scholarly journals MENISCUS ROOT TEARS IN CHILDREN AND ADOLESCENTS

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0003
Author(s):  
S. Clifton Willimon ◽  
Melissa Christino ◽  
Michael Busch ◽  
Crystal Perkins
Keyword(s):  
Pediatric Patients ◽  
Medial Meniscus ◽  
Lateral Meniscus ◽  
Posterior Root ◽  
Associated Injuries ◽  
Inclusion Criteria ◽  
Root Tear ◽  
Meniscus Root ◽  
Meniscus Root Tear

Background: The medial and lateral menisci function to optimize force transmission across the knee by increasing contact area between the femur and tibia, absorbing shock, and transmitting loads. Injuries to the meniscus root attachments result in extrusion of the meniscus, impaired distribution of hoop stresses, and degenerative articular wear. The purpose of this study is to describe meniscus root tears, associated injuries, and treatment in a series of pediatric patients Methods: A single-institution retrospective review was performed of consecutive pediatric patients treated for meniscus root tears from 2013 – 2017. Inclusion criteria were patients less than 19 years of age, arthroscopic evidence of a meniscus root tear, and minimum 6 months clinical follow-up. The primary outcome was surgery for revision of the meniscus repair. Results: Twenty-seven patients were identified to fit inclusion criteria. There were 15 males and 12 females with a mean age of 15.2 years (range 7 – 18 years). Basketball, soccer, and football accounted for the majority (56%) of injuries. The lateral meniscus was involved in 21 patients (78%) and the medial meniscus in 6 patients (22%). The posterior meniscus root was torn in 25 patients (93%) and anterior meniscus root in 2 patients (7%). The most common injury pattern was a lateral meniscus posterior root tear (19 patients, 70%). Associated injuries included an ACL tear (19 patients, 70%), PCL tear (6 patients, 22%), and a tear of the opposite meniscus (7 patients, 26%). Two root tears occurred in isolation, and both were of the posterior root of the medial meniscus. All patients were treated surgically with an arthroscopic transosseous root repair in addition to simultaneous treatment for their associated injuries. Mean follow-up was 14 months (range 6 – 37 months). No patients required additional surgery for their meniscus root tear. Two patients had a second surgery on the affected knee: one for revision ACL reconstruction 2 years following the primary procedure and the other for chondroplasty of the patella 2.5 years following the primary procedure. Conclusions: Meniscus root tears occur in pediatric and adolescent patients, most commonly affecting the posterior root of the lateral meniscus and occurring in association with ACL tears. The adolescent meniscus root injury pattern is unique compared to the adult population in which the medial meniscus posterior root is often injured in isolation. Inspection of the meniscus root attachments with deliberate probing to assess the meniscus roots should be a routine part of every knee arthroscopy. In our case series, transosseous root repair resulted in successful outcomes in all patients without need for any additional meniscus treatment.

scholarly journals Meniscal Root Repair in Pediatric Patients: Minimum 2-Year Outcomes (196)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0030
Author(s):  
S. Clifton Willimon ◽  
Michael Busch ◽  
Asahi Murata ◽  
Crystal Perkins
Keyword(s):  
Patient Satisfaction ◽  
Pediatric Patients ◽  
Medial Meniscus ◽  
Lateral Meniscus ◽  
Injury Pattern ◽  
Posterior Root ◽  
Root Tear ◽  
Meniscus Root ◽  
Root Repair

Objectives: The medial and lateral menisci function to optimize force transmission across the knee by increasing contact area between the femur and tibia, absorbing shock, and transmitting loads. The anterior and posterior meniscus roots anchor the meniscus to bone. Injuries to the meniscus root attachments result in extrusion of the meniscus, impaired distribution of hoop stresses, and progressive degenerative articular wear. As a result of these deleterious effects, there has been increasing emphasis on repair of meniscus root injuries to restore structure and function. The purpose of this study is to describe meniscus root tears, associated injuries, and minimum 2-year treatment outcomes in a series of pediatric patients. Methods: A single-institution, IRB approved, retrospective review was performed of consecutive pediatric patients less than 19 years of age with a meniscus root tear treated with transosseous root repair over a 4-year period. All patients had minimum 24-month clinical follow-up. Partial root tears treated with partial meniscectomy or irreparable root tears were excluded. All meniscus root tears were classified arthroscopically based on the tear types described by LaPradeADDIN EN.CITE 9. The primary outcomes were revision meniscus surgery and patient reported outcome scores (PROs) (Lysholm, Patient Satisfaction, and Tegner activity). Results: Twenty-one patients, 11 males and 10 females with a mean age of 15 years (range 7 – 18 years), met inclusion criteria. There were 15 lateral meniscus root tears and 6 medial meniscus root tears. The tears occurred in the posterior root in 20 patients (95%). The most common injury pattern was a lateral meniscus posterior root tear (14 patients, 67%). 18 patients (86%) had an associated ligament tear: 13 ACL tears and 5 PCL tears. Two root tears occurred in isolation, and both were the posterior root of the medial meniscus. The majority of meniscus root tears (15 patients, 71%) were root avulsions (type 5). Mean follow-up was 42 months (range 25 – 71 months). Three patients had a second surgery on the affected knee. In two patients, one with revision ACL reconstruction and one treated with chondroplasty of the patella, the meniscus root repair was noted to be well healed. A third patient sustained a new injury to the knee 4 years following medial meniscus posterior root repair and underwent partial medial meniscectomy. At final follow-up, PROs were obtained for 17 patients (81%). Mean Lysholm score was 91 (range 51 – 100). Mean patient satisfaction score was 8.7 (range 5 – 10). Fourteen of 16 patients (88%) reported returning to the same or higher level of activity following surgery. Conclusions: Meniscus root tears occur in pediatric patients, most commonly as root avulsions of the posterior root of the lateral meniscus and in association with ACL tears. This is unique as compared to the adult population, in which the medial meniscus posterior root is often injured in isolation and radial tears adjacent the root are the most commonly described injury pattern. In our case series, transosseous root repair resulted in successful outcomes in the majority of patients with durable results at midterm follow-up.

Magnetic Resonance Imaging Findings of Surgically Proven Medial Meniscus Root Tear

2008 ◽  
Vol 32 (3) ◽  
pp. 452-457 ◽  
Author(s):  
Yong Gu Lee ◽  
Jae-Chan Shim ◽  
Yun Sun Choi ◽  
Jin Goo Kim ◽  
Ghi Jai Lee ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Medial Meniscus ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Root Tear ◽  
Meniscus Root ◽  
Meniscus Root Tear

scholarly journals Does meniscectomy have any advantage over conservative treatment in middle-aged patients with degenerative medial meniscus posterior root tear?

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Nam-Hun Lee ◽  
Hyoung-Yeon Seo ◽  
Myung-Jin Sung ◽  
Bo-Ram Na ◽  
Eun-Kyoo Song ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Clinical Outcomes ◽  
Medial Meniscus ◽  
Joint Space ◽  
Posterior Root ◽  
Root Tear ◽  
Aged Patients ◽  
Posterior Root Tear ◽  
Arthroscopic Meniscectomy

Abstract Background The best treatment for degenerative medial meniscus posterior root tear (MMPRT) remains controversial. This study aimed to compare the clinical and radiological outcomes of arthroscopic meniscectomy and conservative treatment for degenerative MMPRT. Methods From January 2007 to December 2014, 146 patients (Meniscectomy group, 90; Conservative group, 56) were evaluated. Clinical outcomes were assessed using the Visual Analog Scale, International Knee Documentation Committee subjective scoring scale, Tegner activity scale, and Lysholm knee scoring scale at the final follow-up. Radiologic outcomes evaluated the progression of osteoarthritis (OA) according to the Kellgren-Lawrence (K-L) classification. We compared the hip-knee-ankle angle (HKAA), medial proximal tibial angle, tibial posterior slope angle, and width of medial joint space. After an average follow-up of 6.3 years, the survivorship was analyzed using the Kaplan–Meier method. Results All clinical outcomes were significantly improved in both groups after treatment, with no significant differences between the two groups at the final follow-up. The progression of OA according to the K-L classification, HKAA and width of medial joint space was significantly advanced in the meniscectomy group (p = 0.03, 0.04, 0.03, respectively). The 10-year survival rates in the meniscectomy and conservative groups were 87 and 88%, respectively. Conclusions This study demonstrated that both conservative treatment and meniscectomy provided symptomatic relief. However, it was confirmed that OA progression was more severe in the meniscectomy. We conclude that arthroscopic meniscectomy had no advantage over conservative treatment in terms of clinical outcomes and OA progression in middle-aged patients with MMPRT. Level of evidence Level III; retrospective comparative study.

scholarly journals Lateral meniscal posterior root tears experience acceptable healing status after transtibial repair technique

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Cathrine Aga ◽  
Ingerid Baksaas Aasen ◽  
Carsten Brocker ◽  
Nina Jullum Kise ◽  
Stig Heir
Keyword(s):  
Lateral Meniscus ◽  
Case Series ◽  
Rate Of Change ◽  
Posterior Root ◽  
Root Tear ◽  
Meniscal Extrusion ◽  
Posterior Root Tear ◽  
Meniscal Root ◽  
Global Rate

Abstract Purpose To evaluate patient MRI results, demography and clinical outcome following transtibial repair of lateral and medial meniscal posterior root tears. Methods Patients treated with transtibial repairs of posterior meniscal root tears from 2015 through 2018 performed pre- and postoperative MRI scans. Outcome measures were continuity/discontinuity of the meniscal root and change in meniscal extrusion on MRI. Other outcomes were KOOS, Lysholm score, Tegner activity scale and the Global Rate of Change (GRoC) score for function and pain at follow-up. Study design Retrospective case-series. Results Of 41 patients, 36 attended follow-up at mean 26 (12–38) months postoperatively. At follow-up, 11 out of 18 lateral meniscus posterior root tear (LMPRT) versus 5 out of 18 medial meniscus posterior root tear (MMPRT) repairs were classified as healed. Meniscal extrusion decreased in LMPRTs from of 2.3 ± 1.5 mm to 1.4 ± 1.09 mm (p = 0.080) and increased in MMPRTs from 3.1 ± 1.6 mm to 4.8 ± 1.9 mm (p = 0.005) at FU (between-group difference, p < 0.001). LMPRT repairs were associated with ACL injury and additional meniscal injury and were younger and with lower BMI. No between-group differences were found for KOOS, Lysholm or GRoC Function scores. Tegner scale was higher and GRoC Pain score lower in the LMPRT group compared to the MMPRTs. Conclusion Following transtibial repair for meniscal posterior root repairs, the LMPRTs had a higher frequency of healing, whereas most MMPRTs continued to extrude, despite surgical intervention. The study confirmed that LMPRTs and MMPRTs differ in demography and associated injuries.

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