Arthroscopic meniscal repair with fibrin clot of complete radial tears of the lateral meniscus in the avascular zone

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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A Useful MRI Classification for Symptomatic Discoid Lateral Meniscus

Knee Surgery and Related Research ◽

10.1186/s43019-021-00108-0 ◽

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.

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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

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-017-4490-1 ◽

2017 ◽

Vol 26 (3) ◽

pp. 793-798 ◽

Cited By ~ 11

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

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

Yearbook of Orthopedics ◽

10.1016/j.yort.2011.04.079 ◽

2011 ◽

Vol 2011 ◽

pp. 208-209

Author(s):

B.F. Morrey

Keyword(s):

Lateral Meniscus ◽

Meniscal Repair

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Meniscal Repair in the Goat Model

The American Journal of Sports Medicine ◽

10.1177/03635465980260022001 ◽

1998 ◽

Vol 26 (2) ◽

pp. 278-284 ◽

Cited By ~ 52

Author(s):

Joseph R. Ritchie ◽

Mark D. Miller ◽

Robert T. Bents ◽

Douglas K. Smith

Keyword(s):

Magnetic Resonance ◽

Current Trend ◽

Meniscal Repair ◽

Fibrin Clot ◽

Magnetic Resonance Arthrography ◽

Magnetic Resonance Imaging Scan ◽

Group Iii ◽

Group I ◽

Magnetic Resonance Arthrogram ◽

Group Ii

We evaluated the effect of adjunctive healing measures on central tears of the adult goat medial meniscus and the role of magnetic resonance arthrography in the assessment of menisci that have undergone a repair. Peripheral tears were made unilaterally in the medial menisci of seven goats in Group I and repaired with nonabsorbable suture. Six Group II goats had central medial meniscal tears repaired as in Group I plus an exogenous fibrin clot. Eight Group III goats had central tears plus abrasion of the parameniscal synovium and tear edges. Six months after surgery, a magnetic resonance imaging scan and a magnetic resonance arthrogram were obtained and the menisci were examined grossly. Group I goats showed healing in all seven knees. Central tears repaired with a fibrin clot (Group II) showed healing in one of six knees (17%). Central tears repaired with abrasion (Group III) showed healing in seven of eight knees (87.5%). Magnetic resonance arthrography was 100% accurate in detecting the presence or absence of complete residual tears. This study supports the current trend of using adjunctive measures for repair of central tears. Furthermore, abrasion of the parameniscal synovium and the tear edges appears to be more effective than the use of an exogenous fibrin clot. Magnetic resonance arthrography is useful in the evaluation of menisci that have undergone repair.

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