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https://www.readbyqxmd.com/read/28925663/top-poems-of-2016-consistent-with-the-principles-of-the-choosing-wisely-campaign
#1
Roland Grad, Mark H Ebell
A challenge in the Choosing Wisely campaign is to identify low-value clinical actions supported by high-quality evidence. We applied a method based on crowdsourcing the Daily POEM (patient-oriented evidence that matters) to identify low-value clinical actions from research studies consistent with the principles of Choosing Wisely. In 2016, we analyzed an average of 1,382 questionnaires on 265 unique POEMs delivered to physician members of the Canadian Medical Association. From these questionnaires, we identified the POEMs ranking highest on one questionnaire item directly linked to reducing overdiagnosis or overtreatment...
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28918786/-treatment-of-meniscal-pathology
#2
Martin Wyman Rathcke, Martin Lind, Morten Ilum Boesen, Nis Nissen, Anders Ploug Boesen, Bjarne Mygind-Klavsen, Per Hölmich
The menisci play a major role in knee function regarding joint movement, stability, load distribution and load transmission. Injuries to the menisci cause pain, and meniscal tears are a common reason for patient referral. In Denmark, partial meniscectomy increased significantly until 2010, and several studies have questioned the long-term effect of meniscectomy as an overall procedure. A Danish national clinical guideline on knee meniscal pathology was published in May 2016, and this article is a short summary of updated knowledge on meniscal pathology and relevant conclusions from the guideline...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28903016/arthroscopic-meniscectomy-for-degenerative-meniscal-tears-reduces-knee-pain-but-is-not-cost-effective-in-a-routine-health-care-setting-a-multi-center-longitudinal-observational-study-using-data-from-the-osteoarthritis-initiative
#3
J J Rongen, T M Govers, P Buma, M M Rovers, G Hannink
OBJECTIVES: It is disputed whether arthroscopic meniscectomy is an (cost-) effective treatment for degenerative meniscus tears in day-to-day clinical practice. The objective of this study was to assess the cost-effectiveness of arthroscopic meniscectomy in subjects with knee osteoarthritis, in routine clinical practice, while taking into account the increased risk for future knee replacement surgery. We compared cost-effectiveness of arthroscopic meniscectomy compared to no surgery. DESIGN: We used a state transition (Markov) simulation model to evaluate the cost-effectiveness of arthroscopic meniscectomy compared to no surgery in subjects with knee osteoarthritis (age range 45-79 years)...
September 10, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28902600/contact-analysis-of-horizontal-cleavage-tear-treatment
#4
Carlos Uquillas, Sally Arno, Austin Ramme, Cheongeun Oh, Peter Walker, Robert Meislin
Horizontal cleavage tears (HCT) commonly occur in the posterior horn of the medial meniscus due to aging and degeneration. The purpose of this study was to investigate the surgical treatment of HCTs and their effect on dynamic tibiofemoral contact mechanics. The tibiofemoral contact mechanics of 10 cadaver knees were investigated using a custom dynamic loading apparatus, pressure sensor, and motion sensing camera. Three loading conditions were analyzed: 500 N compressive load, 500 N compressive load with 100 N posterior shear, and 500 N compressive load with 2...
May 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28894908/discoid-lateral-meniscus-can-be-overlooked-by-magnetic-resonance-imaging-in-patients-with-meniscal-tears
#5
Dong-Wook Sohn, Seong-Il Bin, Jong-Min Kim, Bum-Sik Lee, Seon-Jeong Kim
PURPOSE: MRI evaluation of torn lateral meniscus was compared with arthroscopy. This study calculates the sensitivity, specificity, and accuracy of MRI in determining the presence or absence of discoid lateral meniscus (DLM) for different tear types. METHODS: MR imaging of 156 knees with arthroscopically confirmed lateral meniscus tears was analysed. There were 78 knees (70 patients) in non-DLM group and 78 knees (74 patients) in DLM group on arthroscopy as the reference standard...
September 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28894756/relationships-between-tibiofemoral-contact-forces-and-cartilage-morphology-at-2-to-3-years-after-single-bundle-hamstring-anterior-cruciate-ligament-reconstruction-and-in-healthy-knees
#6
David John Saxby, Adam L Bryant, Xinyang Wang, Luca Modenese, Pauline Gerus, Jason M Konrath, Kim L Bennell, Karine Fortin, Tim Wrigley, Flavia M Cicuttini, Christopher J Vertullo, Julian A Feller, Tim Whitehead, Price Gallie, David G Lloyd
BACKGROUND: Prevention of knee osteoarthritis (OA) following anterior cruciate ligament (ACL) rupture and reconstruction is vital. Risk of postreconstruction knee OA is markedly increased by concurrent meniscal injury. It is unclear whether reconstruction results in normal relationships between tibiofemoral contact forces and cartilage morphology and whether meniscal injury modulates these relationships. HYPOTHESES: Since patients with isolated reconstructions (ie, without meniscal injury) are at lower risk for knee OA, we predicted that relationships between tibiofemoral contact forces and cartilage morphology would be similar to those of normal, healthy knees 2 to 3 years postreconstruction...
August 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28885697/second-look-arthroscopic-findings-after-cora-based-leveling-osteotomy
#7
Barbara Vasquez, Don Hulse, Brian Beale, Sharon Kerwin, Chad Andrews, Brian W Saunders
OBJECTIVE: To describe the arthroscopic appearance of intra-articular structures mid-term (9 months) and long-term (>12 months) after CORA-based leveling osteotomy (CBLO). STUDY DESIGN: Case series. ANIMALS: Dogs (n = 41) with second-look arthroscopy of the stifle after CBLO for treatment of a cranial cruciate ligament (CCL) deficiency. Both stifles were re-evaluated (stifles n = 42) in 1 dog. METHODS: Medical records of dogs that had second-look arthroscopy after CBLO were reviewed...
September 8, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28875226/-treatment-of-degenerative-meniscal-lesions-from-eminence-to-evidence-based-medicine
#8
REVIEW
R Becker, M Bernard, S Scheffler, S Kopf
BACKGROUND: The treatment of degenerative meniscal lesions has received increased attention since the publication of several Level 1 studies over the last few years. The following review of literature including the consensus statement given by ESSKA reports on the management of patients with degenerative meniscal lesions. MATERIAL AND METHODS: The analysis includes the literature of Level 1 to 4 studies and the statement of the consensus group of ESSKA concerning the surgical or conservative management of these patients...
September 5, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28873348/management-of-traumatic-meniscal-tear-and-degenerative-meniscal-lesions-save-the-meniscus
#9
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/28852795/-meniscal-lesion-pre-osteoarthrotic-condition-of-the-knee-joint
#10
REVIEW
L Goebel, J Reinhard, H Madry
BACKGROUND: A close relationship between meniscal damage and articular cartilage exist. Likewise, (partial) meniscectomy may lead to the development of osteoarthritis (OA). OBJECTIVES: With a special emphasis on therapeutic consequences for orthopaedic surgeons, the structural and functional relationship between meniscal tears/extrusion and cartilage loss, and/or the effect of meniscectomy or meniscal repair on the development of OA, are emphasized. MATERIALS AND METHODS: A selective literature review with implementation of own research findings...
August 29, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28852346/medial-meniscus-root-tear-in-the-middle-aged-patient-a-case-based-review
#11
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/28852341/age-differences-in-the-prevalence-of-isolated-medial-and-lateral-meniscal-tears-in-surgically-treated-patients
#12
T J Ridley, Mark A McCarthy, Matthew J Bollier, Brian R Wolf, Annunziato Amendola
PURPOSE: To compare the prevalence of isolated lateral and medial meniscal tears in different aged populations. METHODS: A five-year retrospective review for meniscal procedures performed on a total of 782 patients. Each chart was reviewed to document the prevalence of medial or lateral meniscal injuries. Inclusion criteria were patients found to have documented evidence of meniscal tear, either lateral or medial, without any concomitant injuries and/or any other procedures performed...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28846442/the-incidence-of-subsequent-meniscal-surgery-is-higher-in-the-anterior-cruciate-ligament-reconstructed-knee-than-in-the-contralateral-knee
#13
Brent R Davis, Jason Chen, Maria C S Inacio, Rebecca Love, Heather A Prentice, Gregory B Maletis
BACKGROUND: A goal of anterior cruciate ligament (ACL) reconstruction is to provide a meniscal protective effect for the knee. PURPOSE: (1) To evaluate whether there was a different likelihood of subsequent meniscal surgery in the ACL-reconstructed knee or in the normal contralateral knee and (2) to compare the risk factors associated with subsequent meniscal surgery in the ACL-reconstructed knee and contralateral knee. STUDY DESIGN: Cohort study; Level of evidence, 3...
August 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28841728/is-knee-arthroscopy-beneficial-in-treating-traumatic-meniscal-tears-on-patients-older-than-60-years
#14
Ke Li, Etienne Cavaignac, Hong Chen, Wei Xu, Cheng Chen, Wei Huang
No abstract text is available yet for this article.
August 25, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28831763/relationship-between-magnetic-resonance-imaging-findings-radiological-grading-psychological-distress-and-pain-in-patients-with-symptomatic-knee-osteoarthritis
#15
Marina Carotti, Fausto Salaffi, Marco Di Carlo, Andrea Giovagnoni
BACKGROUND: Synovial hypertrophy, synovial effusions, and abnormalities in the subchondral bone play a key role in the pathogenesis of osteoarthritis (OA) and are associated with pain. Understanding and careful clinical assessment together with better imaging such as magnetic resonance imaging (MRI) of the knee may improve treatment strategies. The aim of this cross-sectional study was to investigate the associations between the structural findings on MRI (bone marrow lesions [BMLs], synovitis, cartilage defects, meniscal lesions), X-ray examination (Kellgren and Lawrence [K/L] grade), and psychological aspects with pain in patients with knee osteoarthritis (KOA)...
August 22, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28831524/-meniscal-root-lesions-clinical-relevance-and-treatment
#16
REVIEW
S Kopf, C Stärke, R Becker
Meniscal roots play an important role in load distribution of the tibiofemoral knee joint. Thus, meniscal root tears are severe injuries of the knee, which significantly expose cartilage to increased stress. Two entities are distinguished: (i) acute root tears that mainly affect the posterolateral root and often occur with ruptures of the anterior cruciate ligament; and (ii) chronic, degenerative root tears that mainly affect the posteromedial root. For diagnosis of both entities, the patient's medical history, a knee examination and especially MRI play key roles...
August 22, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28828058/arthroscopic-knee-anatomy-in-young-achondroplasia-patients
#17
M Del Pilar Duque Orozco, N C Record, K J Rogers, M B Bober, W G Mackenzie, A Atanda
PURPOSE: Achondroplasia is the most common form of skeletal dysplasia, affecting more than 250 000 individuals worldwide. In these patients, the developing knee undergoes multiple anatomical changes. The purpose of this study was to characterise the intra-articular knee anatomy in children with achondroplasia who underwent knee arthroscopy. METHODS: Records of achondroplasia patients who underwent knee arthroscopy between 2009 and 2014 were reviewed. Demographic data, operative reports, follow-up notes, MRI and arthroscopy images were reviewed...
June 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28827270/study-protocol-for-a-randomised-controlled-trial-of-meniscal-surgery-compared-with-exercise-and-patient-education-for-treatment-of-meniscal-tears-in-young-adults
#18
Søren Thorgaard Skou, Martin Lind, Per Hölmich, Hans Peter Jensen, Carsten Jensen, Muhammad Afzal, Uffe Jørgensen, Jonas Bloch Thorlund
INTRODUCTION: Arthroscopic surgery is a very common orthopaedic procedure. While several trials have investigated the effect of knee arthroscopy for middle-aged and older patients with meniscal tears, there is a paucity of trials comparing meniscal surgery with non-surgical treatment for younger adults. The aim of this randomised controlled trial (RCT) is to investigate if early arthroscopic surgery is superior to exercise therapy and education, with the option of later surgery if needed, in improving pain, function and quality of life in younger adults with meniscal tears...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28816515/how-should-we-secure-our-transplanted-meniscus-a-meta-analysis
#19
Julio J Jauregui, Zhan Dong Wu, Sean Meredith, Cullen Griffith, Jonathan D Packer, R Frank Henn
BACKGROUND: Meniscal allograft transplant (MAT) is a salvage procedure for young patients with symptomatic meniscal deficiency. Although many studies report good outcomes, MAT remains controversial, and an optimal fixation technique for the meniscus roots is debated. PURPOSE: To assess the overall outcome of MAT and compare the results of different meniscal root fixation techniques. STUDY DESIGN: Meta-analysis. METHODS: Following specific guidelines, we systematically evaluated all current literature for studies reporting on the outcomes of patients who underwent MAT...
August 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28815275/similar-failure-rate-in-immediate-post-operative-weight-bearing-versus-protected-weight-bearing-following-meniscal-repair-on-peripheral-vertical-meniscal-tears
#20
Bryan Perkins, Kyle R Gronbeck, Ruixian Alexander Yue, Marc A Tompkins
PURPOSE AND HYPOTHESIS: Post-operative weight bearing after meniscal repair is a point of debate among physicians. This study sought to evaluate whether patients adhering to an immediate WBAT rehabilitation programme have a higher failure rate compared to those adhering to a more traditional, protected, NWB status following meniscal repair. The null hypothesis was that there would be no difference in failure between the two groups. METHODS: A retrospective review of meniscal repair patients greater than 5 years from surgery was performed for patients receiving meniscal repair treatment...
August 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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