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Meniscal lesions

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
Axel Marx, Alexander Beier, Pouria Taheri, Martin Röpke, Thomas Kalinski, Andreas M Halder
BACKGROUND: Avascular necrosis after arthroscopic surgery of the knee has already been published. The purpose of this article is to report on the frequently misdiagnosed entity of osteonecrosis of the medial tibial plateau. CASE PRESENTATION: Charts and radiographs of a consecutive series with isolated medial tibial plateau osteonecrosis were analyzed. The criterion for inclusion was the absence of trauma. Six caucasian female patients with an average age of 76...
October 19, 2016: Journal of Medical Case Reports
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
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
Piya-On Numpaisal, Benjamin B Rothrauff, Riccardo Gottardi, Chung-Liang Chien, Rocky S Tuan
PURPOSE: Treatment of meniscus tears is a persistent challenge in orthopaedics. Although cell therapies have shown promise in promoting fibrocartilage formation in in vitro and preclinical studies, clinical application has been limited by the paucity of autologous tissue and the need for ex vivo cell expansion. Rapid dissociation of the free edges of the anterior and posterior meniscus with subsequent implantation in a meniscus lesion may overcome these limitations. The purpose of this study was to explore the effect of rapidly dissociated meniscus tissue in enhancing neotissue formation in a radial meniscus tear, as simulated in an in vitro explant model...
October 11, 2016: Connective Tissue Research
Pinkawas Kongmalai, Bancha Chernchujit
A posterior horn of medial meniscal peripheral capsular is usually associated with the anterior cruciate ligament injury. The conventional repair technique with the camera in the anterolateral portal cannot precisely restore the slope capsular synovium to the original attachment point. We present the arthroscopic technique for improving the accuracy and quality of the repair by working in the posterior compartment. When the posterolateral portal is used as the viewing portal, the accuracy of repair is improved because we can assess the full extent of the lesion and lift the sagging peripheral tissue to the more central part...
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
Bum-Sik Lee, Seong-Il Bin, Jong-Min Kim, Jae Hyan Kim, Eic Ju Lim
PURPOSE: To determine the relationship between preoperative subluxation of the original menisci and postoperative graft subluxation after lateral meniscal allograft transplantation (MAT). METHODS: Fourteen patients who underwent isolated lateral MATs in meniscus-deficient knees with a low-grade chondral lesion (≤ICRS grade 2) were assessed. Lateral subluxation of the native meniscus before meniscectomy and those of remaining meniscal tissue before MAT were measured on mid-coronal MRI scans taken at each time point...
September 30, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Simon Décary, Philippe Ouellet, Pascal-André Vendittoli, Jean-Sébastien Roy, François Desmeules
INTRODUCTION: More evidence on diagnostic validity of physical examination tests for knee disorders is needed to lower frequently used and costly imaging tests. OBJECTIVE: To conduct a systematic review of systematic reviews (SR) and meta-analyses (MA) evaluating the diagnostic validity of physical examination tests for knee disorders. METHODS: A structured literature search was conducted in five databases until January 2016. Methodological quality was assessed using the AMSTAR...
August 5, 2016: Physical Therapy in Sport
N Jan, B Sonnery-Cottet, J-M Fayard, C Kajetanek, M Thaunat
INTRODUCTION: All-inside posteromedial suture for lesions of the posterior horn of the medial meniscus in anterior cruciate ligament (ACL) repair provides effective freshening and good healing. HYPOTHESIS: The posteromedial portal provides satisfactory healing rates without increasing morbidity or complications rates. MATERIAL AND METHODS: Intra- and postoperative complications were collected for a consecutive single-center series of 132 patients undergoing posteromedial hook suture of the medial meniscus in ACL repair...
September 26, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Karima Belhaj, Hicham Elhyaoui, Soumia Meftah, Laila Mahir, Mohamed Rafai, Abdelhak Garch, Fatima Lmidmani, Abdellatif Elfatimi
OBJECTIVE: Meniscal injuries are an extremely common condition that also occurs well in young adults at a sporting injury, than in most elderly where it is often the degenerative changes in the knee illustration. The application of isokinetic knee is widespread, either in assessment or rehabilitation. The objective of the study is to determine the contribution of the isokinetic for meniscal pathology. MATERIAL/PATIENTS AND METHODS: This is a retrospective study of 6 months, including patients followed in physical medicine and rehabilitation for meniscal lesions confirmed by imaging and in whom supported classical rehabilitative and/or isokinetic was indicated...
September 2016: Annals of Physical and Rehabilitation Medicine
Thomas W Hamilton, Rajan Choudhary, Cathy Jenkins, Stephen J Mellon, Christopher A F Dodd, David W Murray, Hemant G Pandit
PURPOSE: Lateral osteophytes have been reported to be associated with lateral compartment disease and as such it is unclear whether medial unicompartmental knee arthroplasty should be performed if these are present. METHODS: Using the OARSI classification system, 0 (no osteophyte) to 3 (large osteophyte), radiographs from a series of cemented meniscal-bearing unicompartmental knee arthroplasty implanted in the setting of full-thickness lateral cartilage where lateral osteophytes were not considered a contraindication were identified and factors associated with the presence and size of lateral osteophytes, and their impact on clinical outcomes and implant survival were assessed...
September 8, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Bert R Mandelbaum
Articular cartilage lesions, whether acute or chronic, are among the most common and difficult-to-treat conditions of the knee in the adolescent and athletic population. The results from a study in this issue as well as some in the previous literature suggest that autologous chondrocyte implantation yields long-term improvement in function and symptoms and may be a viable treatment for young to adult athletes or patients with high physical demands and a long active lifespan. No intervention in the young symptomatic patient will yield inferior results because it appears that no treatment over time has deleterious effects...
September 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Gregory L Cvetanovich, Jonathan C Riboh, Annemarie K Tilton, Brian J Cole
BACKGROUND: Existing studies of autologous chondrocyte implantation (ACI) in adolescent patients have primarily reported outcomes that have not been validated for cartilage repair and have failed to include measures of general health or health-related quality of life. PURPOSE: This study assesses validated knee-specific functional outcomes and health-related quality of life after ACI in adolescent patients. STUDY DESIGN: Case series; Level of evidence, 4...
August 26, 2016: American Journal of Sports Medicine
R Homsi, J Gieseke, J A Luetkens, P Kupczyk, B Maedler, G M Kukuk, F Träber, B Agha, M Rauch, N Rajakaruna, W Willinek, H H Schild, D R Hadizadeh
PURPOSE: To evaluate whether a 3 D proton density-weighted fat-suppressed sequence (PDwFS) of the knee is able to replace multiplanar 2D-PDwFS. MATERIALS AND METHODS: 52 patients (26 men, mean age: 41.9 ± 14.5years) underwent magnetic resonance imaging (MRI) of the knee at 3.0 Tesla using a T/R-coil. The imaging protocol included 3 planes of 2D-PDwFS (acquisition time (AT): 6:40 min; voxel sizes: 0.40 - 0.63 × 0.44 - 0.89 × 3mm³) and a 3D-PDwFS (AT: 6:31 min; voxel size: 0...
October 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Zhen Wang, Zhibing Tang, Chaoqun Liu, Jinlian Liu, Yaozeng Xu
PURPOSE: The purpose of this study is to explore whether arthroscopically assisted reduction and internal fixation (ARIF) is superior to traditional open reduction and internal fixation (ORIF) in the treatment of tibial plateau fractures. METHODS: Fifty-seven patients with tibial plateau fractures (Schatzker type I-IV) treated by ARIF or ORIF from 2010 to 2013 were included in this retrospective study. All patients received pre-operative radiographs and CT scans...
August 23, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
A Levillain, H Magoariec, C Boulocher, A Decambron, V Viateau, T Hoc
The aim of this study was to evaluate the effect of early osteoarthritis (OA) on the viscoelastic properties of rabbit menisci and to correlate the mechanical alterations with the microstructural changes. Anterior Cruciate Ligament Transection (ACLT) was performed in six male New-Zealand White rabbits on the right knee joint. Six healthy rabbits served as controls. Menisci were removed six weeks after ACLT and were graded macroscopically. Indentation-relaxation tests were performed in the anterior and posterior regions of the medial menisci...
August 10, 2016: Journal of the Mechanical Behavior of Biomedical Materials
B L Wise, J Niu, A Guermazi, F Liu, U Heilmeier, E Ku, J A Lynch, Y Zhang, D T Felson, C K Kwoh, N E Lane
OBJECTIVE: Isolated lateral compartment tibiofemoral radiographic osteoarthritis (IL-ROA) is an understudied form of knee osteoarthritis (OA). The objective of the present study was to characterize Magnetic Resonance Imaging (MRI) abnormalities and MR-T2 relaxation time measurements associated with IL-ROA and with isolated medial compartment ROA (IM-ROA) compared with knees without OA. METHOD: 200 case subjects with IL-ROA (Kellgren/Lawrence (K/L) grade≥2 and joint space narrowing (JSN) > 0 in the lateral compartment but JSN = 0 in the medial compartment) were randomly selected from the Osteoarthritis Initiative baseline visit...
August 15, 2016: Osteoarthritis and Cartilage
B Antony, J B Driban, L L Price, G H Lo, R J Ward, M Nevitt, J Lynch, C B Eaton, C Ding, T E McAlindon
OBJECTIVE: To determine the association of different types of meniscal pathology with knee pain, bone marrow lesion (BML) volume, and end-stage knee osteoarthritis (esKOA). DESIGN: Participants were selected from an ancillary project to the Osteoarthritis Initiative (OAI) who had at least one knee with symptomatic osteoarthritis. Baseline magnetic resonance images (MRI) were evaluated for meniscal pathology using a modified International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine (ISAKOS) classification system...
August 15, 2016: Osteoarthritis and Cartilage
Giuseppe Filardo, Berardo Di Matteo, Francesco Tentoni, Alessia Cavicchioli, Alessandro Di Martino, Mirco Lo Presti, Francesco Iacono, Elizaveta Kon, Maurilio Marcacci
BACKGROUND: The management of the postoperative period after knee arthroscopic surgery may be challenging because surgical trauma deeply alters the joint microenvironment, causing the release of several catabolic molecules and proinflammatory factors that might slow down functional recovery. The possibility of using hyaluronic acid (HA) to promote postoperative pain relief and expedite functional improvement seems attractive, considering its biological properties. PURPOSE: The aim of the present double-blind randomized controlled trial was to evaluate the effects, in terms of pain control and functional recovery, provided by a single HA injection performed at the end of arthroscopic meniscectomy...
August 15, 2016: American Journal of Sports Medicine
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