Paper # 163: Arthroscopic Repair Results for Complex Lateral Meniscus Tear Around Popliteus Tendon Suturing Popliteus Tendon as a Post for Stability and Nourishment

Introduction: Although uncommon, the discoid meniscus is quite prone to injury due to its abnormal shape and abnormal histology. The weak or absent peripheral attachment of the discoid meniscus causes instability even after partial meniscectomy. Therefore, recently, after resection of the central part of the meniscus, in which tears develop most frequently, the remnant of the meniscus is preferred to repair. In that time, the Watanabe classification, which classifies the discoid meniscuses in three groups, is used to plan treatment. However, discoid meniscus can develop in the different forms from these three main shapes. In the present study we aimed to analyse the discoid meniscuses, which we encountered during arthroscopic procedures in the knee, according to Watanabe classification. Patients and methods: The lateral discoid meniscuses in the 36 knees of 35 patients, who were operated on because of meniscus tear of either the discoid lateral meniscus itself or the normal medial meniscus, were classified according to Watanabe classification. Results: While the lateral discoid meniscuses were classified as “complete” in 13, “incomplete” in 15 knees, the meniscuses were very thin or absent in the central (one knee) or in the postero-lateral regions (seven knees) of discoid meniscus ( Figure 1 ). In this series this opening was next to the popliteus tendon except in one case. In these cases, the continuity of the meniscus between middle and posterior horn frequently was not possible after central partial meniscectomy (CPM). On the other hand, posterior horn has stable peripheral attachment unlike the Wrisberg type discoid meniscus. Of the 36 discoid meniscuses, CPM was performed in 21 knees, CPM with anterior horn repair in three, CPM with posterior horn repair in one and anterior horn repair without meniscectomy in two patients. In nine patients the lateral discoid meniscus was left alone. [Figure: see text] Discussion and conclusion: When meniscus sparing methods are intended to perform, both to decide the amount of resection and repair of the remnant, besides the shape of meniscus tear, the stability of discoid meniscus is crucial. This study shows that the Watanabe classification cannot be sufficient to include some specific type of lateral discoid meniscus. We believe that to add the discoid meniscuses, with opening in postero-lateral region next to the popliteus tendon, to the Watanabe classification might be useful to decide the amount of resection or repair of the discoid lateral meniscus.

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Which factors are associated with the prevalence of meniscal repair?

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04107-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Xiaoxiao Song ◽

Dongyang Chen ◽

Xinsheng Qi ◽

Qing Jiang ◽

Caiwei Xia

Keyword(s):

Cruciate Ligament ◽

Demographic Data ◽

Meniscal Tear ◽

Univariate Analysis ◽

Lateral Meniscus ◽

Meniscal Repair ◽

Acl Injury ◽

Partial Meniscectomy ◽

Meniscus Tear ◽

Confounding Factors

Abstract Purpose To investigate the potential factors associated with the prevalence of meniscal repair Methods Patients who received partial meniscectomy or meniscal repair in our institution from Jan 2015 to Dec 2019 were included in current study. The inclusion criteria were (1) meniscus tear treated using meniscectomy or repair, (2) with or without concomitant anterior cruciate ligament reconstruction, (3) not multiligamentous injury. Demographic data, including sex, age, body mass index (BMI), injury-to-surgery interval and intra-articular factors such as the location of injury, medial or lateral, ACL rupture or not and the option of procedure (partial meniscectomy or repair) were documented from medical records. Univariate analysis consisted of chi-square. Multivariate logistic regression was then performed to adjust for confounding factors. Results 592 patients including 399 males and 193 females with a mean age of 28.7 years (range from 10 to 75 years) were included in current study. In the univariate analysis, male (p = 0.002), patients aged 40 years or younger (p < 0.001), increased weight (p = 0.010), Posterior meniscus torn (0.011), concurrent ACL ruputure (p < 0.001), lateral meniscus (p = 0.039) and early surgery (p < 0.001) were all associated with the prevalence of meniscal repair. However, After adjusting for confounding factors, we found that age (OR, 0.35; 95% CI, 0.17 - 0.68, p = 0.002), ACL injury (OR, 3.76; 95% CI, 1.97 – 7.21, p < 0.001), side of menisci (OR, 3.29; 95% CI, 1.43 – 7.55, p = 0.005), site of tear (OR, 0.15; 95% CI, 0.07 – 0.32, p < 0.001), and duration of injury (OR, 0.46; 95% CI, 0.28 – 0.82, p = 0.008) were associated with the prevalence of meniscus repair. Conclusions Meniscal tear in aged patients especially those with concomitant ACL injury is likely to be repaired. Additionally, in order to increase the prevalence of repair and slow down progression of OA, the surgical procedure should be performed within two weeks after meniscus tear especially when the tear is located at lateral meniscal posterior. Study design Case-control study; level of evidence, 3.

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Lower lateral femoral compartment proteoglycan density associates with lower knee abduction moment during walking in individuals following anterior cruciate ligament reconstruction and lateral meniscus tear: a preliminary study

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2017.02.196 ◽

2017 ◽

Vol 25 ◽

pp. S122

Author(s):

M. Harkey ◽

J. Spang ◽

D. Nissman ◽

L. Stanley ◽

H. Davis ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Lateral Meniscus ◽

Meniscus Tear ◽

Cruciate Ligament Reconstruction ◽

Knee Abduction ◽

Preliminary Study ◽

Anterior Cruciate

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Complex Lateral Meniscus Tear in a High School Football Player

Athletic Therapy Today ◽

10.1123/att.14.1.39 ◽

2009 ◽

Vol 14 (1) ◽

pp. 39-40

Author(s):

Aaron MacDonald ◽

Darren Johnson ◽

Barton Branam ◽

Michael Krueger

Keyword(s):

High School ◽

Lateral Meniscus ◽

Football Player ◽

Meniscus Tear ◽

High School Football

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Anterior Horn Lateral Meniscus Tear, Repair, and Meniscectomy

The Journal of Knee Surgery ◽

10.1055/s-0033-1360658 ◽

2013 ◽

Vol 27 (03) ◽

pp. 229-234 ◽

Cited By ~ 7

Author(s):

Matthew Prince ◽

Amanda Esquivel ◽

Allison Andre ◽

Henry Goitz

Keyword(s):

Lateral Meniscus ◽

Anterior Horn ◽

Meniscus Tear

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Poorer dynamic postural stability in patients with anterior cruciate ligament rupture combined with lateral meniscus tear than in those with medial meniscus tear

Knee Surgery and Related Research ◽

10.1186/s43019-019-0027-x ◽

2020 ◽

Vol 32 (1) ◽

Cited By ~ 3

Author(s):

Jin Hyuck Lee ◽

Dae-Hee Lee ◽

Jong-Hoon Park ◽

Dong Won Suh ◽

Eunseon Kim ◽

...

Keyword(s):

Muscle Strength ◽

Postural Stability ◽

Lateral Meniscus ◽

Stability Index ◽

Acl Rupture ◽

Meniscus Tear ◽

Significant Difference ◽

Knee Muscle ◽

Dynamic Postural Stability ◽

Knee Muscle Strength

Abstract Background Only limited data are available regarding postural stability between anterior cruciate ligament (ACL)-injured patients with medial meniscus (MM) tear and those with lateral meniscus (LM) tear. The purpose of this study was to compare preoperative postural stability for both involved and uninvolved knees in ACL rupture combined with MM and LM tears. It was hypothesized that there would be a significant difference in postural stability between these two groups. Methods Ninety-three ACL-injured patients (53 combined with MM tears vs. 40 combined with LM tears) were included. Static and dynamic postural stability were evaluated with the overall stability index (OSI), anterior–posterior stability index (APSI), and medial–lateral stability index (MLSI) using stabilometry. Knee muscle strength was evaluated using an isokinetic testing device. Results In the static postural stability test, none of the stability indices showed significant differences between the two groups for both knees (p > 0.05). In the dynamic postural stability test for involved side knees, the OSI and APSI were significantly higher in the LM tear group compared to the MM tear group (OSI: 2.0 ± 0.8 vs. 1.6 ± 0.5, p = 0.001; APSI: 1.5 ± 0.6 vs. 1.3 ± 0.5, p = 0.023), but not the MLSI (p > 0.05). In the static and dynamic postural stability tests in each group, there were no significant differences between the involved and uninvolved side knees (p > 0.05). There was no significant difference in the knee muscle strength between the two groups (p > 0.05). All postural stability showed no significant correlation with knee muscle strength (p > 0.05). Conclusion Dynamic postural stability was poorer in patients with ACL rupture combined with LM tear than in those with MM tear. Therefore, close monitoring for postural stability would be necessary during preoperative and postoperative rehabilitation, especially for patients with ACL rupture combined with LM tear. Level of evidence: Level III

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