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 Operative Treatment of Isolated Meniscus Injuries in Adolescent Patients: A Meta-Analysis and Review

2018 ◽  
Vol 10 (4) ◽  
pp. 311-316 ◽  
Author(s):  
Gina M. Mosich ◽  
Virginia Lieu ◽  
Edward Ebramzadeh ◽  
Jennifer J. Beck
Keyword(s):  
Systematic Review ◽  
Operative Treatment ◽  
Meta Analysis ◽  
Meniscus Repair ◽  
Meniscal Tears ◽  
Level Of Evidence ◽  
Adolescent Population ◽  
Meniscus Tears ◽  
Adolescent Patients

Context: With the rise in sports participation and increased athleticism in the adolescent population, there is an ever-growing need to better understand adolescent meniscus pathology and treatment. Objective: To better understand the operative management of meniscus tears in the adolescent population. Data Sources: A systematic review of PubMed (MEDLINE) and Google Scholar was performed for all archived years. Study Selection: Studies that reported on isolated meniscus tears in adolescent patients (age, 10-19 years) were included. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 4. Data Extraction: Two authors reviewed and extracted data from studies that fulfilled all inclusion criteria. Results: Nine studies on isolated meniscus tears in adolescent patients were found, with level of evidence ranging from 3 to 4. These studies evaluated a total of 373 patients (248 males, 125 females) and 390 knees. Seven studies were published between 1979 and 2000, all of which discuss meniscectomy as the primary treatment. Two studies were published after 2000 and report on meniscus repair surgery. The mean patient age was 14.4 years. A total of 308 meniscectomies and 64 meniscus repairs were performed. Follow-up ranged from 1.8 to 30 years (mean, 10.8 years). A 37% retear rate was reported for patients undergoing meniscus repair. Different outcome measures were used for meniscectomy versus meniscus repair. Three studies evaluating meniscectomy reported Tapper-Hoover scores, showing 54 patients with an excellent result, 58 with good, 57 with fair, and 23 with poor results. Conclusion: A shift in the management of isolated adolescent meniscal tears is reflected in the literature, with a recent increase in operative repair. This is likely secondary to poor outcomes after meniscectomy reflected in long-term follow-up studies. The current literature highlights the need for improved description of tear patterns, standardized reporting of outcome measures, and improved study methodologies to help guide orthopaedic surgeons on operative treatment of meniscal tears in adolescent patients.

Alteration of Knee Kinematics After Anatomic Anterior Cruciate Ligament Reconstruction Is Dependent on Associated Meniscal Injury

2018 ◽  
Vol 46 (5) ◽  
pp. 1158-1165 ◽  
Author(s):  
Berkcan Akpinar ◽  
Eric Thorhauer ◽  
James J. Irrgang ◽  
Scott Tashman ◽  
Freddie H. Fu ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Meniscal Injury ◽  
Meniscal Tears ◽  
Cruciate Ligament Reconstruction ◽  
Significant Difference ◽  
Anterior Cruciate

Background: Limited in vivo kinematic information exists on managing meniscal injury during anterior cruciate ligament reconstruction (ACLR). Hypothesis: Isolated anatomic ACLR restores knee kinematics, whereas ACLR in the presence of medial meniscal injury is associated with altered long-term knee kinematics. Study Design: Cohort study; Level of evidence, 3. Methods: From March 2011 to December 2012, 49 of 57 participants in a clinical trial underwent anatomic ACLR with successful kinematic testing at 24 months after ACLR. Twenty-five patients had associated meniscal tears: medial (n = 11), lateral (n = 9), or bilateral (n = 5). With a dynamic stereo radiography system with superimposed high-resolution computed tomography scans of patient knees, kinematics were measured during downhill running. The initial single-support phase of the gait cycle (0%-10%) was analyzed. Results: Anterior tibial translation (ATT) was the only kinematic outcome between patients’ ACLR and contralateral knees that had significant interactions among meniscal groups ( P = .007). There was significant difference in ATT between patients with intact menisci and medial tears ( P = .036) and with medial tears and lateral tears ( P = .025). Patients with intact menisci had no difference in ATT, with a negligible effect size between the ACLR and contralateral knees (mean ± SEM: 13.1 ± 0.7 mm vs 12.6 ± 0.5 mm, P = .24, Cohen d = 0.15, n = 24), while patients with medial meniscal tears had an increase in ATT, with a medium effect size between the ACLR and contralateral knees (15.4 ± 1.0 mm vs 13.2 ± 1.0 mm, P = .024, Cohen d = 0.66, n = 11). Conclusion: Associated medial meniscal injury in the setting of ACLR leads to increased ATT at 24-month follow-up. Furthermore, isolated anatomic ACLR in the absence of meniscal injury demonstrated no significant difference from native knee kinematics at 24-month follow-up during rigorous “high demand” knee activity with the current sample size. Patients undergoing anatomic ACLR in the presence of medial meniscal injury remained at a higher likelihood of sustaining altered long-term knee kinematics.

scholarly journals Risk Factors Related to the Presence of Meniscal Injury and Irreparable Meniscal Tear at Primary Anterior Cruciate Ligament Reconstruction

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712198903
Author(s):  
Tomohiro Tomihara ◽  
Yusuke Hashimoto ◽  
Shinji Takahashi ◽  
Masatoshi Taniuchi ◽  
Junsei Takigami ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Meniscal Repair ◽  
Meniscal Tears ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Tegner Score

Background: Few studies have attempted to identify risk factors associated with irreparable meniscal tears at anterior cruciate ligament reconstruction (ACLR) and to describe follow-up data, such as the failure rate, after meniscal repair. Purpose: To investigate the associations of age, sex, body mass index (BMI), time to surgery (TTS), and preinjury Tegner score with the presence of meniscal injuries and irreparable meniscal tears at primary ACLR. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A retrospective review was performed on 784 patients who underwent primary ACLR by a single surgeon between 2005 and 2017 (406 men and 378 women; mean age, 25.8 years; mean BMI, 23.1; median TTS, 3 months; median preinjury Tegner score, 7). All patients had a minimum follow-up of 12 months (mean postoperative follow-up, 33.0 months). Multivariate logistic regression analysis was conducted to determine the association of patient variables with the presence of meniscal injuries and irreparable meniscal tears during primary ACLR. Results: The risk factor for medial meniscal injuries was TTS ≥3 months (odds ratio [OR], 4.213; 95% CI, 3.104-5.719; P < .001). The presence of irreparable medial meniscal tears increased with older age (OR, 1.053; 95% CI, 1.024-1.084; P < .001), higher BMI (OR, 1.077; 95% CI, 1.003-1.156; P = .042), and TTS ≥3 months (OR, 1.794; 95% CI, 1.046-3.078; P = .034). On multivariate analysis, none of the variables were significantly associated with lateral meniscal injuries and irreparable meniscal tears. The failure rate, defined as patients who needed additional medial meniscal surgery after medial meniscal repair, was 4.6%. Conclusion: Time from ACL injury to reconstruction of ≥3 months was strongly associated with medial meniscal injuries and irreparable medial meniscal tears at primary ACLR. Older age and increased BMI were also risk factors for the presence of irreparable medial meniscal tears at ACLR.

Surgical Repair of Neglected Bucket-Handle Meniscal Tears Displaced into the Intercondylar Notch: Clinical and Radiological Results

2017 ◽  
Vol 31 (06) ◽  
pp. 514-519 ◽  
Author(s):  
Engin Cetinkaya ◽  
Sarper Gursu ◽  
Murat Gul ◽  
Umit Aykut ◽  
Rasit Ozcafer
Keyword(s):  
Healing Rate ◽  
Cruciate Ligament ◽  
Meniscal Tear ◽  
International Knee Documentation Committee ◽  
Intercondylar Notch ◽  
Meniscal Tears ◽  
Functional Scores ◽  
The Mean ◽  
Bucket Handle

AbstractThe literature contains very limited articles wherein the treatment results of bucket-handle meniscal tears according to various types are evaluated and wherein results for repair of chronic tears are discussed. The objective of this study is a clinical and radiologic evaluation of arthroscopic repair for patients suffering flipped, neglected chronic bucket-handle meniscal tear in the intercondylar notch. A total of 26 patients were evaluated retrospectively. The mean age at the time of surgery was 27 years (range, 16–44). Mean period from meniscal injury to surgery was 28 months (range, 4–96). The mean follow-up period was 31 months (range, 11–67). During the follow-up, the patients were evaluated clinically, functional scores from the International Knee Documentation Committee (IKDC), Lysholm, and Tegner as well as magnetic resonance imaging (MRI). The mean preoperative Lysholm score of 24 increased to 85 postoperatively. Mean IKDC score was 56.3 preoperatively and 84.5 postoperatively. The mean Tegner score of 3.4 increased to 5.6 postoperatively. Mean Lysholm, IKDC, and Tegner scores in the first group were 84, 74, and 5.1, respectively, and in the anterior cruciate ligament (ACL) reconstruction group; 86, 85.9, and 5.8. While 20 (77%) out of 26 patients had none of the clinical findings, 6 patients (23%) presented with these findings. Postoperative MRI assessment revealed meniscal healing in 21 patients (27% complete, 54% partial healing) and no healing in 5 patients (19%). A clinical healing rate of 77% and a radiological healing rate of 81% along with statistically significant increases in Lysholm, IKDC, and Tegner scores prove that the repair option is effective for neglected, chronic bucket-handle meniscal tears flipping to the intercondylar notch. This study showed that good results could be achieved with the repair of neglected, chronic period bucket-handle meniscal tears flipping to the intercondylar notch, whether with an accompanying ACL tear or not.

scholarly journals Possibility of Meniscal Repair for Degenerative and Horizontal Tears

2019 ◽  
Vol 13 (1) ◽  
pp. 260-265
Author(s):  
Takatomo Mine ◽  
Takaaki Ueda ◽  
Koichiro Ihara ◽  
Hiroyuki Kawamura ◽  
Ryutaro Kuriyama ◽  
...  
Keyword(s):  
Clinical Assessment ◽  
Healing Rate ◽  
Meniscal Repair ◽  
Clinical Results ◽  
Complete Healing ◽  
Magnetic Resonance Imaging Examination ◽  
Meniscal Tears ◽  
The Mean

Background: Poor long-term clinical results have been reported following partial and total menisectomy. To preserve the meniscus, many surgeons perform meniscal repairs when possible. However, meniscal repair for degenerative tears and white-white tears is challenging. Methods: 15 patients underwent meniscal repair for degenerative and horizontal tears. Follow-up evaluation included clinical assessment and Magnetic Resonance Imaging examination. The mean follow-up time was 11.9 months (from 8 months to 13 months). Result: The healing rate on clinical assessment was 86.6% 12 months after surgery. MRI showed partial healing in 12 patients, complete healing in 1 and no healing in 2 after 12 months. Conclusion: The findings suggest that it may be possible to repair degenerative and horizontal meniscal tears.

Prospective evaluation for gastrointestinal bleedings at the University Hospital St. Pölten – one year of follow-up

2019 ◽  
Author(s):  
M Stättermayer ◽  
F Riedl ◽  
S Bernhofer ◽  
A Stättermayer ◽  
A Mayer ◽  
...  
Keyword(s):  
University Hospital ◽  
Prospective Evaluation ◽  
One Year ◽  
The University

Survey of bullous pemphigoid in an Italian university hospital: clinical-epidemiological characteristics and follow-up

2018 ◽  
Vol 153 (5) ◽  
Author(s):  
Riccardo Balestri ◽  
Giulia Odorici ◽  
Annalisa Patrizi ◽  
Salvatore D. Infusino ◽  
Michela Magnano ◽  
...  
Keyword(s):  
Bullous Pemphigoid ◽  
University Hospital ◽  
Epidemiological Characteristics

CLINICAL FEATURES, INDICATIONS AND RESULT OF TRACHEOTOMY

2017 ◽  
pp. 50-55
Author(s):  
Duc Luu Ngo ◽  
Tu The Nguyen ◽  
Manh Hung Ho ◽  
Thanh Thai Le
Keyword(s):  
Clinical Features ◽  
University Hospital ◽  
Female Ratio ◽  
Tube Obstruction ◽  
Level Ii ◽  
Study Results ◽  
Male Female Ratio ◽  
Hospital Patients ◽  
Level I

Background: This study aims to survey some clinical features, indications and results of tracheotomy at Hue Central Hospital and Hue University Hospital. Patients and method: Studying on 77 patients who underwent tracheotomy at all of departments and designed as an prospective, descriptive and interventional study. Results: Male-female ratio was 4/1. Mean age was 49 years. Career: farmer 44.2%, worker 27.2%, officials 14.3%, student 7.8%, other jobs 6.5%. Respiratory condition before tracheotomy: underwent intubation 62.3%, didn’t undergo intubation 37.7%. Period of stay of endotracheal tube: 1-5 days 29.2%, 6-14 days 52.1%, >14 days 18.7%. Levels of dyspnea before tracheotomy: level I 41.4%, level II 48.3%, level III 0%, 10.3% of cases didn’t have dyspnea. Twenty cases (26%) were performed as an emergency while fifty seven (74%) as elective produces. Classic indications (37.7%) and modern indications (62.3%). On the bases of the site, we divided tracheostomy into three groups: high (0%), mid (25.3%) and low (74.7%). During follow-up, 44 complications occurred in 29 patients (37.7%). Tracheobronchitis 14.3%, tube obstruction 13%, subcutaneous empysema 10.4%, hemorrhage 5%, diffcult decannulation 5.2%, tube displacement 3.9%, canule watery past 2.6%, wound infection 1.3%. The final result after tracheotomy 3 months: there are 33 patients (42.9%) were successfully decannulated. In the 33 patients who were successfully decannulated: the duration of tracheotomy ranged from 1 day to 90 days, beautiful scar (51.5%), medium scar (36.4%), bad scar (12.1%). Conclusions: In tracheotomy male were more than female, adult were more than children. The main indication was morden indication. Tracheobronchitis and tube obstruction were more common than other complications. Key words: Tracheotomy

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