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Meniscal surgery and rehabilitation

Cécile Toanen, Guillaume Demey, Panagiotis G Ntagiopoulos, Paolo Ferrua, David Dejour
BACKGROUND: Results of anterior cruciate ligament (ACL) reconstruction are traditionally excellent in younger and nonarthritic patients. During the past few decades, people older than 60 years have become more active than ever, with more demanding physical lifestyles. An increase also has been noted in active patients with diagnosed ACL injuries. More patients are requesting treatment for ACL deficiency in hopes of returning to preinjury levels of activity. PURPOSE: The aims of this study were to evaluate the results of ACL reconstruction in patients older than 60 years in terms of functional recovery, return to sports, and postoperative incidence of osteoarthritis and to compare their results with published results of different age groups...
December 1, 2016: American Journal of Sports Medicine
James D Wylie, Lucas S Marchand, Robert T Burks
Anterior cruciate ligament (ACL) reconstruction is common in the active young population. Failure of ACL reconstruction can be due to continued or recurrent instability, stiffness, or patient-reported failure in the setting of seemingly successful surgical reconstruction, such as pain that limits activity. Multiple preoperative, intraoperative, and postoperative variables can be optimized to give the greatest likelihood of success. Some of these include timing of surgery, identification, and treatment of associated ligamentous, meniscal and chondral injuries, tunnel placement, graft choice, fixation, tensioning, and postoperative rehabilitation...
January 2017: Clinics in Sports Medicine
Eun-Kyung Kim
[Purpose] The purpose of this study was to analyze the effect of gluteus medius activity strengthening due to squat with isometric hip adduction and hip abduction in side-lying exercise on knee joint function index and pain in meniscal surgery patients. [Subjects and Methods] This study selected sample of 26 patients who had meniscal surgery more than 4 weeks ago. The patients were divided into squat with isometric hip adduction exercise group I (n=8), hip abduction in side-lying exercise group II (n=9), and combined exercise group III...
October 2016: Journal of Physical Therapy Science
Alaina M Brelin, John-Paul H Rue
Meniscus tears are commonly encountered in the athletic population and can result in significant loss of playing time. Current treatment methods for acute tears consist of meniscectomy and meniscal repair, whereas meniscal allograft transplant is reserved as a salvage procedure for symptomatic meniscectomized patients who desire a more functional knee. This review describes the postoperative rehabilitation protocol for each procedure and evaluates the outcomes in existing literature as it pertains to the athlete...
October 2016: Clinics in Sports Medicine
W Michael Pullen, Brandon Bryant, Trevor Gaskill, Nicholas Sicignano, Amber M Evans, Marlene DeMaio
BACKGROUND: Arthroscopically assisted anterior cruciate ligament (ACL) reconstruction is a common orthopaedic procedure. Graft failure after reconstruction remains a devastating complication, often requiring revision surgery and less aggressive or modified rehabilitation. Worse functional and patient-reported outcomes are reported compared with primary reconstruction. Moreover, both rates and risk factors for revision are variable and inconsistent within the literature. PURPOSE: To determine the rate of revision surgery after ACL reconstruction in a large cohort of patients, to assess the influence of patient characteristics on the odds of revision, and to compare revision rates between active-duty military members and non-active-duty beneficiaries...
December 2016: American Journal of Sports Medicine
Sun Ja Park, Young Mi Kim, Ha Roo Kim
[Purpose] This study aimed to evaluate the effect of hip muscle strengthening on muscle strength and balance in the knee joint after a meniscal injury. [Subjects and Methods] This randomized control study enrolled 24 patients who had undergone arthroscopic treatment after a meniscal injury and began a rehabilitative exercise program 8 weeks after surgery. Subjects were divided into 2 groups of 12 subjects each: gluteus medius resistance exercise group and control group. This study investigated muscle strength and balance in the knee joint flexor, extensor, and abductor during an 8-week period...
April 2016: Journal of Physical Therapy Science
Brian G Pietrosimone, J Troy Blackburn, Yvonne M Golightly, Matthew S Harkey, Brittney A Luc, J D DeFreese, Darin A Padua, Joanne M Jordan, Kim L Bennell
CONTEXT:  Posttraumatic osteoarthritis (PTOA) is a specific phenotype of osteoarthritis (OA) that commonly develops after acute knee injury, such as anterior cruciate ligament (ACL) or meniscal injury (or both). Athletic trainers (ATs) are well positioned to educate patients and begin PTOA management during rehabilitation of the acute injury, yet it remains unknown if ATs currently prioritize long-term outcomes in patients with knee injury. OBJECTIVE:  To investigate ATs' knowledge and perceptions of OA and its treatment after ACL injury, ACL reconstruction, or meniscal injury or surgery...
May 4, 2016: Journal of Athletic Training
A Paul Monk, Loretta J Davies, Sally Hopewell, Kristina Harris, David J Beard, Andrew J Price
BACKGROUND: Rupture of the anterior cruciate ligament (ACL) is a common injury, mainly affecting young, physically active individuals. The injury is characterised by joint instability, leading to decreased activity, which can lead to poor knee-related quality of life. It is also associated with increased risk of secondary osteoarthritis of the knee. It is unclear whether stabilising the knee surgically via ACL reconstruction produces a better overall outcome than non-surgical (conservative) treatment...
April 3, 2016: Cochrane Database of Systematic Reviews
Craig R Bottoni, Eric L Smith, James Shaha, Steven S Shaha, Sarah G Raybin, John M Tokish, Douglas J Rowles
BACKGROUND: The use of allografts for anterior cruciate ligament (ACL) reconstruction in young athletes is controversial. No long-term results have been published comparing tibialis posterior allografts to hamstring autografts. PURPOSE: To evaluate the long-term results of primary ACL reconstruction using either an allograft or autograft. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: From June 2002 to August 2003, patients with a symptomatic ACL-deficient knee were randomized to receive either a hamstring autograft or tibialis posterior allograft...
October 2015: American Journal of Sports Medicine
Bob Yin, Laura Goldsmith, Ralph Gambardella
BACKGROUND: Preoperative patient education is an important part of the informed consent process, and a perceived lack of information can lower patient satisfaction. We sought to evaluate the effect of a web-based multimedia patient education tool on the perioperative experience of patients undergoing first-time knee arthroscopy for a meniscal tear. METHODS: Adult patients undergoing knee arthroscopy for the first time for a primary diagnosis of a meniscal tear were consecutively enrolled into the study from January 2014 through June 2014...
June 17, 2015: Journal of Bone and Joint Surgery. American Volume
Barak Haviv, Shlomo Bronak, Yona Kosashvili, Rafael Thein
PURPOSE: To determine which specific factors influence the improvements in function and pain at the first year following arthroscopic partial meniscectomy. METHODS: Between 2012 and 2013, patients who had arthroscopic partial meniscectomy were included (n = 201) and followed prospectively before surgery and at 12 months. Multivariable stepwise analysis included preoperative variables (age, gender, limb side, height, weight, body mass index, comorbidities, smoking, Tegner activity scale, Lysholm knee score, preceding injury and duration of preoperative symptoms) and arthroscopic findings (degree of cartilage lesions, medial or lateral meniscus involvement, type of meniscal tear and concomitant cruciate tear)...
May 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
K N Arifeen, A Z Chowdhury, N Sakeb, A I Joarder, A K Salek, A M Selimullah
Rupture of the Anterior Cruciate Ligament (ACL) is common, resulting reduced quality of life, increasing the meniscal injury risk, knee instability and early degenerative joint disease. Bone-Patellar Tendon-Bone (BPTB) became the gold standard surgery where conservative management failed. Adding interferential screw provides rigid fixation which is important for early accelerated rehabilitation program in athletes but we have carried out this prospective interventional study in Bangabandhu Sheikh Mujib Medical University (BSMMU) and our private settings from January 2007 to December 2011 to assess whether interferential screws provide any clinical and functional advantage in general population...
January 2015: Mymensingh Medical Journal: MMJ
Roger Menta, Scott Howitt
Meniscal allograft transplantation (MAT) is a relatively new procedure that has gained popularity in the last couple of decades as a possible alternative to a meniscectomy to provide significant pain relief, improve function, and prevent the early onset of degenerative joint disease (DJD). As of present, evidence is limited and conflicting on the success of such procedures. In this case, a 16-year old male athlete underwent numerous surgical procedures to correct a left anterior cruciate ligament (ACL) rupture with associated medial and lateral meniscal damage that occurred as a result of a non-contact mechanism of injury...
December 2014: Journal of the Canadian Chiropractic Association
John T Cavanaugh
Meniscal cartilage plays an essential role in the function and biomechanics of the knee joint. The meniscus functions in load bearing, load transmission, shock absorption, joint stability, joint lubrication, and joint congruity. Individuals today are increasingly more active in later decades of life. Although the incidence of meniscal pathology is difficult to estimate, this increased exposure to athletic activity increases the risk of injury to these structures. Hede and coworkers reported the mean annual incidence of meniscus tears as 9...
December 2014: Journal of Knee Surgery
Kyle Harris, Jeffrey Bradford Driban, Michael R Sitler, Nicole M Cattano, Jennifer M Hootman
REFERENCE/CITATION: Frobell RB, Roos HP, Roos EM, Roemer FW, Ranstam J, Lohmander LS. Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial. BMJ. 2013;346:F232. CLINICAL QUESTION: Does early anterior cruciate ligament (ACL) reconstruction with rehabilitation lead to better patient-reported outcomes and a lower incidence of osteoarthritis at 5 years postinjury compared with delayed ACL reconstruction with rehabilitation? STUDY SELECTION: This randomized controlled trial with extended follow-up at 5 years postrandomization was conducted in 2 Swedish orthopaedic departments...
January 2015: Journal of Athletic Training
Lindsey K Lepley, Edward M Wojtys, Riann M Palmieri-Smith
PURPOSE: The purpose of this study was to determine the effect of concomitant meniscal surgery on the recovery of quadriceps activation and strength at a time when individuals return to sport following anterior cruciate ligament (ACL) reconstruction. METHODS: Forty-six individuals that were cleared for participation following ACL reconstruction were invited to participate in this study. Participants were placed into groups according to surgical reports (ACL-only, n = 24; meniscal repair, n = 12; meniscectomy, n = 10)...
September 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
B Faivre, P Boisrenoult, G Lonjon, N Pujol, P Beaufils
UNLABELLED: Meniscus allograft transplantation (MAT) is used to treat patients with knee pain after total or subtotal meniscectomy. The graft can be inserted during open or arthroscopic surgery. The objectives are anatomic horn positioning and strong fixation to the bone and capsule of an appropriately sized graft. HYPOTHESIS: Arthroscopic MAT with trans-tibial bone fixation ensures better mid-term functional outcomes and limits allograft extrusion. PATIENTS AND METHODS: We conducted a retrospective single-centre study of 23 consecutive patients who underwent MAT between 2001 and 2010...
May 2014: Orthopaedics & Traumatology, Surgery & Research: OTSR
Cathal J Moran, Cecilia Pascual-Garrido, Susan Chubinskaya, Hollis G Potter, Russell F Warren, Brian J Cole, Scott A Rodeo
➤ Novel (i.e., quantitative and semiquantitative) cartilage imaging techniques can evaluate cartilage composition to augment information obtained from traditional magnetic resonance imaging sequences that detail morphology.➤ A well-defined role for drugs leading to chondroprotection has not yet been determined.➤ Shortcomings of bone marrow stimulation include limited production of hyaline repair tissue, unpredictable repair cartilage volume, and a negative impact on later cellular transplantation if required...
February 19, 2014: Journal of Bone and Joint Surgery. American Volume
Eduard J de Valk, Maarten H Moen, Marinus Winters, Eric W P Bakker, Rob Tamminga, Henk van der Hoeven
PURPOSE: The aim of this systematic review was to determine which patient determinants and injury factors, before anterior cruciate ligament reconstruction by arthroscopic single-bundle techniques, affect postoperative rehabilitation. METHODS: A search of PubMed, Embase, and the Cochrane Database of Clinical Trials was performed up to February 2013. After application of our inclusion criteria, a final selection was made based on studies' methodologic score assessed with the Newcastle-Ottawa Scale...
November 2013: Arthroscopy: the Journal of Arthroscopic & related Surgery
D J F von Pfeil, M R Edwards, N C Nelson
OBJECTIVE: To compare the outcome of the tibial plateau levelling osteotomy (TPLO) procedure, using a 6-hole 3.5 mm locking TPLO plate and performed with the muscle elevation technique (ET) and placement of sponges, to the TPLO without performing these steps (non-elevation-technique [NET]). MATERIAL AND METHODS: Medical records and radiographs of dogs with ET (n = 21) or NET (n = 19) were retrospectively reviewed. Signalment, TPLO procedure side, meniscal treatment, surgery time, haemorrhage, pre- and postoperative tibial plateau angle, assistant, amount of rehabilitation, bone healing (cortical, osteotomy, combined healing scores), complications, limb function, recovery time and follow-up were recorded and analysed using multivariate analysis...
2013: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
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