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https://www.readbyqxmd.com/read/29445968/arthroscopic-direct-meniscal-extrusion-reduction-surgical-tips-to-reduce-persistent-meniscal-extrusion-in-meniscal-root-repair
#1
Bancha Chernchujit, Renaldi Prasetia
Meniscal extrusion (ME) is defined as extension of the meniscal margin by at least 3 mm beyond the tibial margin. The main purpose of meniscal root repair is to restore the anatomy and function of the meniscus. Therefore, the reduction in the ME is one of the important objective outcomes. Nevertheless, the reduced meniscal extrusion was obtained in limited patients after meniscal root repair. This technical note described the arthroscopic direct meniscal extrusion reduction as surgical tips to reduce persistent meniscal extrusion in posterior meniscal root repair...
February 14, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29443758/a-novel-arthroscopic-all-inside-suture-technique-using-the-fast-fix-360-system-for-repairing-horizontal-meniscal-tears-in-young-athletes-3-case-reports
#2
Satoru Atsumi, Kunio Hara, Yuji Arai, Manabu Yamada, Naoki Mizoshiri, Aguri Kamitani, Toshikazu Kubo
RATIONALE: Considering the risk of osteoarthritis following resection of a horizontally torn meniscus of the knee, repairing and preserving the meniscus as much as possible is preferred. We report 3 cases of restoration of horizontally torn menisci using a novel arthroscopic method we have called "all-inside interleaf vertical suture" that afforded preservation. PATIENT CONCERNS: The 3 patients (aged 14, 17, and 21 years) had knee pain through sports activity. DIAGNOSES: All patients had horizontal tears in the posteromedial part of the meniscus...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29430489/posterior-cruciate-ligament-current-concepts-review
#3
REVIEW
Santiago Pache, Zachary S Aman, Mitchell Kennedy, Gilberto Yoshinobu Nakama, Gilbert Moatshe, Connor Ziegler, Robert F LaPrade
The posterior cruciate ligament (PCL) is the largest and strongest ligament in the human knee, and the primary posterior stabilizer. Recent anatomy and biomechanical studies have provided an improved understanding of PCL function. PCL injuries are typically combined with other ligamentous, meniscal and chondral injuries. Stress radiography has become an important and validated objective measure in surgical decision making and post-operative assessment. Isolated grade I or II PCL injuries can usually be treated non-operatively...
January 2018: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29430394/both-posterior-root-lateral-medial-meniscus-tears-with-anterior-cruciate-ligament-rupture-the-step-by-step-systematic-arthroscopic-repair%C3%A2-technique
#4
Bancha Chernchujit, Renaldi Prasetia
The occurrence of posterior root tear of both the lateral and medial menisci, combined with anterior cruciate ligament rupture, is rare. Problems may be encountered such as the difficulty to access the medial meniscal root tear, the confusing circumstances about which structure to repair first, and the possibility of the tunnel for each repair to become taut inside the tibial bone. We present the arthroscopy technique step by step to overcome the difficulties in an efficient and time-preserving manner.
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29416975/all-inside-arthroscopic-meniscal-repair-technique-using-a-midbody-accessory-portal
#5
S Tal Hendrix, Adam Kwapisz, Douglas J Wyland
Treatment of symptomatic meniscal tears continues to evolve as we improve our understanding of the biomechanical role of the meniscus and its long-term importance to the health of the knee joint. Suture repair of meniscal tears is challenging, yet the incidence of repairs among our colleagues continues to rise as we aim to preserve meniscal tissue. Many elements of performing a repair are tedious and difficult, including proper meniscal preparation, reduction, mattress suture placement, and fixation. The tear pattern and location present another layer of difficulty...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29416965/vertical-lasso-and-horizontal-lasso-sutures-for-repair-of-horizontal-cleavage-and-horizontal-oblique-meniscal-tears-surgical-technique-and-indications
#6
Kenneth R Brooks
Horizontal cleavage and horizontal oblique meniscal tears have traditionally been treated with partial meniscectomy. Recent research has shown the deleterious long-term effects of meniscectomy in these patients regarding the development of osteoarthritis. Meniscal preservation is thus the preferred method of surgical treatment in patients with these tears. However, traditional repair techniques using inside-out sutures or suture anchor-based devices do not address the horizontally aligned nature of these particular tears and thus do not compress the meniscal tissue in the correct plane...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29399471/platelet-rich-fibrin-clot-augmented-repair-of-horizontal-cleavage-meniscal-tear
#7
Christopher Kowalski, Robert A Gallo
Although horizontal tears of the meniscus have historically been treated with partial meniscectomy due to poor vascularity within the tear, evidence suggests that repair of horizontal meniscal tears may be advantageous to partial meniscectomy. Furthermore, the addition of platelet-rich plasma has shown promise in improving meniscal healing. We present our technique of platelet-rich fibrin clot-augmented repair of horizontal cleavage meniscal tear.
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29399465/endoscopic-all-inside-repair-of-the-flexor-hallucis-longus-tendon-in-posterior-ankle-impingement-patients
#8
Akinobu Nishimura, Shigeto Nakazora, Naoya Ito, Aki Fukuda, Ko Kato, Akihiro Sudo
Longitudinal flexor hallucis longus (FHL) tendon tears are sometimes complicated by posterior ankle impingement syndrome (PAIS), especially in ballet dancers. In recent years, PAIS has been treated endoscopically, but it is difficult to suture FHL tendon tears endoscopically. In this report, we describe how to suture the FHL tendon endoscopically with the Meniscal Viper Repair system (Arthrex, Naples, FL). Without our endoscopic technique, when a patient is found to have a longitudinal tear of the FHL under endoscopy, we must choose to either neglect the tear or convert to an open repair...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29396804/the-role-of-suture-cutout-in-the-failure-of-meniscal-root-repair-during-the-early-post-operative-period-a-biomechanical-study
#9
Ana Perez-Blanca, María Prado Nóvoa, Maximiano Lombardo Torre, Alejandro Espejo-Reina, Francisco Ezquerro Juanco, Alejandro Espejo-Baena
PURPOSE: To assess the role of suture cutout in the mechanics of failure of the repaired posterior meniscal root during the early post-operative period when using sutures of different shape. METHODS: Twenty medial porcine menisci were randomized in two groups depending on the suture shape used to repair the posterior root: thread or tape. The sutured menisci were subjected to cyclic loading (1000 cycles, (10, 30) N) followed by load-to-failure testing. Residual displacements, stiffness, and ultimate failure load were determined...
February 2, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29395746/reinterventions-after-dynamic-intraligamentary-stabilization-in-primary-anterior-cruciate-ligament-repair
#10
Janosch Häberli, Laurenz Jaberg, Kathrin Bieri, Stefan Eggli, Philipp Henle
BACKGROUND: The goal of this study was to perform an in-depth analysis of the frequency and cause of secondary interventions subsequent to primary anterior cruciate ligament (ACL) repair with dynamic intraligamentary stabilization (DIS). METHODS: Between July 2009 and June 2014, 455 patients underwent DIS treatment. The minimum follow-up was 21months (mean 28months, range 21-64months). RESULTS: A total of 215 (48.2%) reinterventions were performed in 190 (42...
January 29, 2018: Knee
https://www.readbyqxmd.com/read/29392109/clinical-outcome-of-meniscus-repair-for-isolated-meniscus-tear-in-athletes
#11
Hiroshi Nakayama, Ryo Kanto, Shunichiro Kambara, Kenji Kurosaka, Shintaro Onishi, Shinichi Yoshiya, Motoi Yamaguchi
Objective: To examine the clinical and functional outcomes for a series of patients who underwent meniscal repair for isolated meniscal tears focusing the study population on athletes. Methods: This study represents a case series of 46 athletes who underwent repair of isolated meniscal lesions of the knee from 2010 to 2015. Cases of discoid meniscal lesions and combined ligament injuries were excluded. The mean age of the patients was 22.9 years ranging from 12 to 50 years...
October 2017: Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology
https://www.readbyqxmd.com/read/29364699/the-strength-of-transosseous-medial-meniscal-root-repair-using-a-simple-suture-technique-is-dependent-on-suture-material-and-position
#12
James R Robinson, Evelyn G Frank, Alan J Hunter, Paul J Jermin, Harinderjit S Gill
BACKGROUND: A simple suture technique in transosseous meniscal root repair can provide equivalent resistance to cyclic load and is less technically demanding to perform compared with more complex suture configurations, yet maximum yield loads are lower. Various suture materials have been investigated for repair, but it is currently not clear which material is optimal in terms of repair strength. Meniscal root anatomy is also complex; consisting of the ligamentous mid-substance (root ligament), the transition zone between the meniscal body and root ligament; the relationship between suture location and maximum failure load has not been investigated in a simulated surgical repair...
January 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29354475/circumferential-suture-repair-of-isolated-horizontal-meniscal-tears-augmented-with-fibrin-clot
#13
Michael S Laidlaw, F Winston Gwathmey
Traditionally, horizontal cleavage meniscus tears have been associated with osteoarthritis, indicative of the degenerative process. Recent treatment measures have focused on maintaining as much meniscal tissue as possible, despite the routine extension of these tears into the central white-white zones. In the absence of tunnel drilling for cruciate ligament reconstructions, the use of an exogenous fibrin clot is a useful adjunct to increase the local growth factors at the tear repair to aid in healing. This surgical technique is to describe the use of an all-arthroscopic tied circumferential suture repair of horizontal meniscal tears augmented with exogenous fibrin clot to treat all locations of horizontal meniscal tears...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354453/arthroscopic-medial-meniscus-posterior-root-reconstruction-using-auto-gracilis-tendon
#14
Dhong Won Lee, Russel Haque, Kyu Sung Chung, Jin Goo Kim
There have been several techniques to repair the medial meniscus posterior root tears (MMPRTs) with the goal of restoring the anatomic and firm fixation of the meniscal root to bone. Many anatomic studies about the menisci also have been developed, so a better understanding of the anatomy could help surgeons perform correct fixation of the MMPRTs. The meniscal roots have ligament-like structures that firmly attach the menisci to the tibial plateau, and this structural concept is important to restore normal biomechanics after anatomic root repair...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354444/meniscal-ramp-lesion-repair-by-a-trans-septal-portal%C3%A2-technique
#15
Kadir Buyukdogan, Michael S Laidlaw, Mark D Miller
The identification of meniscal ramp lesions can be quite difficult or even impossible with conventional anterior arthroscopic viewing and working portals. Although even the use of transnotch viewing maneuvers into the posteromedial compartment increases the likelihood of diagnosis, it is the posteromedial and trans-septal portals that provide the best direct visualization of these many times "hidden lesions." In this surgical technique description, we describe a method to not only adequately visualize the ramp lesion, but also provide subtle variations to existing surgical techniques that can help limit injury to neurovascular structures as well as gain satisfactory vertical suture repair of this posteromedial meniscocapsular injury...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354436/horizontal-cleavage-meniscus-tear-treated-with-all-inside-circumferential-compression-stitches
#16
Jarret M Woodmass, Joshua D Johnson, Isabella T Wu, Daniel B F Saris, Michael J Stuart, Aaron J Krych
Horizontal cleavage meniscus tears are a common orthopedic injury often treated with partial or total meniscectomy versus repair. This Technical Note presents a technique for all-inside repair with uniform compression of the superior and inferior leaflets by placement of multiple circumferential compression stitches using an all-inside self-retrieving suture passing device. The currently described technique provides several advantages for all-inside repair of a horizontal cleavage tear: (1) eliminates the need for a posterior incision, (2) minimizes the risk of neurovascular injury, (3) uses standard arthroscopy portals (or small modifications), and (4) requires only a single suture deployment with a self-retrieving device for each circumferential compression stitch...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354435/inside-out-repair-of-meniscal-ramp-lesions
#17
Nicholas N DePhillipo, Mark E Cinque, Nicholas I Kennedy, Jorge Chahla, Andrew G Geeslin, Gilbert Moatshe, Lars Engebretsen, Robert F LaPrade
Meniscal ramp lesions have been reported to be present in 9% to 17% of patients undergoing anterior cruciate ligament reconstruction. Detection at the time of arthroscopy can be accomplished based upon clinical suspicion and careful evaluation without the use of an accessory posteromedial portal. Options for surgical treatment include arthroscopic repair using an all-inside or inside-out technique. The purpose of this Technical Note is to detail our arthroscopic inside-out repair technique for meniscal ramp lesions...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354420/lateral-meniscus-allograft-transplantation-the-bone-plug-technique
#18
Jarret M Woodmass, Nick R Johnson, Bruce A Levy, Michael J Stuart, Aaron J Krych
Lateral meniscus tears are commonly encountered by orthopaedic surgeons. Despite efforts to repair and preserve the meniscus, meniscectomy is occasionally required to treat irreparable tears. The resulting lateral meniscus deficiency leads to increased tibiofemoral contact pressures and ultimately early osteoarthritic changes in the knee. Lateral meniscal allograft transplant (LMAT) has been proposed as a way to restore the lateral meniscus-deficient knee to its native form. Although several techniques for LMAT have been proposed, osseous fixation has demonstrated increased stability, improved outcomes, and improved long-term survival...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29351558/analysis-of-500-anterior-cruciate-ligament-reconstructions-from-a-private-institutional-register
#19
Lauro Augusto Costa, Noel Oizerovici Foni, Eliane Antonioli, Rogério Teixeira de Carvalho, Isabela Dias Paião, Mário Lenza, Mário Ferretti
PURPOSE: The aims of this study are to describe the epidemiological characteristics of anterior cruciate ligament reconstructions in a private hospital in Brazil and to determine trends in medical practice for comparison with previous studies. METHODS: We retrospectively reviewed the anterior cruciate ligament institutional register to obtain data from all patients who underwent primary anterior cruciate ligament reconstruction from July 2014 to June 2016. Descriptive statistics were used to summarize the sample...
2018: PloS One
https://www.readbyqxmd.com/read/29350634/mri-of-popliteo-meniscal-fasciculi-of-the-knee-a-pictorial-review
#20
Marcello Zappia, Alfonso Reginelli, Vito Chianca, Michela Carfora, Francesco Di Pietto, Germano Iannella, Pier Paolo Mariani, Mariano Di Salvatore, Silvia Bartollino, Nicola Maggialetti, Salvatore Cappabianca, Luca Brunese
The popliteomeniscal fascicules (PMFs) provide the attachment of the lateral meniscus to the popliteus musculotendinous region, forming the floor and the roof the popliteal hiatus. In the second half of 1900's, some anatomic studies claim the important function of the PMF as stabilizers of the lateral meniscus; these anatomical structures work in conjunction with the popliteus musculotendinous unit to prevent excessive lateral meniscal movement and possible meniscus subluxation. A correct diagnosis of the PMFs pathology is crucial to establish the suitable surgical treatment for each patient...
January 19, 2018: Acta Bio-medica: Atenei Parmensis
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