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Meniscal root repair

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https://www.readbyqxmd.com/read/29704113/repair-of-the-lateral-posterior-meniscal-root-improves-stability-in-an-acl-deficient-knee
#1
Philipp Forkel, Constantin von Deimling, Lucca Lacheta, Florian B Imhoff, Peter Foehr, Lukas Willinger, Felix Dyrna, Wolf Petersen, Andreas B Imhoff, Rainer Burgkart
PURPOSE: To investigate the stabilizing effect of a lateral meniscus posterior root repair in an ACL and root deficient knee. METHODS: The hypothesis of the current study was that a sequential transection of the posterior root and the meniscofemoral ligaments in an ACL-deficient knee increases rotational instability, and conversely, a repair of the meniscus root reduces the internal tibial rotation. Therefore, eight human knee joints were tested in a robotic setup (5 N m internal torque, 50 N m anterior translation load)...
April 27, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29622245/editorial-commentary-we-know-we-need-to-fix-knee-meniscal-radial-root-tears-but-how-best-to-perform-the-repairs
#2
EDITORIAL
Robert F LaPrade
The present work further contributes to building the base of the research pyramid by noting the importance of repairing knee meniscal radial root tears. Because of the extensive biomechanical studies that have now been published on the restoration of joint mechanics and with what I believe results in a higher likelihood of an improved healing environment with securing the meniscus root tear down to bone, I would strongly recommend that when one does see a meniscus root tear that the transtibial pullout root repair technique be considered over a side-to-side repair...
April 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29564055/medial-meniscal-root-repair-using-curved-guide-and-soft-suture-anchor
#3
Su-Keon Lee, Bong-Seok Yang, Byeong-Mun Park, Ji-Ung Yeom, Ji-Hyeon Kim, Jeong-Seok Yu
Medial meniscal root tears have been repaired using various methods. Arthroscopic all-inside repair using a suture anchor is one of the popular methods. However, insertion of the suture anchor into the proper position at the posterior root of the medial meniscus is technically difficult. Some methods have been reported to facilitate suture anchor insertion through a high posteromedial portal, a posterior trans-septal portal, or a medial quadriceptal portal. Nevertheless, many surgeons still have difficulty during anchor insertion...
March 2018: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/29537952/meniscal-root-tears-evaluation-and-management
#4
Michael S Day, Michael K Ryan, Eric J Strauss
The management of meniscal root injuries has changed as biomechanical studies have demonstrated the importance of meniscal integrity in load distribution across the knee joint. Meniscal injury causes altered joint mechanics, which is postulated to be related to the onset of arthrosis. Arthroscopic meniscal root repair has been shown to restore more normal joint mechanics and is considered a treatment option in the appropriately indicated patient. Short- and midterm clinical results of meniscal root repair are promising, but long-term results are yet to be established...
March 2018: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29445968/arthroscopic-direct-meniscal-extrusion-reduction-surgical-tips-to-reduce-persistent-meniscal-extrusion-in-meniscal-root-repair
#5
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...
May 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29430489/posterior-cruciate-ligament-current-concepts-review
#6
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-technique
#7
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/29396804/the-role-of-suture-cutout-in-the-failure-of-meniscal-root-repair-during-the-early-post-operative-period-a-biomechanical-study
#8
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...
April 2018: International Orthopaedics
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
#9
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...
March 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29354453/arthroscopic-medial-meniscus-posterior-root-reconstruction-using-auto-gracilis-tendon
#10
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/29285587/the-percutaneous-pie-crusting-medial-release-during-arthroscopic-procedures-of-the-medial-meniscus-does-neither-affect-valgus-laxity-nor-clinical-outcome
#11
Sang-Woo Jeon, Min Jung, Yong-Min Chun, Su-Keon Lee, Woo Seok Jung, Chong Hyuk Choi, Sung-Jae Kim, Sung-Hwan Kim
PURPOSE: To analyze the effect of percutaneous pie-crusting medial release on valgus laxity before and after surgery and on clinical outcomes. METHODS: Eight-hundred fourteen consecutive patients who underwent an arthroscopic procedure for the medial compartment of the knee were evaluated retrospectively. Sex, age, type of operation (meniscectomy, meniscal repair, and posterior root repair), type of accompanying surgery (none, cartilage procedure, ligament procedure and osteotomy) were documented...
December 28, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29175557/meniscal-repair-technique
#12
REVIEW
P Beaufils, N Pujol
Meniscal repair aims to achieve meniscal healing, avoiding the adverse effects of meniscectomy. Longitudinal vertical tears in a vascularized area are the reference indication. The technique generally uses hybrid all-inside implants. The outside-in technique has other indications in more anterior tears. Healing has been demonstrated on CT-arthrography and arthroscopy. Specific techniques have been developed for other pathological situations. Posterior meniscosynovial lesions in a context of chronic anterior laxity are identified by exploration of the posterior compartment, and fixed by all-inside hook suture...
February 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29098324/increased-extrusion-and-icrs-grades-at-2-year-follow-up-following-transtibial-medial-meniscal-root-repair-evaluated-by-mri
#13
Daniel J Kaplan, Erin F Alaia, Andrew P Dold, Robert J Meislin, Eric J Strauss, Laith M Jazrawi, Michael J Alaia
PURPOSE: The purpose of the current study was to evaluate the short-term results of meniscal root repair surgery, assessing clinical and radiographic outcomes, utilizing MRI to assess root healing and extent of post-operative extrusion. METHODS: This was a single-center, retrospective study evaluating patients who had undergone a medial meniscus posterior root repair using a transtibial pullout technique with two locking cinch sutures. Demographic data were collected from patient charts...
November 2, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28884106/understanding-posterior-meniscal-roots-lesions-from-basic-science-to-treatment
#14
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
#15
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 nonoperative treatment for traumatic tear and of nonoperative 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...
December 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
#16
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
#17
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...
November 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
#18
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
#19
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)...
October 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28706841/technique-for-transtibial-knotless-repair-of-lateral-meniscus-root-avulsion
#20
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
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