Posteromedial Meniscal Tears May Be Missed During Anterior Cruciate Ligament Reconstruction

Peltier, A.; Lording, Timothy; Lustig, Sébastien; Servien, Elvire; Maubisson, Laurent; Neyret, Philippe

doi:10.1016/j.arthro.2014.12.003

Cited by 58 publications

(53 citation statements)

References 35 publications

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“…11 Without an excellent view of the lesion, meniscal repair devices may cause complications including migration or breakage of the implant leading to iatrogenic cartilage damage. 6 Thus improved visualization is key to (1) improved diagnosis of MM posterior-horn tears, 12 (2) better debridement before repair, and (3) better control of the complete closure of the lesion, 13 all of which lead to a better healing rate for these lesions. Better visualization also allows the placement of vertical sutures perpendicular to the deep fibers of the menisci, which are biomechanically more adapted.…”

Section: Discussionmentioning

confidence: 99%

Classification and Surgical Repair of Ramp Lesions of the Medial Meniscus

Thaunat

Fayard

Guimarães

et al. 2016

Arthroscopy Techniques

132

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Ramp lesions of the medial meniscus are commonly associated with anterior cruciate ligament ruptures and consist of longitudinal peripheral tears of the posterior horn of the medial meniscus. Given the frequency of partialthickness tears, they can be difficult to diagnose arthroscopically from the anterior compartment. We describe a classification of the different types of ramp lesions depending on both tear pattern (partial-or full-thickness tear) and associated meniscotibial ligament disruption. An original technique of arthroscopic suture placement through a single posteromedial portal with a 25 curved suture hook device is described.D ata from anterior cruciate ligament (ACL) registries show that 47% to 61% of ACL tears are associated with meniscal lesions.

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Section: Discussionmentioning

confidence: 99%

Classification and Surgical Repair of Ramp Lesions of the Medial Meniscus

Thaunat

Fayard

Guimarães

et al. 2016

Arthroscopy Techniques

132

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“…As the main secondary stabiliser in anteroposterior laxity after an ACL injury, it is well known that this structure plays an important role in the long-term development of osteoarthritis and, as shown recently by Robb et al[21], its absence negatively affects the fate of ACL graft survival. These are the reasons why efforts have recently been made to increase our understanding of medial meniscus tears [27], to rediscover certain types of injury like the meniscosynovial or ramp lesions [1,5,8,19,23,25] and to improve long-existing repair techniques [15,20].Another new development in meniscal repair relates to root tears, which have moved into focus over the last One of the most important clinical achievements highlighted at the third international meeting "The Meniscus: Preserve the future", held in Porto in early February this year [9], was the improvement made in the field of meniscal repair. The loss of the meniscus can be regarded as a pre-arthritic condition for the knee due to the loss of protective function [2,3].…”

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confidence: 99%

Time for a paradigm change in meniscal repair: save the meniscus!

Seil

Becker

2016

Knee Surg Sports Traumatol Arthrosc

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impact on that risk, and it became obvious that the differentiation of tear types and repair techniques has resulted in significant progress over the last few years.In 2016, numerous advanced techniques for meniscal repair are being performed, regardless of the site of the tear [4,26]. There is no place in the knee that cannot be reached by the arthroscope. However, some of the repair techniques are in the early stages of development and require further improvement to reach global acceptance [24]. They appear very promising, as many surgeons have adopted them in a short period of time.Meniscus repair is gaining in popularity among an increasing number of surgeons. A better understanding, more sophisticated devices for meniscus repair and the increasing success rate might be some of the explanations. The increasing popularity of meniscus repair also includes meniscus lesions, which are associated with anterior cruciate ligament (ACL) injuries. At several European centres, meniscal repair procedures are now being performed in up to 40-60 % of all ACL reconstructions. In addition, these repairs are being extended increasingly to an athletic population and even professional athletes and football players. The medial meniscus in particular is becoming the focus of attention. As the main secondary stabiliser in anteroposterior laxity after an ACL injury, it is well known that this structure plays an important role in the long-term development of osteoarthritis and, as shown recently by Robb et al.[21], its absence negatively affects the fate of ACL graft survival. These are the reasons why efforts have recently been made to increase our understanding of medial meniscus tears [27], to rediscover certain types of injury like the meniscosynovial or ramp lesions [1,5,8,19,23,25] and to improve long-existing repair techniques [15,20].Another new development in meniscal repair relates to root tears, which have moved into focus over the last One of the most important clinical achievements highlighted at the third international meeting "The Meniscus: Preserve the future", held in Porto in early February this year [9], was the improvement made in the field of meniscal repair. The loss of the meniscus can be regarded as a pre-arthritic condition for the knee due to the loss of protective function [2,3]. However, the tear pattern has a crucial

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“…15 Without an excellent view of the lesion, meniscal repair devices may induce different complications like migration or breakage of the implant, 15,16 leading to iatrogenic cartilage damage. 8 Hence, a better healing rate of posterior horn MM lesions may be expected through a better visualization, allowing for an improved diagnosis, 17 an improved quality of the debridement prior to the repair, and control of a complete closure of the lesion. 18 Better visualization also allows the placement of vertical sutures perpendicular to the deep fibers of the menisci, which are biomechanically more adapted.…”

Section: Discussionmentioning

confidence: 99%