Meniscal Preservation is Important for the Knee Joint

Patil, Shantanu; Shekhar, Anshu; Tapasvi, Sachin

doi:10.4103/ortho.ijortho_247_17

Cited by 22 publications

(12 citation statements)

References 108 publications

(134 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2 The integrity of the menisci has been found to be another important factor to achieve optimal outcomes after a primary ACL repair. 6 Recent research has shown that decreased height of the posterior horn of the lateral meniscus was associated with a higher risk of sustaining a primary ACL injury in females. 7 Moreover, a recent report found that a decreased height of the posterior medial meniscus is a risk factor for ACL reconstruction failure in females.…”

Section: What This Study Adds To Existing Knowledge?mentioning

confidence: 99%

Lateral Meniscus Height and ACL Reconstruction Failure: A Nested Case–Control Study

et al. 2021

View full text Add to dashboard Cite

Previous work has shown that the morphology of the knee joint is associated with the risk of primary anterior cruciate ligament (ACL) injury. The objective of this study is to analyze the effect of the meniscal height, anteroposterior distance of the lateral tibial plateau, and other morphological features of the knee joint on risk of ACL reconstruction failure. A nested case–control study was conducted on patients who underwent an ACL reconstruction surgery during the period between 2008 and 2015. Cases were individuals who failed surgery during the study period. Controls were patients who underwent primary ACL reconstruction surgery successfully during the study period. They were matched by age (±2 years), gender, surgeon, and follow-up time (±1 year). A morphological analysis of the knees was then performed using the preoperative magnetic resonance imaging scans. The anteroposterior distance of the medial and lateral tibial plateaus was measured on the T2 axial cuts. The nonweightbearing maximum height of the posterior horn of both menisci was measured on the T1 sagittal scans. Measurements of the medial and lateral tibial slope and meniscal slope were then taken from the sagittal T1 scans passing through the center of the medial and lateral tibial plateau. A binary logistic regression analysis was done to calculate crude and adjusted odds ratios (ORs) estimates. Thirty-four cases who underwent ACL revision surgery were selected and were matched with 68 controls. Cases had a lower lateral meniscal height (6.39 ± 1.2 vs. 7.02 ± 0.9, p = 0.008, power = 84.4%). No differences were found between the two groups regarding the bone slope of the lateral compartment (6.19 ± 4.8 vs. 6.92 ± 5.8, p = 0.552), the lateral meniscal slope (–0.28 ± 5.8 vs. –1.03 ± 4.7, p = 0.509), and the anteroposterior distance of the lateral tibial plateau (37.1 ± 5.4 vs. 35.6 ± 4, p = 0.165). In addition, no differences were found in the medial meniscus height between cases and controls (5.58 ± 1.2 vs. 5.81 ± 1.2, respectively, p = 0.394). There were also no differences between cases and controls involving the medial bone slope, medial meniscal slope, or anterior posterior distance of the medial tibial plateau. Female patients had a higher medial (4.8 degrees ± 3.2 vs. 3.3 ± 4.1, p = 0.047) and lateral (8.1 degrees ± 5.1 vs. 5.6 degrees ± 5.6, p = 0.031) tibial bone slope, and a lower medial (5.3 mm ± 1.0 vs. 6.1 mm ± 1.2, p = 0.001) and lateral (6.6 ± 1.0 vs. 7.0 ± 1.2, p = 0.035) meniscus height, and medial (4.3 ± 0.4 vs. 4.8 ± 0.4, p =0.000) and lateral (3.3 ± 0.3 vs. 3.9 ± 0.4, p = 0.000) anteroposterior distance than males, respectively.The adjusted OR of suffering an ACL reconstruction failure compared to controls was 5.1 (95% confidence interval [CI]: 1.7–14.9, p = 0.003) for patients who had a lateral meniscus height under 6.0 mm. The adjusted OR of suffering an ACL reconstruction failure was 2.4 (95% CI: 1.0–7.7, p = 0.01) for patients who had an anteroposterior distance above 35.0 mm. Patients with a lateral meniscal height under 6.0 mm have a 5.1-fold risk of suffering an ACL reconstruction failure compared to individuals who have a lateral meniscal height above 6.0 mm. Patients with a higher anteroposterior distance of the lateral tibial plateau also have a higher risk of ACL reconstruction failure.

show abstract

Section: What This Study Adds To Existing Knowledge?mentioning

confidence: 99%

Lateral Meniscus Height and ACL Reconstruction Failure: A Nested Case–Control Study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Meniscus injury is a common and frequent sports injury, and its treatment should maintain the integrity of the meniscal structure and function as much as possible; therefore, meniscal repair has received increasing attention [1][2][3][4]. With the development of an arthroscopic technique and the popularity of the concept of preserving meniscal function, a growing number of doctors have begun to perform arthroscopic meniscal suture repair operations [5][6][7]; however, as a result of inadequate surgical experience, inadequate operation visibility and unskilled operation assistants, various technical errors may occur when meniscal suture repair is performed, particularly during all-inside meniscal suture repair [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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

Shi

Fan

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background: Meniscal repair has received increasing attention, but for inexperienced doctors, unilateral suture anchor pulling out may occur during all-inside meniscal repair, and the treatment outcome may be affected. When the errors happened intraoperatively, how to minimize the loss under guaranteeing of treatment effectiveness is a topic worth studying. Purpose: To explore the practicability and effectiveness of the modified cross-suture method for arthroscopic remediation of unilateral suture anchor pulling out of an all-inside meniscal repair system. Methods: From May 2014 to May 2017, 28 patients diagnosed with injuries of the meniscus and anterior cruciate ligaments (ACL) from the First Department of Orthopaedics of the Second Affiliated Hospital of Xi'an Jiaotong University were enrolled in the study as the observation group, including 18 males and 10 females with an average age of 25.5 ± 2.3 years (range 18-42 years). All patients underwent ACL reconstruction concurrently. All meniscus injuries were repaired with an all-inside meniscal repair technique, and 1-3 needles of unilateral suture anchor pulling out occurred intraoperatively. The modified cross-suture method was used to remedy the error of anchor pulling out and to eventually complete an effective repair. Another 30 patients who underwent ACL reconstruction and all-inside meniscal concurrently without unilateral suture anchor pulling out, including 20 males and 10 females with an average age of 26.3 ± 1.9 years (range 19-45 years), were enrolled as the control group. During postoperative follow-up, range of motion, Lachman test and pivot shift test were performed during the physical examination. The clinical healing of the meniscus was evaluated according to the Barrett standard. The meniscus healing status was also confirmed with magnetic resonance imaging (MRI). The function of the knee joint was evaluated according to the IKDC, Lysholm and Tegner scores.

show abstract

“…Due to its hypovascularity and hypocellularity, a meniscus tear does not heal spontaneously [2,3,4] and prolonged untreated damage may lead to the development of osteoarthritis [5,6,7]. Current orthopedic practice aims to preserve meniscal integrity and restore its function [8,9,10,11]. A variety of arthroscopic methods of meniscus repair is used, including different meniscus suturing techniques, which are often modi ed to increase the effectiveness of the surgery [12,13,14,15].…”

Section: Introductionmentioning

confidence: 99%

Clinical practice and post-operative rehabilitation after knee arthroscopy varies according to surgeon's expertise: a survey among Polish Arthroscopy Society members.

Bąkowski

Bąkowska-Żywicka²,

Piontek

2020

Preprint

View full text Add to dashboard Cite

Background: Meniscal repair has received increasing attention. Currently, there is a variety of arthroscopic methods of meniscus repair available. The purpose of this study was to determine a consensus in meniscus tear treatment in the environment of Polish orthopedists.Methods: 205 registered orthopedic surgeons took part in surveys. The survey consisted of 35 questions regarding general arthroscopy and postoperative management, including physician’s level of expertise, arthroscopy anesthesia, postoperative treatment, rehabilitation and procedures performed. Comparisons were made between knee arthroscopy experts (> 100 arthroscopies performed per year) and non-experts (≤ 100 cases) on aspects of patient care.Results: The most important finding of this study is an agreement in almost all aspects of knee arthroscopy approach. A consensus between polish surgeons was noticed in choosing regional anesthesia for knee arthroscopy, no need for knee braces nor knee medications, using LMW heparin as thromboprophylaxis, 1-2 days hospitalization, recommendation of rehabilitation and magnetic resonance as a diagnostic test for meniscus damage. Surgical expertise was significantly associated with the performance of meniscus sewing procedures (p = 0.009). Experts recommended starting rehabilitation already on the day of surgery (p=0.007) and more likely used objective physical tests (p=0.003). Non-expert surgeons recommended longer period from meniscus suture to a full range knee motion (p=0.001) and admitted that patient’s age does matter for meniscus repair qualification (p=0.002).Conclusions: There is a consensus in almost all issues of meniscus tear treatment in the environment of the Polish orthopedists, however the rehabilitation issues and the use of advanced meniscus repair techniques is associated with surgical expertise.

show abstract

Meniscal Preservation is Important for the Knee Joint

Cited by 22 publications

References 108 publications

Lateral Meniscus Height and ACL Reconstruction Failure: A Nested Case–Control Study

Lateral Meniscus Height and ACL Reconstruction Failure: A Nested Case–Control Study

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

Clinical practice and post-operative rehabilitation after knee arthroscopy varies according to surgeon's expertise: a survey among Polish Arthroscopy Society members.

Contact Info

Product

Resources

About