Diagnosing Meniscal Pathology and Understanding How to Evaluate a Postoperative Meniscus Based on the Operative Procedure

2018 ◽  
Vol 31 (02) ◽  
pp. 166-183 ◽  
Author(s):  
Linda Probyn ◽  
Jaskarndip Chahal ◽  
Lawrence White ◽  
Monica Tafur
Keyword(s):  
Sports Medicine ◽  
Operative Procedure ◽  
Suture Repair ◽  
Meniscal Tears ◽  
Ct Arthrography ◽  
Meniscal Tissue ◽  
Noninvasive Imaging Technique ◽  
Meniscal Pathology ◽  
Magnetic Resonance Imaging Mri ◽  
Postoperative Setting

AbstractMagnetic resonance imaging (MRI) represents the preferred noninvasive imaging technique to diagnose meniscal pathology in the pre- and postoperative setting. Furthermore, characterization of meniscal tissue MR properties has been possible by the development of advanced MRI techniques. Suspected meniscal tears are a frequent indication for MRI and the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification system has been developed to facilitate accurate and uniform reporting of such meniscal tears. Partial meniscectomy and meniscal suture repair are among the commonly performed procedures and several signs have been described to detect postoperative recurrent tears on MRI. Other techniques that have proven useful for meniscal assessment are ultrasound (US) and computed tomography (CT) arthrography. In recent years, US is being increasingly used in the selective assessment of some meniscal pathology such as tears, parameniscal cysts and meniscal extrusion as it is a relatively inexpensive, accessible, and safe technique. CT arthrography has been advocated as an acceptable alternative in patients with contraindications for MRI, with comparable diagnostic performance.

scholarly journals All-Inside Double-Sided Suture Repair for Longitudinal Meniscal Tears

2021 ◽  
Author(s):  
Constant Foissey ◽  
Mathieu Thaunat ◽  
Jean-Marie Fayard
Keyword(s):  
Suture Repair ◽  
Meniscal Tears

Detection of meniscal tears by arthroscopy and arthrotomy in dogs with cranial cruciate ligament rupture

2013 ◽  
Vol 26 (01) ◽  
pp. 42-46 ◽  
Author(s):  
R. Plesman ◽  
J. Campbell ◽  
P. Gilbert
Keyword(s):  
Cruciate Ligament ◽  
Meniscal Tear ◽  
Meniscal Tears ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Medial Parapatellar Arthrotomy ◽  
Meniscal Pathology ◽  
Medial Parapatellar ◽  
Cranial Cruciate Ligament Rupture

SummaryObjectives: To evaluate and compare detection of meniscal tears associated with cranial cruciate ligament insufficiency by either arthroscopy or arthrotomy.Methods: A retrospective, cohort study was completed with stifles (n = 531) of dogs with cranial cruciate ligament rupture. Either a medial parapatellar arthrotomy or an arthroscopy procedure was performed and groups were compared for significant differences in meniscal tears detected using logistic regression analysis.Results: Arthroscopy was performed on 58.8% and arthrotomy on 41.2% of the stifles. In total, 44.4% of the examined stifles had meniscal tears. Meniscal tears were found in 38.8% of the stifles examined by arthrotomy, and 48.4% of those examined by arthroscopy. Overall, the rate of detection of a meniscal tear was significantly different (p = 0.019) between the groups, and meniscal tears were observed more frequently by arthroscopy than by arthrotomy (odds ratio 1.54; 95% confidence interval 1.07 – 2.22).Clinical significance: These results suggest that arthroscopy may be more sensitive than arthrotomy for detection of meniscal pathology in clinical patients. However, these results must be interpreted with caution since this was a retrospective study. Randomized prospective clinical studies are required to further test this hypothesis.

scholarly journals Modern treatment of meniscal tears

2018 ◽  
Vol 3 (5) ◽  
pp. 260-268 ◽  
Author(s):  
Mahmut Nedim Doral ◽  
Onur Bilge ◽  
Gazi Huri ◽  
Egemen Turhan ◽  
René Verdonk
Keyword(s):  
Sports Medicine ◽  
Meniscal Repair ◽  
Clinical Information ◽  
The Body ◽  
Meniscal Tears ◽  
Treatment Methods ◽  
Vital Functions ◽  
Augmentation Techniques ◽  
Tear Pattern ◽  
Modern Treatment

The complex ultrastructure of the meniscus determines its vital functions for the knee, the lower extremity, and the body. The most recent concise, reliable, and valid classification system for meniscal tears is the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Classification, which takes into account the subsequent parameters: tear depth, tear pattern, tear length, tear location/rim width, radial location, location according to the popliteal hiatus, and quality of the meniscal tissue. It is the orthopaedic surgeon’s responsibility to combine clinical information, radiological images, and clinical experience in an effort to individualize management of meniscal tears, taking into account factors related to the patient and lesion. Surgeons should strive not to operate in most cases, but to protect, repair or reconstruct, in order to prevent early development of osteoarthritis by restoring the native structure, function, and biomechanics of the meniscus. Currently, there are three main methods of modern surgical management of meniscus tears: arthroscopic partial meniscectomy; meniscal repair with or without augmentation techniques; and meniscal reconstruction. Meniscus surgery has come a long way from the old slogan, “If it is torn, take it out!” to the currently accepted slogan, “Save the meniscus!” which has guided evolving modern treatment methods for meniscal tears. This last slogan will probably constitute the basis for newer alternative biological treatment methods in the future.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170067.

Dual-Detector Spiral CT Arthrography of the Knee: Accuracy for Detection of Meniscal Abnormalities and Unstable Meniscal Tears

Radiology ◽  
2000 ◽  
Vol 216 (3) ◽  
pp. 851-857 ◽  
Author(s):  
Bruno C. Vande Berg ◽  
Frederic E. Lecouvet ◽  
Pascal Poilvache ◽  
Jean-Emile Dubuc ◽  
Bernard Bedat ◽  
...  
Keyword(s):  
Spiral Ct ◽  
Meniscal Tears ◽  
Ct Arthrography ◽  
Dual Detector

scholarly journals Correlation of meniscus tears on MRI and arthroscopy using the ISAKOS classification provides satisfactory intermethod and inter-rater reliability

2020 ◽  
Vol 5 (4) ◽  
pp. 201-207
Author(s):  
Jay Shah ◽  
Rocco Hlis ◽  
Oganes Ashikyan ◽  
Anthony Cai ◽  
Kyle Planchard ◽  
...  
Keyword(s):  
Sports Medicine ◽  
Intraclass Correlation ◽  
Lateral Meniscus ◽  
Meniscal Tears ◽  
Tissue Quality ◽  
Level Of Evidence ◽  
Meniscus Tears ◽  
3.0 T ◽  
3.0 T Mri

ObjectiveTo evaluate the inter-rater and intermethod correlation (reliability between MRI and arthroscopy) of knee for findings of meniscus tears using International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification on both 1.5 and 3.0 T images.Methods81 knees were evaluated in 69 patients aged 30.0±12.6 years (mean±SD). Consecutive arthroscopy-proven meniscal tears were evaluated by two board-certified radiologists on MRI and two sports surgeons on arthroscopies. The surgically validated ISAKOS classification of meniscal tears was used to describe medial meniscus (MM) and lateral meniscus (LM) tears on MRI and re-evaluation of images from completed arthroscopies. Prevalence-adjusted bias-adjusted kappa (PABAK), t-tests and intraclass correlation coefficient (ICC) were calculated.ResultsFor LM on 1.5 T, the agreements for location, depth, tear length and pattern were good to excellent in all categories except fair for tissue quality (PABAK=0.35–0.41) and zone 2 (PABAK=0.35) identification. For MM, the agreements were good to excellent in all except moderate for tissue quality (PABAK=0.6) and zone 1 and 3 (PABAK=0.40–0.47), and fair for zone 2 identification (PABAK=0.27). Similar results were seen on 3 T with improved LM zonal identification (PABAK=0.52–0.90) and better correlation of tear lengths, which were different on 1.5 T vs 3.0 T (p=0.01–0.03). For 1.5 T cases, both MM and LM tear lengths were larger on MRI versus arthroscopy (MM, p=0.004; LM, p=0.095). For 3 T, the MM tear lengths were larger on MRI versus arthroscopy (p=0.001).ConclusionISAKOS classification of meniscal tears on both 1.5 and 3.0 T MRI provides satisfactory inter-rater and intermethod reliability for use in clinical practice. Level of evidence: IV.

Midterm and Long-term Results after Arthroscopic Suture Repair of Isolated, Longitudinal, Vertical Meniscal Tears in Stable Knees

2006 ◽  
Vol 34 (7) ◽  
pp. 1072-1076 ◽  
Author(s):  
Martin Majewski ◽  
Reinhard Stoll ◽  
Heinz Widmer ◽  
Werner Müller ◽  
Niklaus F. Friederich
Keyword(s):  
Long Term Results ◽  
Suture Repair ◽  
Meniscal Tears

scholarly journals Advances in Meniscal Tissue Engineering

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Umile Giuseppe Longo ◽  
Mattia Loppini ◽  
Francisco Forriol ◽  
Giovanni Romeo ◽  
Nicola Maffulli ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
Gene Therapy ◽  
Growth Factors ◽  
Knee Injuries ◽  
Meniscal Tears ◽  
Cell Based Therapy ◽  
Meniscal Tissue ◽  
Meniscal Lesions ◽  
Meniscal Healing

Meniscal tears are the most common knee injuries and have a poor ability of healing. In the last few decades, several techniques have been increasingly used to optimize meniscal healing. Current research efforts of tissue engineering try to combine cell-based therapy, growth factors, gene therapy, and reabsorbable scaffolds to promote healing of meniscal defects. Preliminary studies did not allow to draw definitive conclusions on the use of these techniques for routine management of meniscal lesions. We performed a review of the available literature on current techniques of tissue engineering for the management of meniscal tears.

scholarly journals Clinical and MRI Evaluation of Meniscal Tears Repaired with Bioabsorbable Arrows

2007 ◽  
Vol 96 (3) ◽  
pp. 252-255 ◽  
Author(s):  
L. Tielinen ◽  
J. Lindahl ◽  
S. Koskinen ◽  
E. Hirvensalo
Keyword(s):  
Ligament Reconstruction ◽  
Healing Rate ◽  
Good Alternative ◽  
Meniscus Repair ◽  
University Hospital ◽  
Meniscal Tears ◽  
Secondary Surgery ◽  
Meniscal Tissue ◽  
Mri Evaluation

Background and Aims: Excision of meniscal tissue has been shown to increase the risk of degenerative changes of the knee joint. Whenever possible, meniscus repair has become the procedure of choice for treatment of meniscal tears. Materials and Methods: The present retrospective study evaluated the healing results of 77 meniscal ruptures treated with the an all-inside technique (Biofix meniscus arrow). The study group consisted of 73 patients with 77 longitudinal, vertical meniscal ruptures treated at Helsinki University Hospital between the beginning of January 1997 and the end of March 2001. The patients who had not received secondary surgery for failed repair during the follow-up period were examined clinically and with MRI. Results: Fifty-one out of 77 meniscal ruptures (66%) healed clinically. In repairs performed in conjunction with ligament reconstruction the healing rate was higher (79%) than in the isolated tears (56%). The poorest results were seen in the very long vertical tears with luxation of the meniscus (38% healing rate). Conclusions: Bioabsorbable arrows offer a good alternative for treatment of meniscal ruptures, but the arrows alone do not seem to be sufficient to provide a reliable long-lasting result in the repair of very unstable meniscal ruptures.

scholarly journals The Role of MRI Pancreatic Protocol in Assessing Response to Neoadjuvant Therapy for Patients With Borderline Resectable Pancreatic Cancer

2022 ◽  
Vol 11 ◽  
Author(s):  
Nervana Hussien ◽  
Rasha S. Hussien ◽  
Darine Helmy Amin Saad ◽  
Mohamed El Kassas ◽  
Walid F. Elkhatib ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Neoadjuvant Therapy ◽  
Operative Procedure ◽  
Resectable Pancreatic Cancer ◽  
Borderline Resectable ◽  
Borderline Resectable Pancreatic Cancer ◽  
Number Of Patients ◽  
Magnetic Resonance Imaging Mri ◽  
Post Therapy

BackgroundBorderline Resectable Pancreatic Cancer (BRPC) remains a unique entity that is difficult to categorize due to variance in definitions and the small number of patients. The ultimate goal is to achieve a free resection (R0) after a favorable response to neoadjuvant therapy that is somewhat difficult to assess by current radiological parameters.AimTo evaluate the role of Magnetic Resonance Imaging (MRI) pancreatic protocol, including Diffusion-Weighted Imaging (DWI), in patients with BRPC receiving neoadjuvant therapy, and further compare it to RECIST criteria and outcome.MethodsHistologically confirmed BRPC patients were prospectively included. DWI-MRI was performed pre- and post-therapy. Clinical characteristics with ensuing operability were recorded and correlated to radiological RECIST/apparent diffusion coefficient (ADC) change, preoperative therapy administrated, surgical resection status, and survival.ResultsOut of 30 BRPC cases, only 11 (36.7%) ultimately underwent pancreaticoduodenectomy. Attaining a stationary or stable disease via ADC/RECIST was achieved in the majority of cases (60%/53.3% respectively). Of the 12 patients (40%) who achieved a regression by ADC, 11 underwent surgery with an R0 status. These surgical cases showed variable RECIST responses (PR=5, SD=4, PD=3). Responders by ADC to neoadjuvant therapy were significantly associated to presenting with abdominal pain (p =0.07), a decline in post-therapy CA19-9 (p<0.001), going through surgery (p<0.001), and even achieving better survival (p<0.001 vs. 0.66).ConclusionDWI-MRI ADC picked up patients most likely to undergo a successful operative procedure better than traditional RECIST criteria. An algorithm incorporating novel radiological advances with CA19-9 deserves further assessment in future studies.

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