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Meniscal root repair

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https://www.readbyqxmd.com/read/28508006/early-osteoarthritis-after-untreated-anterior-meniscal-root-tears-an-in-vivo-animal-study
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/27401006/biomechanical-and-viscoelastic-properties-of-different-posterior-meniscal-root-fixation-techniques
#9
Philipp Forkel, Peter Foehr, Johannes C Meyer, Elmar Herbst, Wolf Petersen, Peter U Brucker, Rainer Burgkart, Andreas B Imhoff
PURPOSE: The purpose of the present study was to biomechanically compare three different posterior meniscal root repair techniques. Transtibial fixation of a posterior meniscus root tear (PMRT) combined with an anterior cruciate ligament (ACL) reconstruction via one tunnel only shows similar properties in terms of cyclic loading and load to failure compared with direct anchor fixation. METHODS: Twenty-eight porcine knees were randomly assigned to 4 groups (n = 7 each): (1) native posterior meniscal root, (2) suture anchor repair, (3) refixation via a tibial ACL tunnel in combination with an interference screw fixation of the ACL graft, and (4) refixation via a tibial ACL tunnel in combination with an interference screw fixation of the ACL graft with an additional extracortical button fixation...
July 11, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27354949/posterior-meniscal-root-repair-the-transtibial-double-tunnel-pullout-technique
#10
Jorge Chahla, Samuel G Moulton, Christopher M LaPrade, Chase S Dean, Robert F LaPrade
Meniscal root tears are increasingly recognized as an important pathology. Failure to recognize this pathology could lead to early onset osteoarthritis of the ipsilateral knee joint compartment similar to a total meniscectomy. Therefore, surgical treatment is necessary to restore meniscal function and to normalize contact pressures, when there is joint overload and sufficient remaining articular cartilage. This article details our anatomic posterior root repair procedure using a transtibial double tunnel pullout technique...
April 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27347730/posterior-meniscal-root-injuries
#11
REVIEW
Gilbert Moatshe, Jorge Chahla, Erik Slette, Lars Engebretsen, Robert F Laprade
- Meniscal root tears (MRTs) are defined as radial tears within 1 cm of the meniscal root insertion, or an avulsion of the insertion of the meniscus. These injuries change joint loading due to failure of the meniscus to convert axial loads into hoop stresses, resulting in joint overloading and degenerative changes in the knee. Meniscal root repair is recommended in patients without advanced osteoarthritis (Outerbridge 3-4), in order to restore joint congruence and loading and therefore to avoid the long-term effect of joint overloading...
October 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27284511/transosseous-medial-meniscal-root-repair-using-a-modified-mason-allen-suture-configuration
#12
Chad D Lavender, Shane R Hanzlik, Paul E Caldwell, Sara E Pearson
Medial meniscal tears are among the most common injuries to the knee joint. Loss of the meniscus has been linked to increased contact pressures on the adjacent articular cartilage and progression of degenerative changes in the knee. A subset of tears known as "root tears" involves the insertion of the posterior horn of the meniscus to the bone. Arthroscopic partial meniscectomy for root tears led to undesirable outcomes, which prompted surgeons to explore restorative procedures. Multiple repair techniques have been presented with an emphasis placed on initial secure fixation and stimulation of potential healing...
December 2015: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27274472/the-optimal-suture-site-for-the-repair-of-posterior-horn-root-tears-biomechanical-evaluation-of-pullout-strength-in-porcine-menisci
#13
Young-Mo Kim, Yong-Bum Joo, Chang-Kyun Noh, Il-Young Park
PURPOSE: There are few studies on biomechanical evaluation of suture points in repair of root tears. The purpose of this study was to determine the point of greatest pullout strength for root tear repair. MATERIALS AND METHODS: A total of 120 fresh porcine medial menisci were obtained. The red-red and red-white zones of the meniscus were divided by two lines designated as lines A and B (groups A and B). Groups A and B were further divided into three groups each by dividing lines A and B into three points: 3, 5, and 7 mm from the meniscal ligament root insertion...
June 2016: Knee Surgery & related Research
https://www.readbyqxmd.com/read/27274444/an-all-inside-repair-for-full-radial-posterior-lateral-meniscus-tears
#14
Takashi Soejima, Kousuke Tabuchi, Kouji Noguchi, Takashi Inoue, Michihiro Katouda, Hidetaka Murakami, Shuji Horibe
There is controversy about the treatment for unstable full radial posterior lateral meniscus tears, particularly that involving the posterior root. Some surgeons have advocated repairing these types of meniscus tears using various techniques, but their methods are somewhat technical. We developed the technique for an all-inside repair for full radial posterior lateral meniscus tears using the Meniscal Viper (Arthrex, Naples, FL). A doubled thread is passed through 1 edge of the radial tear by the Meniscal Viper and is kept in place without tying the knot...
February 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27180255/evaluation-of-meniscal-extrusion-with-posterior-root-disruption-and-repair-using-ultrasound
#15
Grant Rowland, Damon Mar, Terence McIff, Joshua Nelson
BACKGROUND: Ultrasound techniques have been utilized for detection of discrete meniscus tears and extrusion. Meniscal extrusion is associated with increased contact pressure and decreased contact area contributing to the advancement of knee osteoarthritis. The purpose of this biomechanical study was to detect meniscal extrusion using a clinically available, portable ultrasound device. And further, to show that extent of injury and a weight-bearing state correlate with amount of extrusion...
August 2016: Knee
https://www.readbyqxmd.com/read/27004274/meniscal-root-tears-identification-and-repair
#16
David B Doherty, Walter R Lowe
Intact menisci are capable of converting the axial load of tibiofemoral contact into hoop stress that protects the knee joint. Total meniscectomy leads to rapid degeneration of the knee. Strong clinical and biomechanical data show meniscal root tears and avulsions are the functional equivalent of total meniscectomy. Lateral root tears commonly occur with knee ligament sprains and tears. Medial root tears are generally more chronic, and can be caused by preexisting knee arthritis. Meniscal root repair is indicated when there is identification of a meniscal root tear in a knee with minimal to no arthritis...
March 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/26603753/prevalence-of-lateral-meniscal-extrusion-for-posterior-lateral-meniscal-root-lesion-with-and-without-concomitant-midbody-radial-tear-in-anterior-cruciate-ligament-injury
#17
Jie-Wei Shen, Guan-Yang Song, Hui Zhang, Qian-Qian Wang, Jin Zhang, Yue Li, Hua Feng
PURPOSE: To investigate the prevalence of lateral meniscal extrusion for patients with posterior lateral meniscal root lesions (PLMRLs) and for those with concomitant midbody radial tears (MRTs) in anterior cruciate ligament (ACL) injuries. METHODS: A database of consecutive patients undergoing primary ACL reconstruction between 2011 and 2013 was retrospectively reviewed to identify patients with isolated ACL injuries and those with associated PLMRLs. Patients with (1) unavailable preoperative magnetic resonance imaging scans, (2) other concomitant ligamentous injuries, (3) severe degeneration or malalignment, (4) infection or tumor, or (5) history of surgery on the injured side were excluded...
May 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/26535186/anterior-medial-meniscal-root-tears-a-novel-arthroscopic-all-inside-repair
#18
L Osti, A Del Buono, N Maffulli
BACKGROUND: Management of tears of the anterior and posterior roots of the meniscus is still controversial. We wish to propose a simple technique of suture anchor to repair tears of the anterior root of the medial meniscus. METHODS: Twelve patients, active males, underwent arthroscopic repair of the anterior meniscal horn between 2009 and 2011. All were assessed postoperatively at an average follow-up of 1 year after the index operation. RESULTS: At the last appointment, the average Lysholm scores was improved from a pre-operative average value of 48±17 to a postoperative value of 91±7 (P<0...
May 2015: Translational Medicine @ UniSa
https://www.readbyqxmd.com/read/26493550/a-meta-analysis-of-clinical-and-radiographic-outcomes-of-posterior-horn-medial-meniscus-root-repairs
#19
REVIEW
Kyu Sung Chung, Jeong Ku Ha, Ho Jong Ra, Jin Goo Kim
PURPOSE: Although interest in medial meniscus posterior root tear (MMPRT) repair has increased, few case series have been reported. This meta-analysis aimed to examine the clinical and radiological effects of MMPRT repair by pooling pre- and post-operative data from case-series reports. METHODS: A literature search was performed using MEDLINE/PubMed, the Cochrane Central Register of Controlled Trials, and EMBASE databases. Pre- and post-operative data were pooled to investigate the effects of MMPRT repair, including the Lysholm score improvement, meniscal extrusion (mm) reduction, progression of the Kellgren-Lawrence (K-L) grade, and cartilage status according to the Outerbridge classification...
May 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/26354199/editorial-commentary-meniscal-root-avulsion-repair-outcomes-are-at-the-level-of-a-salvage-procedure
#20
EDITORIAL
James H Lubowitz
Indications for meniscal root avulsion repair require refinement because current results show failure or extrusion in more than one-third of patients, and long-term follow-up is required before concluding that saving the meniscus results in osteoarthritis prevention.
September 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
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