Arthroscopic meniscus repair with bioabsorbable arrows

Petsche, Timothy S.; Selesnick, Harlan; Rochman, Adam S.

doi:10.1053/jars.2002.30615

Cited by 71 publications

(56 citation statements)

References 13 publications

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“…However, preservation of meniscal tissue is an over whelming rationale in young active patients and several authors have demonstrated that tears located in the central onethird avascular zone can be successfully repaired. 6,12,58,59,68,80,82,90 sults of meniscal repair using fixators, such as arrows, 22,29,43,48,50,83,84 staples, 49 and all-inside biodegradable screws 32,38,69 ; however, arthroscopicassisted suture repair remains the gold standard and is our preferred method. In addition, we have demonstrated that a rehabilitation program that implements immediate knee motion the first postoperative day after meniscus repair (performed either alone or with anterior cruciate ligament [ACL] reconstruction) is not deleterious to the healing meniscus tissue and prevents knee arthrofibrosis.…”

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confidence: 99%

Meniscal Repair and Transplantation: Indications, Techniques, Rehabilitation, and Clinical Outcome

Heckmann

Barber-Westin²,

Noyes³

2006

J Orthop Sports Phys Ther

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The purpose of this paper is to provide current knowledge regarding the indications, operative techniques, rehabilitation programs, and clinical outcomes of meniscus repair and transplantation procedures. Meniscus tears that occur in the periphery may be repaired using a variety of operative procedures with high success rates. Complex multiplanar tears that extend into the central one-third avascular zone can also be successfully repaired using a meticulous vertically divergent suture technique. The outcome of these repairs justifies preservation of meniscal tissue, especially in younger athletic individuals. Meniscal transplantation is a valid treatment option for patients who have undergone meniscectomy and have related tibiofemoral joint pain, or in whom articular cartilage deterioration in the meniscectomized compartment is present. Rehabilitation after these operations includes knee motion and quadriceps-strengthening exercises initiated the first day postoperatively. The initial goal is to prevent excessive weight bearing and joint compressive forces that could disrupt the healing meniscus repair or transplant. The protocol contains modifications according to the type of meniscal tear, if a concomitant procedure is done (such as a ligament reconstruction) or if noteworthy articular cartilage deterioration is present. Patients who have repairs of peripheral meniscus tears are generally progressed more rapidly than those who have repairs of tears extending in the central one-third region or those who undergo meniscal transplantation. The safety and effectiveness of the rehabilitation program has been demonstrated in several clinical studies. We recommend preservation of meniscal tissue, regardless of age, in active patients whenever possible.

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mentioning

confidence: 99%

Meniscal Repair and Transplantation: Indications, Techniques, Rehabilitation, and Clinical Outcome

Heckmann

Barber-Westin²,

Noyes³

2006

J Orthop Sports Phys Ther

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“…He found that there was a 7% incidence of failure, and in five cases mild subcutaneous irritation was noted that resolved in all cases within 3 to 7 months. 24 In a published prospective report of 37 patients, average age 26.8 years, undergoing repair with the Mitek Meniscal Fastener (Mitek, Norwood, Massachusetts) at 1 year follow-up, there were 5 reruptures and 32 cases in which the procedure was interpreted as successful. The authors conclude that the failure rate was comparable to that of other studies in the literature and that the healing rate was high with few associated complications.…”

Section: ⅲ Resultsmentioning

confidence: 99%

“…[19][20][21][22] Various techniques have been described including open, arthroscopic-assisted, outside-in, inside-out, all-inside, suture-based, and implant or fixator based. 16,[21][22][23][24] …”

Section: ⅲ Introductionmentioning

confidence: 99%

Meniscus Repair: Update on New Techniques

Sgaglione¹

2002

Techniques in Knee Surgery

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Ⅲ ABSTRACTIncreasing emphasis on the comprehensive reconstruction of the knee and on restoration of knee function after injury has heightened the interest in meniscus preservation. The approach to meniscal tears in the active individual emphasizes tissue repair over resection because meniscal tissue preservation has several potential advantages that improve the biomechanics and natural history of knee function over time. The technical approach to meniscal repair has significantly evolved in the last 10 years and continues to expand. Numerous techniques and multiple devices have been introduced and present the clinician with a vast array of surgical options. More recently, case reports documenting morbidities associated with the use of newer generation meniscal repair fixators have raised concerns regarding these devices and prompted recommendation that repair using suture may be preferred. An update on meniscus repair techniques is presented outlining and reviewing the current available procedures and implants including postoperative care, preliminary results, and complications. Technical pearls and pitfalls including optimal indications are reviewed for several of the repair methods as well as potential future directions in the approach to meniscal disease.

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“…Petsche et al (3) avaliaram pacientes submetidos a meniscorrafia com flecha e observaram melhora estatisticamente significativa nas escalas Lysholm e Tegner. Houve dois casos de nova ruptura em paciente que apresentava lesão do LCA; o primeiro em um com o ligamento não tratado e outro naquele submetido à reconstrução do LCA.…”

Section: Discussionunclassified

“…A reparação do LCA não influenciou os resultados. iNTrODUçãO Vários autores (1)(2)(3) analisaram o uso de implantes absorvíveis para a reparação das lesões longitudinais do menisco. Com os implantes, realiza-se essa reparação sem manipular fios e nós, evitando uma incisão complementar, o que torna o procedimento totalmente artroscó-pico, mais fácil e rápido.…”

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Evolução funcional da reparação do menisco por implante absorvível

Júnior¹

2009

Rev. bras. ortop.

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Objetivo: Avaliar a evolução funcional dos joelhos submetidos à reparação da ruptura longitudinal do menisco com o implante absorvível flecha (arrow). Métodos: Entre junho de 1997 e fevereiro de 2001, 23 pacientes com idade média de 26 anos foram avaliados. O seguimento médio foi de quatro meses . Realizaram-se 19 reparações mediais e quatro laterais. Os pacientes foram avaliados no pré e no pós-operatório quanto à função, de acordo com a escala de Lysholm e, no pós-operatório, pelo IKDC. Resultados: Para melhor compreensão, os 23 indivíduos tratados foram divididos em três grupos. Vinte e um apresentaram lesão do ligamento cruzado anterior e 11 foram submetidos à reconstrução ligamentar (grupo I), com resultados considerados satisfatórios. Dez dos 21 pacientes com lesão do LCA não foram submetidos à reconstrução ligamentar (grupo II), dos quais cinco evoluíram satisfatoriamente, sem necessidade de reconstrução ligamentar, cinco, com queixa de instabilidade e foram submetidos à reconstrução ligamentar. Quatro desses pacientes apresentaram o menisco íntegro e uma ruptura do menisco medial. Dois apresentaram LCA intacto (grupo III), um evoluiu satisfatoriamente e outro apresentou ruptura do menisco lateral. De acordo com a escala de Lysholm, a média pré-operató-ria foi de 57,53 e a média pós-operatória, de 86,95, representando melhora estatisticamente significativa (Wilcoxon p < 0,01). Foi utilizada a ANOVA não paramétrica para dados ordinais com medidas repetidas para avaliar as medidas no pré e pós-operatório, considerando os grupos I e II. Avaliou-se a estabilização do joelho e não se detectou diferença estatisticamente significativa entre os grupos I e II (p = 0,648). Mesmo supondo que houvesse diferença entre os dois grupos, ambos tiveram o mesmo comportamento. Na avaliação pós-operatória pelo IKDC, quatro pacientes foram classificados como A; 13, como B; e 6, como C. Dos seis pacientes com resultados C, apenas dois apresentaram ruptura do menisco. Conclusão: Dos 23 pacientes, apenas dois apresentaram falha da cicatrização dos meniscos reparados. De acordo com a escala de Lysholm, houve melhora significativa dos pacientes tratados. A reparação do LCA não influenciou os resultados. Descritores

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Arthroscopic meniscus repair with bioabsorbable arrows

Cited by 71 publications

References 13 publications

Meniscal Repair and Transplantation: Indications, Techniques, Rehabilitation, and Clinical Outcome

Meniscal Repair and Transplantation: Indications, Techniques, Rehabilitation, and Clinical Outcome

Meniscus Repair: Update on New Techniques

Evolução funcional da reparação do menisco por implante absorvível

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