Radial Displacement of the Medial Meniscus in Varus Osteoarthritis of the Knee

Sugita, Takehiko; Kawamata, Toru; Ohnuma, Masahiro; Yoshizumi, Yusuke; Sato, Katsumi

doi:10.1097/00003086-200106000-00023

Cited by 64 publications

(56 citation statements)

References 8 publications

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“…Meniscal tears are often accompanied by varying degrees of meniscal extrusion ( Figure 6). 47 Several investigators have reported more frequent meniscal extrusion of the meniscal body in the OA knee, [72][73][74] and meniscal extru sion has been reported to be a potent risk factor for car tilage loss. 75,76 Medial meniscal body extrusion is also a strong risk factor for the development of bone marrow lesions 77 and contributes to the jointspace narrow ing seen on conventional tibiofemoral radiographs.…”

Section: Menisci Anatomy and Functionmentioning

confidence: 99%

Meniscus pathology, osteoarthritis and the treatment controversy

et al. 2012

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The menisci are internal structures that are of central importance for a healthy knee joint; they have a key role in the structural progression of knee osteoarthritis (OA), and the risk of the disease dramatically increases if they are damaged by injury or degenerative processes. Meniscus damage might be considered a signifying feature of incipient OA in middle-aged and elderly people. As approximately every third knee of people in these groups has a damaged meniscus, tears are common incidental findings of knee MRI. However, as most tears do not cause symptoms, careful clinical evaluation is required to determine if a damaged meniscus is likely to directly impact a patient's symptoms. Conservative management of patients with knee pain and a degenerative meniscal tear should be considered as a first-line therapy before surgical treatment is contemplated. Patients with mechanical interference of joint movements, such as painful catching or locking, might need surgical treatment with meniscal repair if possible. In a subset of patients, meniscal resection might relieve pain and other symptoms that potentially originate directly from the torn meniscus. However, the possibility of an increased risk of OA if functional meniscal tissue is removed cannot be overlooked.

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Section: Menisci Anatomy and Functionmentioning

confidence: 99%

Meniscus pathology, osteoarthritis and the treatment controversy

et al. 2012

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“…It is highly prevalent in osteoarthritis [7], and recently it has been shown that these meniscal changes are predictive of structural progression of osteoarthritis [32]. One of the factors in need of further analysis is the inconsistency between the patterns of meniscal versus chondral damage in osteoarthritic patients [73]: it can frequently be observed that a segment of the meniscus, which was thought to experience an excessive load, was yet well preserved, or that cartilage lesions on the tibial plateau were located underneath an intact meniscus. These findings demonstrate that the exact interactions between the meniscus-cartilage-subchondral bone complex still largely remain unknown.…”

Section: Subchondral Bone Changes Associated With Meniscal Lesionsmentioning

confidence: 99%

The subchondral bone in articular cartilage repair: current problems in the surgical management

Gomoll

Madry

Knutsen

et al. 2010

Knee Surg Sports Traumatol Arthrosc

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As the understanding of interactions between articular cartilage and subchondral bone continues to evolve, increased attention is being directed at treatment options for the entire osteochondral unit, rather than focusing on the articular surface only. It is becoming apparent that without support from an intact subchondral bed, any treatment of the surface chondral lesion is likely to fail. This article reviews issues affecting the entire osteochondral unit, such as subchondral changes after marrow-stimulation techniques and meniscectomy or large osteochondral defects created by prosthetic resurfacing techniques. Also discussed are surgical techniques designed to address these issues, including the use of osteochondral allografts, autologous bone grafting, next generation cell-based implants, as well as strategies after failed subchondral repair and problems specific to the ankle joint. Lastly, since this area remains in constant evolution, the requirements for prospective studies needed to evaluate these emerging technologies will be reviewed.

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“…1,14,16,18,22,32 Meniscus extrusion prevents the meniscus from resisting hoop stresses and shielding the adjacent articular cartilage from axial load. 2,6,21 Over time, the joint-space narrowing produced by meniscus extrusion can lead to symptomatic knee osteoarthritis.…”

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confidence: 99%