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Knee meniscus

Aaron J Krych, Patrick J Reardon, Nick R Johnson, Rohith Mohan, Logan Peter, Bruce A Levy, Michael J Stuart
PURPOSE: Medial meniscus posterior root tears (MMPRTs) are a significant source of pain and dysfunction, but little is known about the natural history and outcome and for non-operative management of these lesions. The purpose of this study was to evaluate (1) the mid-term clinical and radiographic outcomes of non-operative treatment of MMPRTs and (2) risk factors for worse outcomes. METHODS: A retrospective review was performed for patients with symptomatic, unrepaired MMPRTs and a minimum 2-year follow-up for IKDC and Tegner outcome scores...
October 19, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Elizabeth M Meier, Bin Wu, Aamir Siddiqui, Donna G Tepper, Michael T Longaker, Mai T Lam
: Efforts have been made to engineer knee meniscus tissue for injury repair, yet most attempts have been unsuccessful. Creating a cell source that resembles the complex, heterogeneous phenotype of the meniscus cell remains difficult. Stem cell differentiation has been investigated, mainly using bone marrow mesenchymal cells and biochemical means for differentiation, resulting in no solution. Mechanical stimulation has been investigated to an extent with no conclusion. Here, we explore the potential for and effectiveness of mechanical stimulation to induce the meniscal phenotype in adipose-derived stromal cells...
September 2016: Plastic and Reconstructive Surgery. Global Open
Fei Yu, Hui Zeng, Ming Lei, De-Ming Xiao, Wei Li, Hao Yuan, Jian-Jing Lin
This study investigated the effects of SIRT1 gene knock-out on osteoarthritis in mice, and the possible roles of SREBP2 protein and the PI3K/AKT signaling pathway in the effects. Mice were randomly divided into a normal group and a SIRT1 gene knock-out group (6 mice in each group). In these groups, one side of the knee anterior cruciate ligament was traversed, and the ipsilateral medial meniscus was cut to establish an osteoarthritis model of knee joint. The countralateral synovial bursa was cut out, serving as controls...
October 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
Sung Il Wang
In symptomatic discoid medial meniscus, partial meniscectomy is the principal treatment method and can yield promising short-term results. However, unlike the nondiscoid meniscus, discoid medial meniscus is frequently associated with horizontal cleavage tears, attributable to the presence of myxoid degeneration in the intrameniscal substance, in that it may potentially occur deteriorating long-term results because of re-tearing of remaining meniscus or secondary degeneration of cartilage of the medial compartment after meniscectomy...
October 14, 2016: Acta Orthopaedica et Traumatologica Turcica
Ravi Gupta, Gladson David Masih, Gaurav Chander, Vikas Bachhal
BACKGROUND: Despite improvements in instability after anterior cruciate ligament (ACL) reconstruction, associated intraarticular injuries remain a major cause of concern and important prognostic factor for long term results as it may lead to osteoarthritis. Delay in ACL reconstruction has been in variably linked to increase in these injuries but there is lack of consensus regarding optimal timing of reconstruction. The goal of this study was to investigate delay in surgery and other factors, associated with intraarticular injuries in ACL deficient knees...
September 2016: Indian Journal of Orthopaedics
Takayuki Furumatsu, Toshifumi Ozaki
The multifunctional growth factor CYR61/CTGF/NOV (CCN) 2, also known as connective tissue growth factor, regulates cellular proliferation, differentiation, and tissue regeneration. Recent literatures have described important roles of CCN2 in the meniscus metabolism. However, the mechanical stress-mediated transcriptional regulation of CCN2 in the meniscus remains unclear. The meniscus is a fibrocartilaginous tissue that controls complex biomechanics of the knee joint. Therefore, the injured unstable meniscus has a poor healing potential especially in the avascular inner region...
2017: Methods in Molecular Biology
C H Siebert, R Becker, M Buchner, J Förster, K-H Frosch, A Losch, P Niemeyer, S Scheffler
The number of patients with meniscal injuries is increasing constantly, but the treatment algorithms are undergoing continuous change. The effects of meniscal surgery, as well as the indications for the procedure, are currently a matter of heated debate. Various German speaking associations addressing topics related to the knee have joined forces to develop guidelines for the diagnosis, evaluation and therapy of meniscal lesions. The hope is that this first of two publications will shed light on some of the ongoing issues and offer guidance to health care professionals treating these patients...
October 11, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Ozkan Kose, Selahattin Ozyurek, Adil Turan, Ferhat Guler
Reverse Segond fracture is originally described as an indirect radiographic clue for a specific injury complex of the knee joint that includes posterior cruciate ligament (PCL) rupture and medial meniscal tear. Herein, we describe a case with reverse Segond fracture associated with PCL avulsion fracture instead of PCL rupture. According to current literature review, reverse Segond fracture is not only associated with PCL and medial meniscal injuries, but also frequently associated with anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries...
October 7, 2016: Acta Orthopaedica et Traumatologica Turcica
Andrew R Palisch, Ronald R Winters, Marc H Willis, Collin D Bray, Theodore B Shybut
The menisci play an important biomechanical role in axial load distribution of the knees by means of hoop strength, which is contingent on intact circumferentially oriented collagen fibers and meniscal root attachments. Disruption of the meniscal root attachments leads to altered biomechanics, resulting in progressive cartilage loss, osteoarthritis, and subchondral edema, with the potential for development of a subchondral insufficiency fracture. Identification of meniscal root tears at magnetic resonance (MR) imaging is crucial because new arthroscopic surgical techniques (transtibial pullout repair) have been developed to repair meniscal root tears and preserve the tibiofemoral cartilage of the knee...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Richard Kijowski, Humberto Rosas, Alexey Samsonov, Kevin King, Rob Peters, Fang Liu
PURPOSE: To investigate the feasibility of using compressed sensing (CS) to accelerate three-dimensional fast spin-echo (3D-FSE) imaging of the knee. MATERIALS AND METHODS: A 3D-FSE sequence was performed at 3T with CS (CUBE-CS with 3:16-minute scan time) and without CS (CUBE with 4:44-minute scan time) twice on the knees of 10 healthy volunteers to assess signal-to-noise ratio (SNR) using the addition-subtraction method and once on the knees of 50 symptomatic patients to assess diagnostic performance...
October 11, 2016: Journal of Magnetic Resonance Imaging: JMRI
Zhiguo Yuan, Shuyun Liu, Chunxiang Hao, Weimin Guo, Shuang Gao, Mingjie Wang, Mingxue Chen, Zhen Sun, Yichi Xu, Yu Wang, Jiang Peng, Mei Yuan, Quan-Yi Guo
Tissue-engineered meniscus regeneration is a very promising treatment strategy for meniscus lesions. However, generating the scaffold presents a huge challenge for meniscus engineering as this has to meet particular biomechanical and biocompatibility requirements. In this study, we utilized acellular meniscus extracellular matrix (AMECM) and demineralized cancellous bone (DCB) to construct three different types of three-dimensional porous meniscus scaffold: AMECM, DCB, and AMECM/DCB, respectively. We tested the scaffolds' physicochemical characteristics and observed their interactions with meniscus fibrochondrocytes to evaluate their cytocompatibility...
September 28, 2016: Biomaterials
James L Cook, Keiichi Kuroki, Aaron M Stoker, Farrah A Monibi, Brandon L Roller
The knee is a fascinating yet complex joint. Researchers and clinicians agree that the joint is an organ comprised of highly specialized intrinsic and extrinsic tissues contributing to both health and disease. Key to the function and movement of the knee are the menisci, exquisite fibrocartilage structures that are critical structures for maintaining biologic and biomechanical integrity of the joint. The biologic/physiologic functions of the menisci must be understood at the tissue, cellular and even molecular levels in order to determine clinically relevant methods for assessing it and influencing it...
October 7, 2016: Connective Tissue Research
Juan Ma, Ruibin Li, Guangbo Qu, Huiyu Liu, Bing Yan, Tian Xia, Yajun Liu, Sijin Liu
Carbon nanotubes (CNTs) have promising applications in a wide range of biomedical fields, including imaging, drug/gene delivery and other therapeutics; however, the biosafety concerns of CNTs should be addressed. To date, many reports have documented the toxicological effects on the cells, tissue or organs that are in direct contact with the tubes; however, there is limited evidence to unravel the secondary toxicity upon CNT treatment. Moreover, more effort is needed to gain a definitive understanding of the adverse outcome pathway (AOP) for CNTs, and a pragmatic framework for risk assessment has not been established yet...
September 29, 2016: Nanoscale
Marco Nitri, Jorge Chahla, David Civitarese, Sanjeev Bhatia, Samuel G Moulton, Christopher M LaPrade, Robert F LaPrade
Complete radial tears of the medial meniscus significantly decrease the meniscal tissue's ability to dissipate tibiofemoral loads and have been described as functionally similar to a total meniscectomy, predisposing patients to early osteoarthritis. At present, no consensus exists regarding the optimal surgical treatment of a radial meniscal tear. Current repair techniques have led to a reportedly high rate of incomplete healing or healing of the meniscus in a nonanatomic, gapped position, which compromises its ability to withstand hoop stresses...
August 2016: Arthroscopy Techniques
Ayoosh Pareek, Michael P O'Malley, Bruce A Levy, Michael J Stuart, Aaron J Krych
Understanding of meniscal function through basic science, natural history, and biomechanics has highlighted the importance of preserving the meniscus to maintain normal knee biomechanics. Tears that may alter these biomechanics can contribute to the progressive nature of degenerative joint disease in the knee. Radial tears result in the disruption of the circumferential fibers causing inability of the native meniscus to resist normal hoop stresses, thereby leading to increased focal areas of pressure that cause complications such as early onset arthrosis...
August 2016: Arthroscopy Techniques
Adrian Todor, Sergiu Caterev, Dan Viorel Nistor
Arthroscopic partial medial meniscectomy is a very common orthopaedic procedure performed for symptomatic, irreparable meniscus tears. It is usually associated with a very good outcome and minimal complications. In some patients with tight medial compartment, the posterior horn of the medial meniscus can be difficult to visualize, and access in this area with instruments may be challenging. To increase the opening of the medial compartment, after valgus-extension stress position of the knee, different techniques of deep medial collateral ligament release have been described...
August 2016: Arthroscopy Techniques
Alexandra S Gersing, Benedikt J Schwaiger, Ursula Heilmeier, Gabby B Joseph, Luca Facchetti, Martin Kretzschmar, John A Lynch, Charles E McCulloch, Michael C Nevitt, Lynne S Steinbach, Thomas M Link
OBJECTIVES: To evaluate the ability of different MRI sequences to detect chondrocalcinosis within knee cartilage and menisci, and to analyze the association with joint degeneration. METHODS: Subjects with radiographic knee chondrocalcinosis (n = 90, age 67.7 ± 7.3 years, 50 women) were selected from the Osteoarthritis Initiative and matched to controls without radiographic chondrocalcinosis (n = 90). Visualization of calcium-containing crystals (CaC) was compared between 3D T1-weighted gradient-echo (T1GE), 3D dual echo steady-state (DESS), 2D intermediate-weighted (IW), and proton density (PD)-weighted fast spin-echo (FSE) sequences obtained with 3T MRI and correlated with a semiquantitative CaC score obtained from radiographs...
October 4, 2016: European Radiology
Eisuke Nomura, Hisatada Hiraoka, Hiroya Sakai
We report two cases of the spontaneous recurrent hemarthrosis of the knee. In these cases lateral meniscus was severely torn and a small tubular soft tissue with pulsation was identified on the synovium in the posterolateral corner during arthroscopic surgery of the knee joint. Gentle grasping of this tissue by forceps led to pulsating bleeding, which stopped by electrocoagulation. This soft tissue was considered a source of bleeding, since no recurrence of hemarthrosis was observed for more than four years after surgery...
2016: Case Reports in Orthopedics
Michael D Ringler, Ezekiel E Shotts, Mark S Collins, B Matthew Howe
OBJECTIVE: Unlike with anterior cruciate ligament injury, little is known about the prevalence of intra-articular pathology associated with isolated posterior cruciate ligament (PCL) injury in the knee. The objectives of this study were to characterize and identify the frequency of meniscal tears and osteochondral injuries in these patients, and to see if management might be affected. MATERIALS AND METHODS: Altogether, 48 knee MRI exams with isolated PCL tears were evaluated for the presence of: grade and location of PCL tear, meniscal tear, articular chondral lesion, bone bruise, and fracture...
October 4, 2016: Skeletal Radiology
J Martin Leland
With knee arthroscopy being the most common orthopaedic procedure performed in the United States, it is crucial to be able to access the entire knee without iatrogenic injury. Frequently orthopaedic surgeons encounter tight medial compartments, creating difficulty in accessing the posterior horn of the medial meniscus without damaging the articular cartilage. Partial release of the medial collateral ligament during knee arthroscopy protects chondrocytes.
October 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
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