Subjective Knee Function and Risk of Failure Are Equivalent for Men and Women at 5 Years After Meniscus Repair

Objectives: (1) To determine whether intraoperative PRP affects meniscus repair failure risk. (2) To determine whether the effect of PRP on meniscus failure risk is influenced by ACL reconstruction status or by PRP preparation. Methods: 550 patients (mean age 28.8 years SD 11.3) who underwent meniscus repair surgery with PRP (n=203 total, n=148 prepared with GPS III system, n=55 Angel system) or without PRP (n=347) and with (n=399) or without (n=151) concurrent ACL reconstruction were assessed for meniscus repair failure within 3 years. The independent effect of PRP on meniscus repair failure risk was determined by multivariate Cox proportional hazards modeling with adjustment for age, sex, body mass index (BMI), ACL status, tear pattern, tear vascularity, repair technique, side (medial or lateral) and number of sutures or implants utilized. Results: Failures within 3 years occurred in 17.0% of patients without PRP and 14.7% of patients with PRP (p=0.52) (Angel PRP: 14.6%; GPS III PRP: 12.0%; p=0.59). Increased patient age was protective against meniscus failure regardless of ACL or PRP status (per 5-year increase in age: adjusted Hazard Ratio [aHR] 0.90, 95% confidence interval [CI] 0.81, 1.0; p=0.047). The effect of PRP on meniscus failure risk was dependent upon concomitant ACL injury status (Figure). Among isolated meniscus repairs (20.3% failures at 3 years), PRP was independently associated with lower risk of failure (aHR 0.18, 95% confidence interval (CI) 0.03, 0.59; p=0.002) with no difference between PRP vendors (p=0.84). Among meniscus repairs with concomitant ACLR (14.1% failures at 3 years), PRP was not independently associated with risk of failure (aHR 1.39 CI 0.81, 2.36; p=0.23) with no difference between PRP venders (p=0.78). Conclusion: Both PRP preparations utilized in the current study had a substantial protective effect on isolated meniscus repair failure risk over 3 years. In the setting of concomitant ACL reconstruction, intraoperative PRP does not reduce meniscus repair failure risk. [Figure: see text]

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Knee function after meniscus repair and total meniscectomy — A 7-year follow-up study

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/s0749-8063(87)80059-2 ◽

1987 ◽

Vol 3 (3) ◽

pp. 166-169 ◽

Cited By ~ 40

Author(s):

Karola Sommerlath ◽

Jan Gillquist

Keyword(s):

Meniscus Repair ◽

Knee Function ◽

Follow Up Study

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Post-Traumatic Osteoarthritis Assessment in Emerging and Advanced Pre-Clinical Meniscus Repair Strategies: A Review

Frontiers in Bioengineering and Biotechnology ◽

10.3389/fbioe.2021.787330 ◽

2021 ◽

Vol 9 ◽

Author(s):

Jay Trivedi ◽

Daniel Betensky ◽

Salomi Desai ◽

Chathuraka T. Jayasuriya

Keyword(s):

Scientific Journal ◽

Predictive Biomarkers ◽

Meniscus Repair ◽

Knee Function ◽

Surgical Approaches ◽

Radiographic Evaluation ◽

Live Animal ◽

Meniscus Injury ◽

Post Traumatic ◽

Meniscus Injuries

Surgical repair of meniscus injury is intended to help alleviate pain, prevent further exacerbation of the injury, restore normal knee function, and inhibit the accelerated development of post-traumatic osteoarthritis (PTOA). Meniscus injuries that are treated poorly or left untreated are reported to significantly increase the risk of PTOA in patients. Current surgical approaches for the treatment of meniscus injuries do not eliminate the risk of accelerated PTOA development. Through recent efforts by scientists to develop innovative and more effective meniscus repair strategies, the use of biologics, allografts, and scaffolds have come into the forefront in pre-clinical investigations. However, gauging the extent to which these (and other) approaches inhibit the development of PTOA in the knee joint is often overlooked, yet an important consideration for determining the overall efficacy of potential treatments. In this review, we catalog recent advancements in pre-clinical therapies for meniscus injuries and discuss the assessment methodologies that are used for gauging the success of these treatments based on their effect on PTOA severity. Methodologies include histopathological evaluation of cartilage, radiographic evaluation of the knee, analysis of knee function, and quantification of OA predictive biomarkers. Lastly, we analyze the prevalence of these methodologies using a systemic PubMed® search for original scientific journal articles published in the last 3-years. We indexed 37 meniscus repair/replacement studies conducted in live animal models. Overall, our findings show that approximately 75% of these studies have performed at least one assessment for PTOA following meniscus injury repair. Out of this, 84% studies have reported an improvement in PTOA resulting from treatment.

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Does Intra-operative PRP Improve Patient Function & Complication Rates Following ACL Reconstruction With Meniscus Repair?

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00124 ◽

2020 ◽

Vol 8 (3_suppl2) ◽

pp. 2325967120S0012

Author(s):

Matthew Weldon ◽

Walter R. Lowe ◽

Kyle Lauck ◽

Jacquelyn Kleihege ◽

Ryan J. Warth ◽

...

Keyword(s):

Postoperative Complications ◽

Acl Reconstruction ◽

Matched Control ◽

Meniscus Repair ◽

Knee Function ◽

Meniscus Tear ◽

Functional Testing ◽

Postoperative Knee ◽

Objective Functional ◽

Return To Activity

Objectives: The frequent injury and compromised healing of intra-articular structures (i.e. cruciate ligaments and menisci) has led to an intense interest among surgeons and scientists for discovering new methods of enhancing the biological healing response of these tissues. Platelet-rich-plasma (PRP) contains various growth factors that positively effect biological healing, unfortunately few existing clinical studies are available to determine the risks and benefits of these therapies. Therefore, the purpose of this study was to determine the influence of intraoperative PRP on postoperative knee function and complications out to 2-years following ACL reconstruction with meniscus repair. Methods: A matched case-control study was conducted using a single surgeon database of 673 patients undergoing ACL reconstruction with concomitant meniscus repair (Figure 1) resulting in 324 patients [PRP (n = 162) vs matched-control (n = 162)] who met the study criteria. Patients were matched on age, gender, graft type, and meniscus tear size and location. The single assessment numeric evaluation (SANE) was administered at 2-years and served as the primary outcome measure. Secondary outcomes included the time to return-to-activity (mo), self-reported knee function [International Knee Disability Committee (IKDC)], objective functional testing (knee ROM, single-leg balance, single leg-hopping, agility testing), and postoperative complications (graft failure, infection, loss of motion, venous thrombosis, etc). Univariate models were used for between groups comparisons and alpha was set at .05 for all analyses. Results: There were no differences in SANE knee function scores between the PRP and matched-control groups at 2-years, respectively (91.6 ±11.2 vs 92.4 ±10.6, P = .599). Additionally, no differences were observed between groups for self-reported function (IKDC score; 87.6 ±13.3 vs 88.1 ±12.6, P = .952), objective functional testing (P > .05), and timing of return-to-activity (7.8 ±1.9 vs 8.0 ±1.9, P = .765). The PRP group demonstrated a higher rate of postoperative knee motion loss complications when compared to the control group (13.5% vs 4.9%, P < .001). No other differences were observed in postoperative complications (P > .05). Conclusion: The added use of intraoperative PRP did not improve self-reported knee function, objective functional testing, and timing of return-to-activity for patients undergoing ACL reconstruction with concomitant meniscus repair. Furthermore, the use of PRP may have negative consequences for regaining knee ROM after surgery. Based on these data, surgeons should cautiously consider the application of PRP when surgical planning for intra-articular injuries of the knee.

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Smoking is associated with prolonged time of the return to daily and sport activities and decreased knee function after meniscus repair with outside-in technique: Retrospective cohort study

Journal of Orthopaedic Surgery ◽

10.1177/23094990211012287 ◽

2021 ◽

Vol 29 (2) ◽

pp. 230949902110122

Author(s):

Marcin Domzalski ◽

Krystian Muszynski ◽

Marcin Mostowy ◽

Julia Wojtowicz ◽

Anna Garlinska

Keyword(s):

Meniscal Repair ◽

Return To Sport ◽

Meniscus Repair ◽

Knee Function ◽

Daily Activities ◽

Meniscal Lesion ◽

Duration Of Symptoms ◽

Prolonged Time ◽

Sport Activities

Background: Arthroscopic repair of post-traumatic meniscal lesion is one of the most common procedures in the orthopedics. Although algorithm of the treatment of meniscal lesion, this procedure is rarely discussed in combination with smoking as a risk factor for the meniscal healing. Purpose: The aim of this study was to assess the knee function, and the amount of time needed to return to daily and sport activities after the non-bucket-handle meniscal outside-in repair depending on Tobacco use. Methods: Retrospective chart review identified 99 patients after isolated outside-in meniscal repair within a series of 292 consecutive patients who underwent meniscus repair during a 3 years period. Ninety-two patients were available for follow-up and were divided into smokers and non-smokers group. Demographic data were collected from their medical records which included: age and body mass index, gender, side of index knee, duration of symptoms prior to surgery, meniscal involvement. At the time of the minimum 2 years follow-up examination: KOOS, time of the return to daily activities, time of the return to sport activities, and Tegner scale were collected. Results: The smoking and non-smoking groups were similar in age, sex, BMI, side, meniscus involved, Tegner scale, and duration of symptoms. Smokers population was 3.5 years older on average. The knee function was significantly better in non-smokers group with average KOOS score 80.2 vs 67.4 in smokers group. In smokers population delayed time of return to daily activities (5.4 vs 4.2 months) and prolonged time of the return to sport activities (9.4 vs 7.6 months) were observed. Conclusions: Smoking is associated with significantly prolonged time of the return to daily and sport activities and decreased knee function after meniscus repair with outside-in technique. Level of evidence: III

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Ultrastructural comparison of prolactin adenomas of pituitary in men and women

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100103796 ◽

1988 ◽

Vol 46 ◽

pp. 346-347

Author(s):

R.C. Caughey ◽

U.P. Kalyan-Raman

Keyword(s):

Endoplasmic Reticulum ◽

Electron Microscope ◽

Phosphate Buffer ◽

Pituitary Adenomas ◽

Osmium Tetroxide ◽

Secretory Granules ◽

Uranyl Acetate ◽

En Bloc ◽

Men And Women ◽

Transmission Electron

Prolactin producing pituitary adenomas are ultrastructurally characterized by secretory granules varying in size (150-300nm), abundance of endoplasmic reticulum, and misplaced exocytosis. They are also subclassified as sparsely or densely granulated according to the amount of granules present. The hormone levels in men and women vary, being higher in men; so also the symptoms vary between both sexes. In order to understand this variation, we studied 21 prolactin producing pituitary adenomas by transmission electron microscope. This was out of a total of 80 pituitary adenomas. There were 6 men and 15 women in this group of 21 prolactinomas.All of the pituitary adenomas were fixed in 2.5% glutaraldehyde, rinsed in Millonig's phosphate buffer, and post fixed with 1% osmium tetroxide. They were then en bloc stained with 0.5% uranyl acetate, rinsed with Walpole's non-phosphate buffer, dehydrated with graded series of ethanols and embedded with Epon 812 epoxy resin.

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Race Difference in Auditory Sensitivity

Journal of Speech and Hearing Research ◽

10.1044/jshr.0704.389 ◽

1964 ◽

Vol 7 (4) ◽

pp. 389-393 ◽

Cited By ~ 3

Author(s):

David C. Shepherd ◽

Robert Goldstein ◽

Benjamin Rosenblüt

Keyword(s):

White Women ◽

White Men ◽

Sensitivity Study ◽

Auditory Sensitivity ◽

Race Difference ◽

Men And Women ◽

Auditory Thresholds ◽

Békésy Audiometry ◽

Method Of Adjustment ◽

Better Than

Two separate studies investigated race and sex differences in normal auditory sensitivity. Study I measured thresholds at 500, 1000, and 2000 cps of 23 white men, 26 white women, 21 negro men, and 24 negro women using the method of limits. In Study II thresholds of 10 white men, 10 white women, 10 negro men, and 10 negro women were measured at 1000 cps using four different stimulus conditions and the method of adjustment by means of Bekesy audiometry. Results indicated that the white men and women in Study I heard significantly better than their negro counterparts at 1000 and 2000 cps. There were no significant differences between the average thresholds measured at 1000 cps of the white and negro men in Study II. White women produced better auditory thresholds with three stimulus conditions and significantly more sensitive thresholds with the slow pulsed stimulus than did the negro women in Study II.

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