Meniscal transplant in children

Tuca, María; Luderowski, Eva; Rodeo, Scott

doi:10.1097/mop.0000000000000306

Cited by 13 publications

(18 citation statements)

References 62 publications

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“…Meniscal allograft transplantation has been proposed as a valid alternative in young patients with symptoms derived from a total or subtotal meniscal deficits, the so-called post meniscectomy syndrome. 63 Regardless of the variability of techniques for meniscal transplantations, the overall rate of reported functional improvement at 7–14 years is 70%, with a failure rate close to 10%. 64 In the adult population, Yoon et al compared this procedure among patients with meniscal deficit due to a discoid meniscus versus other causes, finding similar positive results.…”

Section: Treatmentmentioning

confidence: 99%

Discoid meniscus: current concepts

et al. 2020

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Discoid meniscus is the most frequent congenital malformation of the menisci, and primarily affects the lateral meniscus; it is highly prevalent in the Asian population. The anatomic, vascular, and ultrastructural features of the discoid meniscus make it susceptible to complex tears. Discoid meniscus anomalies are described according to their shape; however, there is consensus that peripheral stability of the meniscus should also be defined. Initial workup includes plain X-rays and magnetic resonance imaging, while arthroscopic evaluation confirms shape and stability of the meniscus. Clinical presentation is highly variable, depending on shape, associated hypermobility, and concomitant meniscal tears. Treatment seeks to re-establish typical anatomy using saucerization, tear reparation, and stable fixation of the meniscus. Cite this article: EFORT Open Rev 2020;5:371-379. DOI: 10.1302/2058-5241.5.190023

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Section: Treatmentmentioning

confidence: 99%

Discoid meniscus: current concepts

et al. 2020

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“…There is a paucity of data concerning the application of MAT in the pediatric population. 77 The increasing participation of children in sports, including elite sports, has led to a rising number of sports-related injuries in children and adolescents. This results in a higher number of children with premature loss of meniscus leading to early progressive degenerative joint disease.…”

Section: Meniscus Allograft Transplantation (Mat)mentioning

confidence: 99%

“…Discoid meniscus tears represent another possible cause of meniscus-deficient knees in youngsters, with further candidates for MAT. 77…”

Section: Meniscus Allograft Transplantation (Mat)mentioning

confidence: 99%

“…Concerning the pediatric population, there are few reports in the literature on the outcome of MAT. 77 MAT is an effective method for treating meniscal deficiency following irreparable tears in discoid meniscus based on a series that compared MAT in discoid versus nondiscoid knees at a minimum 2-year follow-up. 81 Despite the fact that the discoid group had a significantly lower range of motion, functional scores improved similarly in both groups.…”

Section: Meniscus Allograft Transplantation (Mat)mentioning

confidence: 99%

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Meniscal allograft transplants and new scaffolding techniques

Pereira

Cengiz

Gomes³

et al. 2019

EFORT Open Reviews

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Clinical management of meniscal injuries has changed radically in recent years. We have moved from the model of systematic tissue removal (meniscectomy) to understanding the need to preserve the tissue. Based on the increased knowledge of the basic science of meniscal functions and their role in joint homeostasis, meniscus preservation and/or repair, whenever indicated and possible, are currently the guidelines for management. However, when repair is no longer possible or when facing the fact of the previous partial, subtotal or total loss of the meniscus, meniscus replacement has proved its clinical value. Nevertheless, meniscectomy remains amongst the most frequent orthopaedic procedures. Meniscus replacement is currently possible by means of meniscal allograft transplantation (MAT) which provides replacement of the whole meniscus with or without bone plugs/slots. Partial replacement has been achieved by means of meniscal scaffolds (mainly collagen or polyurethane-based). Despite the favourable clinical outcomes, it is still debatable whether MAT is capable of preventing progression to osteoarthritis. Moreover, current scaffolds have shown some fundamental limitations, such as the fact that the newly formed tissue may be different from the native fibrocartilage of the meniscus. Regenerative tissue engineering strategies have been used in an attempt to provide a new generation of meniscal implants, either for partial or total replacement. The goal is to provide biomaterials (acellular or cell-seeded constructs) which provide the biomechanical properties but also the biological features to replace the loss of native tissue. Moreover, these approaches include possibilities for patient-specific implants of correct size and shape, as well as advanced strategies combining cells, bioactive agents, hydrogels or gene therapy. Herein, the clinical evidence and tips concerning MAT, currently available meniscus scaffolds and future perspectives are discussed. Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180103

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“…In effect, the Posterior/Anterior position is much more crucial because a position which is too anterior constitutes a main reason for graft rupture (Samitier et al, 2015 ; Wylie et al, 2017 ). A femoral offset guide in different sizes (from 4 mm to 7 mm) has been proposed to control the Posterior/Anterior positioning (Tuca et al, 2016 ; Sekiya et al, 2016 ). It is hooked above the lateral femoral condyle but there is no visual arthroscopic landmark to ensure that the chosen target has been reached: the technique with offset guide has the disadvantage the position of the tunnel cannot be seen when the guide is in place whereas with the CLR technique, the position can be identified during all the procedure, regardless of the degree of flexion.…”

Section: Introductionmentioning

confidence: 99%

The capsular line reference, a new arthroscopic reference for posterior/anterior femoral tunnel positioning in anterior cruciate ligament reconstruction

2018

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BackgroundFemoral malposition is the first cause for graft rupture during ACL reconstruction. Arthroscopic landmarks can be difficult to identify. So, landmark has to be found for reliable tunnel placement. A proximal-distal reference was described as “Apex reference” reported by Hart et al. but no posterior/anterior reference exists in the literature.The purpose of this study was to do a 3D CT-scan assessment of the femoral tunnel positioning using the Capsular Line Reference (CLR) as a landmark for posterior/anterior placement in ACL reconstruction. We hypothesized the CLR could provide a precise and reliable antero/posterior femoral tunnel positioning less than 2 mm from the Bernard & Hertel posterior quarter.MethodsSeven cadaveric knee specimens with a mean age of 79.2 ± 11 years were used. Using standard approaches, the CLR was identified corresponding to a white line (the capsule) appearing at the posterior border of the femoral condyle after bony debridement of the medial and posterior part of the lateral femoral condyle. The center of the tunnel was marked. An inside-out technique with anteromedial drilling technique was performed using an 8-mm diameter reamer. The distal femurs were sawed and a CT-scan was done for each specimen to obtain 3-dimensional image reconstructions. These 3D reconstructions were analyzed to measure the position tunnel center on the posterior/anterior axis and the distance from the posterior/anterior quadrant according to the Bernard & Hertel method.ResultsThe mean position for the posterior/anterior axis was 27.0 ± 1.8% (25–28.9) with a median of 26.9%. The position from the first quarter of the Bernard & Hertel method was 0.9 ± 0.8 mm (0–1.8) with a median of 0.8 mm.ConclusionThe CLR is a reliable and reproducible arthroscopic landmark to place the femoral tunnel for ACL reconstruction in the anterior/posterior axis. Proximal/distal position depends on the choice of the surgeon to reproduce anteromedial or posterolateral fibers.

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Meniscal transplant in children

Cited by 13 publications

References 62 publications

Discoid meniscus: current concepts

Discoid meniscus: current concepts

Meniscal allograft transplants and new scaffolding techniques

The capsular line reference, a new arthroscopic reference for posterior/anterior femoral tunnel positioning in anterior cruciate ligament reconstruction

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