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Knee meniscus tear

Ingrid Eitzen, Hege Grindem, Agnethe Nilstad, Håvard Moksnes, May Arna Risberg
BACKGROUND: Reduced quadriceps strength influences knee function and increases the risk of knee osteoarthritis. Thus, it is of significant clinical relevance to precisely quantify strength deficits in patients with knee injuries. PURPOSE: To evaluate isokinetic concentric quadriceps muscle strength torque values, assessed both from peak torque and at specific knee flexion joint angles, in patients with anterior cruciate ligament (ACL) injury, focal cartilage lesions, and degenerative meniscus tears...
October 2016: Orthopaedic Journal of Sports Medicine
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
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
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
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
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
Tetsuo Hagino, Satoshi Ochiai, Shinya Senga, Takashi Yamashita, Masanori Wako, Takashi Ando, Hirotaka Haro
PURPOSE: To study discoid meniscus in children who underwent arthroscopic surgery at our center. SUBJECTS AND METHODS: Thirty-four patients (39 knees) younger than 15 years with discoid lateral meniscus (mean age, 12.9 years; 13 males, 21 females) who underwent arthroscopic surgeries since 2007 were studied. The surgical procedure consisted of, in principle, saucerization with additional suture repair in the case of meniscal instability at the peripheral rim of the residual meniscus...
October 1, 2016: Archives of Orthopaedic and Trauma Surgery
Yuezheng Hu, Xinxian Xu, Xiaoyun Pan, Huachen Yu, Yu Zhang, Hong Wen
BACKGROUND: The treatment of discoid meniscus is debatable. This study aimed to assess the clinical efficacy of combined outside-in and FasT-Fix sutures for the treatment of serious discoid meniscal tears. METHODS: This study included 32 consecutive patients who underwent arthroscopic meniscal plasty for serious discoid meniscal tears (full-thickness vertical, longitudinal tears >10mm) between October 2006 and June 2012. A combination of outside-in and FasT-Fix sutures was used to treat serious discoid meniscal tears...
September 17, 2016: Knee
Robert W Westermann, Thomas Sean Lynch, Kurt P Spindler
Since 2015, the Multicenter Orthopedic Outcomes Network (MOON) has addressed several factors associated with patient outcome after anterior cruciate ligament (ACL) injury. These factors include predictors of high grade knee laxity, the impact of meniscus treatment on joint space narrowing after surgery, graft selection, treating diabetic patients, predictors of clinically significant pain, and outcomes of patients where meniscus tears were left in situ without treatment. The presence of meniscus tears and generalized laxity predict a lax examination under anesthesia prior to surgery...
October 2016: Journal of Knee Surgery
L Felli, G Garlaschi, A Muda, A Tagliafico, M Formica, A Zanirato, M Alessio-Mazzola
PURPOSE: The aim of this study was to compare the accuracy of clinical examination to that of MRI evaluated by two independent radiologists for the diagnosis of meniscal tears and chronic anterior cruciate ligament injuries and to assess the MRI accuracy in the diagnosis of cartilage defects. METHODS: Seventy-six consecutive patients with suspected intra-articular knee pathology were prospectively evaluated by objective examination, 1.5 T MRI, re-examined by trained radiologist and arthroscopy...
September 14, 2016: Musculoskeletal Surgery
Kyu Sung Chung, Jeong Ku Ha, Ho Jong Ra, Jin Goo Kim
PURPOSE: To investigate pain and tenderness, stress testing, clinical outcome scores, complications, and operation time at 24 months and magnetic resonance imaging (MRI) analysis at 12 months after the release of the distal attachment of the superficial medial collateral ligament (sMCL) during medial meniscus posterior root tear (MMPRT) fixation. METHODS: Patients who received MMPRT fixation with a follow-up of at least 2 years were included. During fixation, the release of the distal attachment of the sMCL on the proximal tibia was performed to improve visualization and provide sufficient working space...
September 7, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
A Z Chowdhury, M M Tarik, I K Kundu, M A Hannan, M G Sarwar, M A Faisal, K N Arifeen, B C Debnath
The meniscus is the most commonly injured structure in the knee joint. Carefully performed clinical examination can give better diagnosis of meniscal tear. The aim of this study was to find out the correlation between clinical and arthroscopic findings in meniscal tear of knee. This cross sectional observational study was conducted in the Department of Orthopaedic Surgery, BSMMU, Dhaka from July 2012 to June 2014. Thirty patients of meniscal tear were selected as per inclusion and exclusion criteria. After proper evaluation and clinical examination of these patient arthroscopic examinations was done under spinal anesthesia...
July 2016: Mymensingh Medical Journal: MMJ
Robert H Brophy, Linda J Sandell, Muhammad Farooq Rai
BACKGROUND: Meniscus tears are classified as traumatic or degenerative based on the tear pattern. There is little evidence demonstrating biological differences between the 2 tear types. HYPOTHESIS: Gene expression signatures in the injured meniscus are different between traumatic (vertical) and degenerative (complex, horizontal, or flap) tears. STUDY DESIGN: Controlled laboratory study. METHODS: Samples of the torn meniscus from the white-white zone were removed at the time of clinically indicated partial meniscectomy from 48 patients (37 with degenerative tears and 11 with traumatic tears)...
September 7, 2016: American Journal of Sports Medicine
Jae Gyoon Kim, Seung-Yup Lee, Suhwoo Chay, Hong Chul Lim, Ji-Hoon Bae
PURPOSE: The purpose of this study was to evaluate the demographics, clinical features, and outcomes of arthroscopic partial meniscectomy (APM) for isolated medial meniscus horizontal cleavage tears (MMHCTs) in patients under 45 years of age. MATERIALS AND METHODS: We retrospectively reviewed 98 patients (100 knees) under 45 years who underwent APM for MMHCTs. Clinical outcomes were assessed using International Knee Document Committee (IKDC) subjective core, Tegner activity scale, visual analog scale (VAS) pain score, and a question on the symptom relief...
September 2016: Knee Surgery & related Research
Nicholas A Sgaglione
Repair of knee meniscus radial tears can result in clinical success. More precise and well-defined indications, surgical techniques, and outcomes are needed.
September 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Y Kodama, T Furumatsu, M Fujii, T Tanaka, S Miyazawa, T Ozaki
A medial meniscus posterior root tear (MMPRT) may increase the tibiofemoral contact pressure by decreasing the tibiofemoral contact area. Meniscal dysfunction induced by posterior root injury may lead to the development of osteoarthritic knees. Repair of a MMPRT can restore medial meniscus (MM) function and prevent knee osteoarthritis progression. Several surgical procedures have been reported for treating a MMPRT. However, these procedures are associated with several technical difficulties. Here, we describe a technique to stabilize a torn MM posterior root using the FasT-Fix(®) all-inside meniscal suture device and a new aiming device...
August 23, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
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