The role of meniscal repair for prevention of early onset of osteoarthritis

Weber, Johannes; Koch, Matthias; Angele, Peter; Zellner, Johannes

doi:10.1186/s40634-018-0122-z

Cited by 54 publications

(50 citation statements)

References 43 publications

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“…The menisci always bear an extremely high stress in every posture of the gait cycle. The meniscus tear in a healthy knee may eventually result in the occurrence of knee OA due to the meniscus dysfunction and the consequent overloading in the intraarticular space [39], [40]. According to the results of previous case–control studies, OA is more likely to occur in a knee with meniscal tears but without cartilage lesions than in a knee with an intact meniscus, indicating that the meniscal tear comes before any visible cartilage changes can be noted [33], [41].…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional finite-element analysis of aggravating medial meniscus tears on knee osteoarthritis

Lijun

Zhang

et al. 2020

Journal of Orthopaedic Translation

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BackgroundThe biomechanical change during the medial meniscus damage in the process of knee osteoarthritis has not been explored. The purpose of this study was to determine the effect of aggravating medial meniscus degenerative tear on the progress of knee osteoarthritis through the finite-element simulation method.MethodsThe three-dimensional digital model of a total-knee joint was obtained using a combination of magnetic resonance imaging and computed tomography images. Four types of medial meniscus tears were created to represent the aggravating degenerative meniscus lesions. Meniscectomy of each meniscal tear was also utilized in the simulation. The compression and shear stress of bony tissue, cartilage, and meniscus were evaluated, and meniscus extrusion of the healthy knee, postinjured knee, and postmeniscectomy knee were investigated under the posture of balanced standing.ResultsBased on the results of finite-element simulation, the peak shear principal stress, peak compression principal stress, and meniscus extrusion increased gradually as the meniscus tears’ region enlarged progressively (from 7.333 MPa to 15.14 MPa on medial femur and from 6 MPa to 20.94 MPa on medial tibia). The higher stress and larger meniscus extrusion displacement in all tests were observed in the flap and complex tears. The oblique tears also had a biomechanical variation of stress and meniscus extrusion in the knee joint, but their level was milder. Both the peak value of the stress and meniscus displacement increased after the meniscectomy.ConclusionIn contrast to the damaged hemijoint, the stress applied on the healthy lateral hemijoint increased. The change of biomechanics was more obvious with the aggravation of meniscus injury. The advanced degenerative damage resulted in increasing stress that was more likely to cause symptomatic clinical manifestation in the knee joint and accelerate the progress of osteoarthritis. Moreover, we found that the meniscus injury caused higher stress concentration on the contralateral side of the joint. We also discovered that the meniscectomy can lead to more serious biomechanical changes, and although this technique can relieve pain over a period of time, it increased the risk of osteoarthritis (OA) occurrence.The translational potential of this articleIt is clear that the meniscal lesions can cause osteoarthritic knee, but the biomechanical change during the meniscus damage period has not been explored. We have evaluated the variation of stress during the aggravating medial degenerative meniscus tears and the relationship in the process of knee OA through finite-element simulation. This study does favour to obtain a better understanding on the symptoms and pathological changes of OA. It also may provide some potential directions for the prophylaxis and treatment of OA.

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Section: Discussionmentioning

confidence: 99%

Three-dimensional finite-element analysis of aggravating medial meniscus tears on knee osteoarthritis

Lijun

Zhang

et al. 2020

Journal of Orthopaedic Translation

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“… 10 , 11 The importance of meniscus repair is in keeping with past literature. 8 , 9 Johnson et al found that at almost 11 years after isolated meniscus repair, minimal joint changes were seen in only 8% of his patients on the surgical knee with 3% of patients having changes also on the contralateral side. He evaluated radiographs and found joint changes in 69% of his patients after a meniscectomy was done.…”

Section: Discussionmentioning

confidence: 99%

“…Restoring or preserving the normal anatomy of the knee leads to restoration of function but can also return knee biomechanics to the intact state. 5 6 7 8 9 This in turn can reduce loading and sheer forces on the hyaline cartilage. 10 , 11 Many surgeries were done that seek to restore the normal structure and function of the knee.…”

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confidence: 99%

Risk of Subsequent Knee Arthroplasty After Sports Medicine Procedures

Enweze¹,

Varshneya²,

Sherman³

et al. 2020

JAAOS Glob Res Rev

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Introduction: Approximately 10% of men and 13% of women older than the age of 60 are affected by symptomatic osteoarthritis of the knee. Anatomic repair or reconstruction after knee injury has been a central tenet of surgical treatment to reduce the risk of osteoarthritis. The purpose of this study was to examine common sports medicine procedures of the knee and determine the proportion of patients who subsequently undergo total knee arthroplasty (TKA). Methods: The MarketScan database was queried from the period of January 2007 through December 2016. Patients were identified, who underwent a procedure of the knee, as defined by Current Procedural Terminology codes relating to nonarthroplasty procedures of the knee. Patients in whom laterality could not be confirmed or underwent another ipsilateral knee procedure before TKA were excluded from this study. The primary outcome of this study was the overall rate of TKA after index knee surgery. Time from index procedure to TKA was a secondary outcome. A multivariate regression analysis was used to control for covariates such as age, sex, and comorbidity status. Results: A total of 843,749 patients underwent one of the 13 common sports medicine procedures of the knee. The procedure with the highest unadjusted rate of subsequent TKA was arthroscopic osteochondral allograft (5.81%), whereas anterior cruciate ligament (ACL) reconstruction with meniscus repair demonstrated the lowest rate of subsequent TKA (0.01%). When adjusting for confounding factors, the regression analysis identified meniscal transplantation (odds ratio [OR] = 3.06, P < 0.0001) as having the highest risk of subsequent TKA, followed by osteochondral autograft (OR = 1.74, P = 0.0424) and arthroscopic osteochondral allograft (OR = 1.49, P < 0.0001). ACL reconstruction with meniscus repair (OR = 0.02, P < 0.0001), ACL reconstruction alone (OR = 0.17, P < 0.0001), ACL with meniscectomy (OR = 0.20, P < 0.0001), and meniscal repair (OR = 0.65, P < 0.0001) had the lowest rate of subsequent TKA. ACL reconstruction with meniscus repair had the longest period from index procedure to TKA at 2827 days. Conclusion: ACL reconstruction and meniscus preservation demonstrated an extremely low rate of conversion to TKA when compared with patients who needed salvage interventions such as meniscus and cartilage transplantation. None of the salvage interventions delayed the need for a TKA. Meniscal transplantation had the highest risk of all procedures of going on to a TKA.

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“…Таким чином, є прямий взаємозв'язок між відновленням цілісності меніска та профілактикою раннього прогресування деформуючого артрозу колінних суглобів. Однак невірне передопераційне планування та вибір тактики лікування пошкоджень меніска підвищують ризик повторного оперативного лікування [10].…”

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Modern Views on the Treatment of Patients with Injuries of the Medial and Lateral Menisci of the Knee Joint (Literature Review)

Dolgopolov

Siforov

2021

HOTP

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Summary. We have analyzed the literature to determine the tactics of the knee menisci injury surgical treatment. It has been determined that the use of cellular technologies for suturing a damaged meniscus allows satisfactory results even in patients with ruptures in the avascular zones, despite the fact that partial meniscectomy is considered the "gold standard" of surgical treatment for ruptures in the “white” zone. It should be considered the advantages and disadvantages of different stitching techniques and the specific clinical and physical characteristics of each patient.

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The role of meniscal repair for prevention of early onset of osteoarthritis

Cited by 54 publications

References 43 publications

Three-dimensional finite-element analysis of aggravating medial meniscus tears on knee osteoarthritis

Three-dimensional finite-element analysis of aggravating medial meniscus tears on knee osteoarthritis

Risk of Subsequent Knee Arthroplasty After Sports Medicine Procedures

Modern Views on the Treatment of Patients with Injuries of the Medial and Lateral Menisci of the Knee Joint (Literature Review)

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