Meniscal Repair for Radial Tears of the Midbody of the Lateral Meniscus

2011 ◽  
Vol 2011 ◽  
pp. 208-209
Author(s):  
B.F. Morrey
Keyword(s):  
Lateral Meniscus ◽  
Meniscal Repair

scholarly journals Which factors are associated with the prevalence of meniscal repair?

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.

scholarly journals A Useful MRI Classification for Symptomatic Discoid Lateral Meniscus

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Eui Yub Jung ◽  
Seongmin Jeong ◽  
Sun-Kyu Kim ◽  
Sung-Sahn Lee ◽  
Dong Jin Ryu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Lateral Meniscus ◽  
Meniscal Repair ◽  
Discoid Lateral Meniscus ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Signal Change ◽  
Magnetic Resonance Imaging Mri ◽  
Arthroscopic Procedures ◽  
Group 1

Abstract Purpose The purpose of this study is to classify the discoid lateral meniscus (DLM) according to the signal and shape in magnetic resonance imaging (MRI), and to provide information not only in diagnosis but also in treatment. Materials and Methods We reviewed 162 cases who diagnosed with DLM by MRI and underwent arthroscopic procedures from April 2010 to March 2018. Three observers reviewed MRI findings of all cases and predicted arthroscopic tear using three MRI criteria (criterion 1,2 and 3). Among three criteria, the criterion that most accurately predicts arthroscopic tear was selected. Using this criterion, the cases of predicted tear were named group 1. In addition, group 1 was divided into three subgroups (group 1a, 1b and 1c) by deformation or displacement on MRI and arthroscopic type of tear and procedures were analyzed according to these subgroups. Results The intra-meniscal signal change itself (criterion 3) on MRI showed the highest agreement with the arthroscopic tear. No meniscal deformation and displacement on MRI (group 1a) showed no specific type of tear and more cases of meniscal saucerization. The meniscal deformation on MRI (group 1b) showed more simple horizontal tears and more cases of meniscal saucerization. The meniscal displacement on MRI (group 1c) showed more peripheral tears and more cases of meniscal repair and subtotal meniscectomy. Comparing arthroscopic type of tear and type of arthroscopic procedure between three subgroups, there were significant differences in three groups (P < .05). Conclusions Intra-meniscal signal change itself on MRI is the most accurate finding to predict arthroscopic tear in symptomatic DLM. In addition, subgroup analysis by deformation or displacement on MRI is helpful to predict the type of arthroscopic tear and procedures.

The all-inside meniscal repair technique has less risk of injury to the lateral geniculate artery than the inside-out repair technique when suturing the lateral meniscus

2017 ◽  
Vol 26 (3) ◽  
pp. 793-798 ◽  
Author(s):  
Adrián Cuéllar ◽  
Ricardo Cuéllar ◽  
Jorge Díaz Heredia ◽  
Asier Cuéllar ◽  
Ignacio García-Alonso ◽  
...  
Keyword(s):  
Lateral Meniscus ◽  
Meniscal Repair ◽  
Repair Technique ◽  
Risk Of Injury ◽  
Lateral Geniculate ◽  
Inside Out

scholarly journals The Safe Distance to the Popliteal Neurovascular Bundle in Pediatric Knee Arthroscopic Surgery: An Age-Based Magnetic Resonance Imaging Anatomic Study

2019 ◽  
Vol 7 (7) ◽  
pp. 232596711985502 ◽  
Author(s):  
Jonathan M. Schachne ◽  
Madison R. Heath ◽  
Yi-Meng Yen ◽  
Kevin G. Shea ◽  
Daniel W. Green ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Skeletal Maturity ◽  
Lateral Meniscus ◽  
Meniscal Repair ◽  
Free Edge ◽  
Neurovascular Bundle ◽  
Posterior Horn ◽  
Regression Analyses ◽  
Resonance Imaging ◽  
Safe Distance

Background: The close proximity of the popliteal neurovascular bundle to the posterior horn of the lateral meniscus puts it at risk of compromise during lateral meniscal repair. This is particularly important in smaller pediatric patients, who are commonly treated for lateral meniscal abnormalities in isolation (discoid meniscus) or concomitantly with anterior cruciate ligament reconstruction. Purpose: To quantify the distance between the posterior horn of the lateral meniscus and the popliteal neurovascular bundle along the path of meniscal repair and to investigate for associations with age, sex, height, weight, body mass index (BMI), and skeletal maturity. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 144 magnetic resonance imaging scans were evaluated in a cohort of patients aged 10 to 18 years without meniscal or ligament abnormalities. Measurements were made along a line from the anterolateral portal between the popliteal neurovascular bundle and the free edge, midpoint, and meniscocapsular junctions of the posterior horn of the lateral meniscus. In addition to descriptive statistics of these distances by age and sex, analyses of variance and linear regression analyses were performed to investigate for associations with age, sex, height, weight, BMI, and skeletal maturity. Results: Male participants had a significantly larger mean free edge distance (14.4 ± 2.5 vs 13.1 ± 2.5 mm, respectively; P = .005) and midpoint distance (9.6 ± 2.2 vs 8.9 ± 1.8 mm, respectively; P = .011) than female participants but not a significantly larger meniscocapsular distance (5.2 ± 1.6 vs 4.6 ± 1.4 mm, respectively; P = .096). Linear regression analyses revealed significant associations between these distances and age, height, weight, and BMI ( P < .001 for all). There were statistically significant pairwise differences for free edge and midpoint distances to the neurovascular bundle between patients with open and closed physes. Conclusion: The distance between the posterior horn of the lateral meniscus and the popliteal vasculature along a trajectory from the standard anterolateral arthroscopic portal increases linearly throughout development between the ages of 10 and 18 years. There were also significant associations between height, weight, BMI, and skeletal maturity and these anatomic distances. Knowing the safe distance to the popliteal vasculature will increase the safety of arthroscopic lateral meniscal repair in children, especially with all-inside devices that require setting the penetration depth for the advancement of a sharp delivery device beyond the posterior capsule.

Different Regional Healing Rates with the Outside-In Technique for Meniscal Repair

1998 ◽  
Vol 26 (3) ◽  
pp. 446-452 ◽  
Author(s):  
Michiel F. van Trommel ◽  
Peter T. Simonian ◽  
Hollis G. Potter ◽  
Thomas L. Wickiewicz
Keyword(s):  
Medial Meniscus ◽  
Lateral Meniscus ◽  
Meniscal Repair ◽  
Current Method ◽  
Complete Healing ◽  
Posterior Horn ◽  
Resonance Imaging ◽  
Anterior Portion ◽  
Meniscus Tears

Fifty-one patients with meniscal repair using the outside-in technique were reassessed with second-look arthroscopic procedures (N 15), arthrographic examination (N 41), magnetic resonance imaging (N 36), or a combination of these techniques. Forty-one medial and 10 lateral menisci were repaired. The average clinical follow-up was 15 months (range, 3 to 80). Forty-five of 51 patients had tears that were located in or extended into the posterior horn of the medial or lateral meniscus. Complete healing occurred in 23 menisci (45%), partial healing was observed in 16 (15 medial, 1 lateral) (32%), and no healing occurred in 12 (24%). Remarkably, in all 15 patients who had tears extending from the posterior to the middle third of the medial meniscus that were partially healed, it was always the posterior third that had not fully healed. This finding is statistically significant. In addition, the middle third of these menisci had not fully healed in five patients. No healing occurred in the two patients with tears in the posterior third of the medial meniscus. Poor healing with the outside-in technique was observed in patients with tears into the posterior horn of the medial meniscus. For tears in the middle and anterior portion of the medial meniscus, as well as all lateral meniscus tears, the outside-in technique is our current method of choice.

scholarly journals A Surgical Algorithm According to Pivot-Shift Grade in Patients With ACL Injury: A Prospective Clinical and Radiological Evaluation

2021 ◽  
Vol 9 (8) ◽  
pp. 232596712110254
Author(s):  
Ramazan Akmese ◽  
Sancar Alp Ovali ◽  
Mehmet Mesut Celebi ◽  
Batu Malatyali ◽  
Hakan Kocaoglu
Keyword(s):  
Pivot Shift ◽  
Root Function ◽  
Lateral Meniscus ◽  
Meniscal Repair ◽  
Anterolateral Ligament ◽  
Rotational Instability ◽  
Meniscus Root ◽  
The Mean ◽  
Grade 3

Background: Some patients have a positive pivot-shift finding and rotational instability after anterior cruciate ligament (ACL) reconstruction (ACLR). Three major pathologies known to affect the pivot-shift examination include ACL tear, anterolateral ligament injury, and loss of posterior lateral meniscus root function. Purpose: To describe a surgical algorithm determining indications for lateral extra-articular tenodesis (LET) based on intraoperative pivot-shift examination to prevent postoperative pivot shift and rotational instability and to evaluate the 2-year clinical and functional outcomes. Study Design: Case series; Level of evidence, 4. Methods: The study included 47 consecutive patients (39 men and 8 women) who underwent operative treatment for ACL injury between 2016 and 2017. Pivot-shift examination was performed under anesthesia, and the pivot shift was graded as grade 1 (glide), grade 2 (clunk), or grade 3 (gross). According to the surgical algorithm, single-bundle ACLR was performed in patients with grade 1 pivot shift. In patients with grade 2 with loss of posterior lateral meniscus root function, concurrent lateral meniscal repair was performed, and in patients with grade 2 with an intact lateral meniscus posterior root, concurrent extra-articular iliotibial band tenodesis was performed. Patients with grade 3 underwent ACLR, lateral meniscal repair, and LET. Clinical and radiographic evaluations were performed. Results: The mean age was 27.2 years (range, 16-56 years). In total, 26 (55.3%) patients were evaluated as having pivot-shift grade 1; 16 (34%) patients, grade 2; and 5 (10.6%) patients, grade 3. A total of 7 (14.9%) patients underwent LET in addition to ACLR. Two of these patients had pivot-shift grade 2, and LET was performed since the lateral meniscus posterior root was intact. In 14 of 16 patients with grade 2, lateral meniscus root disruption was detected, and lateral meniscal repair was performed. One patient was excluded from the further follow-up because of graft failure. At a mean postoperative follow-up of 29 months in 46 patients, the pivot-shift examination was negative in all patients. The mean Lysholm and International Knee Documentation Committee subjective scores were 95.35 ± 4.40 and 82.87 ± 9.36, respectively. Radiographic evidence of osteoarthritis was not detected. Conclusion: Only 14.9% of patients needed LET. With proper ACL, lateral meniscal, and anterolateral ligament surgery, it was possible to prevent positive pivot-shift findings postoperatively.

scholarly journals An arthroscopic repair technique for meniscal tear using a needle and suture: outside-in transfer all-inside repair

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhiqiang Wang ◽  
Yan Xiong ◽  
Xin Tang ◽  
Qi Li ◽  
Zhong Zhang ◽  
...  
Keyword(s):  
Subcutaneous Tissue ◽  
Meniscal Tear ◽  
Lateral Meniscus ◽  
Meniscal Repair ◽  
Arthroscopic Repair ◽  
Normal Anatomy ◽  
Meniscal Tears ◽  
Repair Technique ◽  
Meniscus Tissue ◽  
Repair Techniques

Abstract Background At present, most repair techniques for meniscal tears fix the meniscus directly over the capsule. This changes the normal anatomy and biomechanics and limits the activity of the meniscus during motion. We introduce an arthroscopic repair technique by suturing the true meniscus tissue without the capsule and subcutaneous tissue. Methods After confirmation of a tear, a custom-designed meniscal repair needle first penetrates percutaneously, crossing the capsular portion and the torn meniscus, and exits from the femoral surface of one side of the torn meniscus. Then a No. 2 PDS suture is passed through the needle and retrieved through the arthroscopy portal. Next, the needle is withdrawn to the synovial margin of the meniscus and is reinserted, exiting the femoral surface of the other side of the torn meniscus. The suture is pulled out through the same portal with a grasper. Finally, arthroscopic knotting is performed. Results We had 149 cases of meniscal tears repaired with this outside-in transfer all-inside technique since July 2016. Conclusions It is a simple, minimally invasive, and economical procedure that is appropriate for most parts of the meniscus except the posterior horn of the lateral meniscus, and it can be used to fix torn meniscus tissue firmly while also preserving the inherent activity of the meniscus.

Sign in / Sign up

Export Citation Format

Share Document