniscectomy or meniscal repair on the development of OA, are emphasized. MATERIALS AND METHODS: A selective literature review with implementation of own research findings...
August 29, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28827270/study-protocol-for-a-randomised-controlled-trial-of-meniscal-surgery-compared-with-exercise-and-patient-education-for-treatment-of-meniscal-tears-in-young-adults
#11
Søren Thorgaard Skou, Martin Lind, Per Hölmich, Hans Peter Jensen, Carsten Jensen, Muhammad Afzal, Uffe Jørgensen, Jonas Bloch Thorlund
INTRODUCTION: Arthroscopic surgery is a very common orthopaedic procedure. While several trials have investigated the effect of knee arthroscopy for middle-aged and older patients with meniscal tears, there is a paucity of trials comparing meniscal surgery with non-surgical treatment for younger adults. The aim of this randomised controlled trial (RCT) is to investigate if early arthroscopic surgery is superior to exercise therapy and education, with the option of later surgery if needed, in improving pain, function and quality of life in younger adults with meniscal tears...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28806097/opioid-demand-before-and-after-anterior-cruciate-ligament-reconstruction
#12
Chris A Anthony, Robert W Westermann, Nicholas Bedard, Natalie Glass, Matt Bollier, Carolyn M Hettrich, Brian R Wolf
BACKGROUND: Surgeons and health care systems have received a call to action in an effort to curtail the current opioid epidemic. PURPOSE: To (1) define the natural history of opioid demand after anterior cruciate ligament reconstruction (ACLR), (2) consider how filling preoperative opioid prescriptions affects opioid demand after ACLR, and (3) evaluate the effect of additional procedures during ACLR and patient age on postoperative opioid demand. STUDY DESIGN: Cohort study; Level of evidence, 3...
August 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28806096/results-of-anterior-cruciate-ligament-reconstruction-with-patellar-tendon-autografts-objective-factors-associated-with-the-development-of-osteoarthritis-at-20-to-33-years-after-surgery
#13
K Donald Shelbourne, Rodney W Benner, Tinker Gray
BACKGROUND: Few studies exist that report objective radiographic and physical examination results at >20 years after anterior cruciate ligament (ACL) reconstruction. HYPOTHESIS: The risk of osteoarthritis (OA) at >20 years after surgery would be statistically significantly higher if an increased severity of factors was present. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Between 1982 and 1994, 1428 knees met the inclusion criteria of being primary ACL surgery, having no existing OA or other ligamentous laxity, and having no known graft tear...
August 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28805136/the-ovine-model-for-meniscus-tissue-engineering-considerations-of-anatomy-function-implantation-and-evaluation
#14
Andrzej Brzezinski, Salim A Ghodbane, Jay M Patel, Barbara A Perry, Charles J Gatt, Michael G Dunn
Meniscus injuries represent one of the most-common intra-articular knee injuries. The current treatment options include meniscectomy and allograft transplantation, both with poor long-term outcomes. Therefore, there is a need for regenerative techniques to restore meniscal function. In order to pre-clinically test scaffolds for meniscus replacement, large-animal models need to be established and standardized. This review establishes the anatomical and compositional similarities between the human and sheep menisci and provides guidance for implantation and evaluation of such devices...
August 12, 2017: Tissue Engineering. Part C, Methods
https://www.readbyqxmd.com/read/28780004/prognostic-factors-for-all-inside-meniscal-repair-a-87-case-series
#15
L Laurendon, T Neri, F Farizon, R Philippot
INTRODUCTION: Repair is indicated for tears in non-degenerative menisci. The literature reports a 15% failure rate for all-inside repair. The aim of the present study was to determine prognostic factors for failure of all-inside meniscal repair. The study hypothesis was that epidemiological, clinical and surgical factors affect success. MATERIAL AND METHODS: A retrospective study included 87 meniscal repair procedures, with or without anterior cruciate ligament (ACL) tear...
August 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28757192/delivery-of-epidermalgrowthfactor-receptor-inhibitor-via-a-customized-collagen-scaffold-promotes-meniscal-defect-regeneration-in-a-rabbit-model
#16
Zongyou Pan, Yan Wu, Xiaolei Zhang, Qianbao Fu, Jun Li, Yang Yang, Dongsheng Yu, Yuzi Xu, Xiaolang Lu, Heng Sun, Xianzhu Zhang, Boon Chin Heng, Varitsara Bunpetch, Shufang Zhang, Hongwei Ouyang
Meniscal injury is one of the most common knee joint injuries, which remains an intractable challenge in clinical practice to date. Aberrant epidermalgrowthfactor receptor (EGFR) activation levels in both human and mice menisci following injury, prompted us to investigate the functional role of EGFR by utilizing an inducible cartilage-specific EGFR-deficient mouse model. We demonstrated that conditional EGFR deletion in mice resulted in increased partial meniscectomy-induced ECM production within the meniscus, which is comparable to utilization of the small molecule EGFR inhibitor, gefitinib, to block EGFR activity...
July 27, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28756934/postoperative-anticholinergic-poisoning-concealed-complications-of-a-commonly-used-medication
#17
Xiao Chi Zhang, Natalija Farrell, Thomas Haronian, Jason Hack
BACKGROUND: Scopolamine is a potent anticholinergic compound used commonly for the prevention of postoperative nausea and vomiting. Scopolamine can cause atypical anticholinergic syndromes due to its prominent central antimuscarinic effects. CASE REPORT: A 47-year-old female presented to the emergency department (ED) 20 h after hospital discharge for a right-knee meniscectomy, with altered mental status (AMS) and dystonic extremity movements that began 12 h after her procedure...
July 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28735822/conservative-management-of-a-traumatic-meniscal-injury-utilising-osteopathy-and-exercise-rehabilitation-a-case-report
#18
Jack Feehan, Chris Macfarlane, Brett Vaughan
Meniscal injury is one of the most common knee soft tissue injuries, commonly affecting young athletes and an older, degenerative population. Treatment largely depends on the type and extent of the injury with arthroscopic repair or meniscectomy being mainstays. Although non-surgical approaches have been described, there is no published literature regarding a combination of indirect osteopathic techniques and rehabilitation in the management of these injuries. The current case report follows a 20-year-old male presenting with a 5-day history of acute knee pain, following trauma during an Australian Rules Football (AFL) match...
August 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28719787/in-vivo-performance-of-a-novel-anatomically-shaped-total-meniscal-prosthesis-made-of-polycarbonate-urethane-a-12-month-evaluation-in-goats
#19
Anne C T Vrancken, Gerjon Hannink, Wojciech Madej, Nico Verdonschot, Tony G van Tienen, Pieter Buma
BACKGROUND: Injury or loss of the meniscus generally leads to degenerative osteoarthritic changes in the knee joint. However, the treatment options for symptomatic patients with total meniscectomy are limited. Therefore, we developed a novel, anatomically shaped, total meniscal implant made of polycarbonate urethane. PURPOSE: To evaluate the in vivo performance of this novel total meniscal implant. The assessment particularly focused on the implant's response to long-term physiological loading in a goat model and its chondroprotective capacity in comparison to clinically relevant controls...
July 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28712027/concomitant-meniscal-injury-in-anterior-cruciate-ligament-reconstruction%C3%A2-does-not-lead-to-poorer-short-term-post-operative-outcomes
#20
Amritpal Singh, Desmond Thiam Wei, Cheryl Tan Pei Lin, Shen Liang, Saumitra Goyal, Kimberly-Anne Tan, Brian Zhaojie Chin, Lingaraj Krishna
PURPOSE: The main objective was to compare post-operative outcomes in patients undergoing anterior cruciate ligament (ACL) reconstruction both with and without concomitant meniscus injury at a mean follow-up of 3.5 years. The secondary objective was to study the effect of different meniscal injury sites and treatment modalities on post-operative outcomes (PROS). METHODS: This is a retrospective analysis of a prospectively maintained database of patients undergoing ACL reconstruction at our tertiary institution between 2009 and 2012...
July 15, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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