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Meniscal root repair

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https://www.readbyqxmd.com/read/28884106/understanding-posterior-meniscal-roots-lesions-from-basic-science-to-treatment
#1
REVIEW
Raphael Serra Cruz, Marcio Balbinotti Ferrari, Leonardo Metsavaht, Robert F LaPrade
The variability of symptoms and the fact that they are not easily recognized in imaging studies make the diagnosis and treatment of posterior meniscal roots lesions a challenging task to the orthopedist. In recent years, a more precise understanding of the anatomy and biomechanical impair of the knee joint in these cases has enabled great advances in therapeutic approaches. Well-documented studies have shown that the repair of these lesions presents superior functional and clinical improvement when compared with meniscectomy...
June 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28873348/management-of-traumatic-meniscal-tear-and-degenerative-meniscal-lesions-save-the-meniscus
#2
REVIEW
P Beaufils, N Pujol
Meniscectomy remains one of the most frequent orthopedic procedures, despite meniscal sparing having been advocated for several decades now. Incidence is excessive in the light of scientifically robust studies demonstrating the interest of meniscal repair or of non-operative treatment for traumatic tear and of non-operative treatment for degenerative meniscal lesions. It is high time that the paradigm shifted, in favor of meniscal preservation. In traumatic tear, and most particularly longitudinal vertical tear in vascularized zones, repair shows a high success rates in terms of recovery time, functional outcome and cartilage protection...
September 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28852346/medial-meniscus-root-tear-in-the-middle-aged-patient-a-case-based-review
#3
Joseph H Carreau, Sean E Sitton, Matthew Bollier
Biomechanical studies have shown that medial meniscal root tears result in meniscal extrusion and increased tibiofemoral joint contact pressures, which can accelerate the progression of arthritis. Repair is generally recommended for acute injuries in the young, active patient population. The far more common presentation however, is a subacute root tear with medial meniscal extrusion in a middle aged patient. Coexisting arthritis is common in this population and complicates decision making. Treatment should be based on the severity of the underlying arthritis...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28806092/comparable-outcomes-after-bucket-handle-meniscal-repair-and-vertical-meniscal-repair-can-be-achieved-at-a-minimum-2-years-follow-up
#4
Gilbert Moatshe, Mark E Cinque, Jonathan A Godin, Alexander R Vap, Jorge Chahla, Robert F LaPrade
BACKGROUND: Meniscal tears can lead to significant pain and disability, necessitating surgical treatment. Nondisplaced vertical tears are usually smaller in size and can be repaired in most cases; however, bucket-handle tears are usually larger and displaced, and the repair of these tears can be challenging. Purpose/Hypothesis: The purpose was to report the outcomes after inside-out vertical mattress suture meniscal repair of bucket-handle tears and to compare these outcomes with those of patients who underwent repair of nondisplaced vertical meniscal tears with a minimum of 2 years' follow-up...
August 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28748490/a-simple-cinch-is-superior-to-a-locking-loop-for-meniscus-root-repair-a-human-biomechanical-comparison-of-suture-constructs-in-a-transtibial-pull-out-model
#5
Aaron J Krych, Nick R Johnson, Isabella T Wu, Patrick A Smith, Michael J Stuart
PURPOSE: To determine the cyclic displacement and ultimate failure loads of two clinically relevant suture configurations for repair of medial and lateral meniscus root tears. METHODS: A total of 10 matched pair fresh-frozen, human meniscus specimens were randomly assigned to either simple cinch or locking loop meniscus-suture fixation techniques for transtibial pull-out repair in either medial (n = 10 matched pairs) or lateral (n = 10 matched pairs) meniscal root tears...
July 26, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28707050/tensile-strength-of-the-pullout-repair-technique-for-the-medial-meniscus-posterior-root-tear-a-porcine-study
#6
Masataka Fujii, Takayuki Furumatsu, Haowei Xue, Shinichi Miyazawa, Yuya Kodama, Tomohito Hino, Yusuke Kamatsuki, Toshifumi Ozaki
PURPOSE: The purpose of this study was to compare the load-to-failure of different common suturing techniques with a new technique for the medial meniscus posterior root tear (MMPRT). METHODS: Thirty porcine medial menisci were randomly assigned to three suturing techniques used for transtibial pullout repair of the MMPRT (n = 10 per group). Three different meniscal suture configurations were studied: the two simple suture (TSS) technique, the conventional modified Mason-Allen suture (MMA) technique, and the new MMA technique using the FasT-Fix combined with the Ultrabraid (F-MMA)...
July 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28706841/technique-for-transtibial-knotless-repair-of-lateral-meniscus-root-avulsion
#7
Emily Harnden, Timothy Lin, Adam Wilson, John B Reid
Tear of the meniscal root results in loss of circumferential hoop tension in the meniscus and increased tibiofemoral contact pressure, leading to cartilage wear. Repair of the meniscal root can restore function of the meniscus. Many techniques for root repair have recently been described. We present a technique for root repair using a transtibial socket and knotless suture technique that can be performed through standard arthroscopy portals.
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706802/medial-meniscus-posterior-root-tear-repair-using-a-2-simple-suture-pullout-technique
#8
Tarek Mohamed Samy, Wael A M Nassar, Zeiad Mohamed Zakaria, Ahmed Khaled Farrag Abdelaziz
Medial meniscus posterior root tear is one of the underestimated knee injuries in terms of incidence. Despite its grave sequelae, using simple but effective technique can maintain the native knee joint longevity. In the current note, a 2-simple-suture pullout technique was used to effectively reduce the meniscus posterior root to its anatomic position. The success of the technique depended on proper tool selection as well as tibial tunnel direction that allowed easier root suturing and better suture tensioning, without inducing any iatrogenic articular cartilage injury or meniscal tissue loss...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706793/medial-meniscus-posterior-root-repair-using-a-transtibial-technique
#9
Jarret M Woodmass, Rohith Mohan, Michael J Stuart, Aaron J Krych
The meniscal roots are critical in maintaining the normal shock absorbing function of the meniscus. If a meniscal root tear is left untreated, meniscal extrusion can occur rendering the meniscus nonfunctional resulting in degenerative arthritis. Two main repair techniques are described: (1) suture anchors (direct fixation) and (2) sutures pulled through a tibial tunnel (indirect fixation). Meniscal root repair using a suture anchor technique is technically challenging requiring a posterior portal and a curved suture passing device that can be difficult to manipulate within the knee...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28698804/the-knee-meniscus-management-of-traumatic-tears-and-degenerative-lesions
#10
Philippe Beaufils, Roland Becker, Sebastian Kopf, Ollivier Matthieu, Nicolas Pujol
Meniscectomy is one of the most popular orthopaedic procedures, but long-term results are not entirely satisfactory and the concept of meniscal preservation has therefore progressed over the years. However, the meniscectomy rate remains too high even though robust scientific publications indicate the value of meniscal repair or non-removal in traumatic tears and non-operative treatment rather than meniscectomy in degenerative meniscal lesionsIn traumatic tears, the first-line choice is repair or non-removal...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28674738/three-single-loops-enhance-the-biomechanical-behavior-of-the-transtibial-pull-out-technique-for-posterior-meniscal-root-repair
#11
Lawrence Camarda, Giuseppe Pitarresi, Michele Lauria, Federico Fazzari, Michele D'Arienzo
PURPOSE: To investigate the effect of applying an additional suture to enhance the biomechanical behavior of the suture-meniscus construct used during the transtibial pull-out repair technique. METHODS: A total of 20 fresh-frozen porcine tibiae with intact medial menisci were used. In one half of all specimens (N = 10), two non-absorbable sutures were passed directly over the meniscal root from the tibia side of the meniscus to the femoral side (2SS). In other ten specimens, three sutures were passed over the meniscal root (3SS)...
July 3, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28660229/lateral-meniscus-posterior-root-and-meniscofemoral-ligaments-as-stabilizing-structures-in-the-acl-deficient-knee-a-biomechanical-study
#12
Jonathan M Frank, Gilbert Moatshe, Alex W Brady, Grant J Dornan, Ashley Coggins, Kyle J Muckenhirn, Erik L Slette, Jacob D Mikula, Robert F LaPrade
BACKGROUND: The biomechanical effects of lateral meniscal posterior root tears with and without meniscofemoral ligament (MFL) tears in anterior cruciate ligament (ACL)-deficient knees have not been studied in detail. PURPOSE: To determine the biomechanical effects of the lateral meniscus (LM) posterior root tear in ACL-intact and ACL-deficient knees. In addition, the biomechanical effects of disrupting the MFLs in ACL-deficient knees with meniscal root tears were evaluated...
June 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28508006/early-osteoarthritis-after-untreated-anterior-meniscal-root-tears-an-in-vivo-animal-study
#13
Brett D Steineman, Robert F LaPrade, Kelly S Santangelo, Brent T Warner, Laurie R Goodrich, Tammy L Haut Donahue
BACKGROUND: Meniscal root tears cause menisci and their insertions to inadequately distribute loads and potentially leave underlying articular cartilage unprotected. Untreated meniscal root tears are becoming increasingly recognized to induce joint degradation; however, little information is known about anterior meniscal root tears and how they affect joint tissue. PURPOSE: To observe the early degenerative changes within the synovial fluid, menisci, tibial articular cartilage, and subchondral bone after arthroscopic creation of untreated anterior meniscal root tears...
April 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28409107/a-transosseous-bone-bridge-repair-for-posterior-horn-meniscal-root-tears-during-anterior-cruciate-ligament-reconstruction
#14
Jonathan M Frank, Daniel J Liechti, Jack Anavian, Thomas R Hackett
Meniscal root tears occur in isolation or concurrently with ligamentous knee injury and cause significantly altered knee mechanics with the loss of normal meniscus hoop stress. This loss of normal meniscus function can result in abnormal knee kinematics and, subsequently, more rapid degenerative changes of the knee articular surface. In the setting of anterior cruciate ligament tear, the posterolateral meniscus root is most commonly damaged. Several techniques exist for meniscus root repair; however, none have been shown to be clearly superior...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28373943/simplified-arthroscopic-lateral-meniscal-root-repair-involving-the-use-of-2-cinch-loop-sutures
#15
Patrick A Smith, Jordan A Bley
The meniscal root attachments are critical for meniscal function by securing the menisci in place and allowing optimal shock absorption in the knee. Successful meniscal root repair has been shown to restore the knee's tibiofemoral contact pressure to the same state as an intact meniscus. Although there have been multiple different repair techniques described, there is no report in the literature regarding the use of 2 simple cinch-loop sutures for a meniscal root repair. This article presents an arthroscopic lateral meniscal root repair technique involving the use of 2 simple cinch-loop configuration sutures and tibial suture anchor fixation...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28298056/outcomes-after-biologically-augmented-isolated-meniscal-repair-with-marrow-venting-are-comparable-with-those-after-meniscal-repair-with-concomitant-anterior-cruciate-ligament-reconstruction
#16
Chase S Dean, Jorge Chahla, Lauren M Matheny, Justin J Mitchell, Robert F LaPrade
BACKGROUND: Meniscal repair in the setting of anterior cruciate ligament (ACL) reconstruction has demonstrated superior outcomes compared with isolated meniscal repair. Limited evidence exists for the effects of biological augmentation in isolated meniscal repair, particularly as compared with meniscal repair with concomitant ACL reconstruction. Purpose/Hypothesis: The purpose of this study was to compare the outcomes and survivorship of meniscal repair in 2 cohorts of patients: meniscal repair with biological augmentation using a marrow venting procedure (MVP) of the intercondylar notch, and meniscal repair with concomitant ACL reconstruction...
May 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27919916/posterior-meniscal-root-repairs-outcomes-of-an-anatomic-transtibial-pull-out-technique
#17
Robert F LaPrade, Lauren M Matheny, Samuel G Moulton, Evan W James, Chase S Dean
BACKGROUND: Outcomes after transtibial pull-out repair for posterior meniscal root tears remain underreported, and factors that may affect outcomes are unknown. Purpose/Hypothesis: The purpose of this study was to compare patient-centered outcomes after transtibial pull-out repair for posterior root tears in patients <50 and ≥50 years of age. We hypothesized that improvement in function and activity level at minimum 2-year follow-up would be similar among patients <50 years of age compared with patients ≥50 years and among patients undergoing medial versus lateral root repairs...
March 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27807116/tibiofemoral-contact-mechanics-with-horizontal-cleavage-tear-and-resection-of-the-medial-meniscus-in-the-human-knee
#18
Jason L Koh, Seung Jin Yi, Yupeng Ren, Todd A Zimmerman, Li-Qun Zhang
BACKGROUND: The meniscus is known to increase the contact area and decrease contact pressure in the tibiofemoral compartments of the knee. Radial tears of the meniscal root attachment along with partial resections of the torn meniscal tissue decrease the contact area and increase pressure; however, there is a lack of information on the effects of a horizontal cleavage tear (HCT) and partial leaf meniscectomy of such tears on tibiofemoral contact pressure and contact area. METHODS: Twelve fresh-frozen human cadaveric knees were tested under 10 conditions: 5 serial conditions of posterior medial meniscectomy (intact meniscus, HCT, repaired HCT, inferior leaf resection, and resection of both inferior and superior leaves), each at 2 knee flexion angles (0° and 60°) under an 800-N axial load...
November 2, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27726749/posterior-root-meniscal-tears-preoperative-intraoperative-and-postoperative-imaging-for-transtibial-pullout-repair
#19
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
https://www.readbyqxmd.com/read/27567426/pullout-repair-of-a-medial-meniscus-posterior-root-tear-using-a-fast-fix-%C3%A2-all-inside-suture-technique
#20
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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