Reporting knee meniscal tears: technical aspects, typical pitfalls and how to avoid them

Bolog, Nicolae; Andreisek, Gustav

doi:10.1007/s13244-016-0472-y

Cited by 24 publications

(15 citation statements)

References 80 publications

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“… 94 Three specific lesions related especially to posterior meniscal roots are present: root avulsion injuries, radial tears and degenerative changes. 95 Meniscal extrusion, which is also present with posterior root tears, impairs the stability and biomechanical functions of the menisci. 96 Although the management of these lesions is relatively new, a current algorithm was suggested by Bhatia et al: 52 non-operative treatments (anti-inflammatory medication, activity modification, unloader bracing and intra-articular chondroprotective injections, etc.)…”

Section: Management Of Special Lesionsmentioning

confidence: 99%

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Modern treatment of meniscal tears

et al. 2018

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The complex ultrastructure of the meniscus determines its vital functions for the knee, the lower extremity, and the body.The most recent concise, reliable, and valid classification system for meniscal tears is the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Classification, which takes into account the subsequent parameters: tear depth, tear pattern, tear length, tear location/rim width, radial location, location according to the popliteal hiatus, and quality of the meniscal tissue.It is the orthopaedic surgeon’s responsibility to combine clinical information, radiological images, and clinical experience in an effort to individualize management of meniscal tears, taking into account factors related to the patient and lesion.Surgeons should strive not to operate in most cases, but to protect, repair or reconstruct, in order to prevent early development of osteoarthritis by restoring the native structure, function, and biomechanics of the meniscus.Currently, there are three main methods of modern surgical management of meniscus tears: arthroscopic partial meniscectomy; meniscal repair with or without augmentation techniques; and meniscal reconstruction. Meniscus surgery has come a long way from the old slogan, “If it is torn, take it out!” to the currently accepted slogan, “Save the meniscus!” which has guided evolving modern treatment methods for meniscal tears. This last slogan will probably constitute the basis for newer alternative biological treatment methods in the future.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170067.

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Section: Management Of Special Lesionsmentioning

confidence: 99%

“…Regarding meniscal repair, the subsequently described techniques at present are: trans-osseous pull-out suture, suture anchor and side-to-side repairs. 95 , 97 , 98 …”

Section: Management Of Special Lesionsmentioning

confidence: 99%

Modern treatment of meniscal tears

et al. 2018

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“…When the deployment gun is misemployed or the needle is hindered by the femoral condyle, the two anchor implants may be introduced into the meniscus simultaneously, or one anchor implant may be fell off or pulled out. In these cases, only the unilateral anchor play the role of fixation and the repair system is failed, especially for the repair of the medial meniscus [8][9][10] . Under these circumstances, the meniscal repair system is usually completely removed and the new repair system is implanted [8] .…”

Section: Discussionmentioning

confidence: 99%

“…For instance, improper suture pattern used, iatrogenic meniscal or chondral injury, improper tensioning of the suture and pulling out of suture anchor [8] . Once unilateral suture anchor of the all-inside meniscal repair system is pulled out, the suture will fail, and the treatment will be affected [8][9][10] . Therefore, we have explored a method of modified cross-suture to remedy the unilateral suture anchor pulling out of the meniscal repair system during the all-inside meniscal suture repair.…”

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The modified cross-suture technique for unilateral pulled-out anchor during all-inside meniscal repair

Shi

Fan

et al. 2019

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Background: In consideration of meniscal repair has received increasingly more attention, but for inexperienced doctors, various technical errors may occur when meniscal suture repair is performed, particularly during all-inside meniscal suture repairing. When the errors is happened intraoperatively, how to minimize the loss under the effectiveness of treatment is a topic worth studying. Methods: From May 2014 to May 2017, 28 cases diagnosed with injures of meniscus and anterior cruciate ligaments were enrolled in the study as observation group. All cases underwent anterior cruciate ligament (ACL) reconstruction concurrently. All meniscus injuries were repaired with an allinside meniscal repair technique, and 1-3 needles of unilateral suture anchor pulling out occurred intraoperatively. The method of modified cross-suture was used to remedy the error of anchor pulling out and to eventually complete the effective repair. During postoperative follow-up, the range of motion, Lachman test and pivot shift test were confirmed by physical examination. The clinical healing of meniscus was evaluated according to the Barrett standard. Meniscus healing status was also confirmed with magnetic resonance imaging (MRI). The function of the knee joint was evaluated with the IKDC, Lysholm and Tegner scores. Results: 25 cases of observation group and 28 cases of control group received complete follow-up with an average follow-up of 18.4±5.2 months. All operations were finished by the same surgeon. Atthe follow-up one year after operation, the average knee ROM of two groups were 125.2±4.3 degrees and 124.7±3.8 degrees, the clinical healing rate of the meniscus of two groups were 92.0% (23/25) and 92.9% (26/28), the MRI healing rate of the menniscus of two groups were 72.0% (18/25) and 71.4% (20/28), the IKDC, Lysholm and Tegner scores of two groups were 90.52±2.8, 89.17±3.1, 6.81±1.7 and 91.42±1.9, 90.32±3.4, 7.02±1.4, the differences were not statistically significant (P>0.05).Conclusions: The method of modified cross-suture is effective for arthroscopic remediation for unilateral suture anchor pulling out of an all-inside meniscal repair system. BackgroundMeniscus injury is a kind of common and frequent sports injury, and its treatment should maintain the

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“…эта частота повреждений менисков остается стабильной до возраста 50-60 лет, затем наблюдается ее небольшое снижение. Диагностика повреждений менисков характеризуется значительным количеством ложноположительных и ложноотрицательных результатов [2,3]. Так называемые дегенеративные разрывы менисков происходят у людей старшей возрастной группы, чаще всего в возрасте 55-70 лет [4,5].…”

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Analysis of Gait and Knee Function Prior to and After Meniscus Resection

Skvortsov¹,

Kaurkin²,

Akhpashev³

et al. 2018

Traumatology and Orthopedics of Russia

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Background. Injuries of meniscus are the frequent lesions in the knee joint (KJ). A big number of false-positive and false-negative outcomes may mislead not only a patient but also a specialist in traumatology and orthopedics. Functional and biomechanical studies of the knee joint might provide additional data for clinical decision making and diagnostics.Materials and Methods. The authors studied 47 patients with traumatic and degenerative tears of the KJ meniscus. All patients were divided into 3 groups. Group I included 10 patients analyzed before and after the arthroscopic treatment, Group II included 22 patients analyzed before treatment only and Group III included 15 patients analyzed after the surgical treatment only. The authors studied the gait biomechanics as well as hip and knee function. In Group I the time from disease onset to the surgical treatment was 9.7 months. The grade on the KOOS scale was 29.4 points before the treatment and 80.2 points after the treatment. In Group II, the grade was 34.2 points. In Group III, the grade was 85.6 point.Results. The temporal characteristics of the gait cycle did not exhibit any differences from the normal state in all the groups. In Group I a statistically significant increase of the hip extension amplitude was observed, both for the operated and the intact leg. In Groups II and III the authors did not observe this pattern. The abduction-adduction and rotation motions in the hip did not exhibit any significant changes in all the three groups. In Group I knee joint kinematics at the affected side did not differ from intact leg prior to the treatment. After the surgery the value of magnitude phase during the basic knee flexion at the operated side significantly decreased. The amplitude itself increased, but the difference did not reach a statistical significance due to high data dispersion. Patients of Group II and III also demonstrated significant difference in the phase of basic flexion with the same value on the intact side. The abduction-adduction motions were decreased at the intact side after the surgery in the first group.Conclusion. Thus, the meniscus injury results in slight disorder in the walking and biomechanics of the knee which are successfully compensated during one year after arthroscopic treatment.

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Reporting knee meniscal tears: technical aspects, typical pitfalls and how to avoid them

Cited by 24 publications

References 80 publications

Modern treatment of meniscal tears

Modern treatment of meniscal tears

The modified cross-suture technique for unilateral pulled-out anchor during all-inside meniscal repair

Analysis of Gait and Knee Function Prior to and After Meniscus Resection

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