Modified all-inside meniscal repair using spinal needles for radial tear of the midbody of the lateral meniscus: a technical note

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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In Vitro Repair of Meniscal Radial Tear With Hydrogels Seeded With Adipose Stem Cells and TGF-β3

The American Journal of Sports Medicine ◽

10.1177/0363546518782973 ◽

2018 ◽

Vol 46 (10) ◽

pp. 2402-2413 ◽

Cited By ~ 23

Author(s):

Hiroshi Sasaki ◽

Benjamin B. Rothrauff ◽

Peter G. Alexander ◽

Hang Lin ◽

Riccardo Gottardi ◽

...

Keyword(s):

Stem Cells ◽

Transforming Growth Factor ◽

Meniscal Repair ◽

Explant Culture ◽

Differentiation Potential ◽

3 Dimensional ◽

Institutional Review ◽

Radial Tear ◽

In Vitro Repair

Background: Radial tears of the meniscus are a common knee injury, frequently resulting in osteoarthritis. To date, there are no established, effective treatments for radial tears. Adipose-derived stem cells (ASCs) may be an attractive cell source for meniscal regeneration because they can be quickly isolated in large number and are capable of undergoing induced fibrochondrogenic differentiation mediated by transforming growth factor β3 (TGF-β3). However, the use of ASCs for meniscal repair is largely unexplored. Hypothesis: ASC-seeded hydrogels with preloaded TGF-β3 will improve meniscal healing of radial tears, as modeled in an explant model. Study Design: Controlled laboratory study. Methods: With an institutional review board–exempted protocol, human ASCs were isolated from the infrapatellar fat pads of 3 donors, obtained after total knee replacement, and characterized. ASCs were encapsulated in photocrosslinkable methacrylated gelatin hydrogels to form 3-dimensional constructs, which were placed into tissue culture. The effect of TGF-β3—whether preloaded into the hydrogel or added as a soluble medium supplement—on matrix-sulfated proteoglycan deposition in the constructs was evaluated. A meniscal explant culture model was used to simulate meniscal repair. Cylindrical-shaped explants were excised from the inner avascular region of adult bovine menisci, and a radial tear was modeled by cutting perpendicular to the meniscal main fibers to the length of the radius. Six combinations of hydrogels—namely, acellular and ASC-seeded hydrogels supplemented with preloaded TGF-β3 (2 µg/mL) or soluble TGF-β3 (10 ng/mL) and without supplement—were injected into the radial tear and stabilized by photocrosslinking with visible light. At 4 and 8 weeks of culture, healing was assessed through histology, immunofluorescence staining, and mechanical testing. Results: ASCs isolated from the 3 donors exhibited colony-forming and multilineage differentiation potential. Hydrogels preloaded with TGF-β3 and those cultured in soluble TGF-β3 showed robust matrix-sulfated proteoglycan deposition. ASC-seeded hydrogels promoted superior healing as compared with acellular hydrogels, with preloaded or soluble TGF-β3 further improving histological scores and mechanical properties. Conclusion: These findings demonstrated that ASC-seeded hydrogels preloaded with TGF-β3 enhanced healing of radial meniscal tears in an in vitro meniscal repair model. Clinical Relevance: Injection delivery of ASCs in a TGF-β3-preloaded photocrosslinkable hydrogel represents a novel candidate strategy to repair meniscal radial tears and minimize further osteoarthritic joint degeneration.

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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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Lateral meniscal allograft transplantation and stabilisation in a dog with stifle subluxation

Veterinary Record Case Reports ◽

10.1136/vetreccr-2019-000940 ◽

2020 ◽

Vol 8 (3) ◽

pp. e000940

Author(s):

Patrick Alan Ridge ◽

Alba Rial García

Keyword(s):

Cruciate Ligament ◽

Lateral Meniscus ◽

Vigorous Exercise ◽

Active Lifestyle ◽

Meniscal Allograft Transplantation ◽

Cranial Cruciate Ligament ◽

Meniscal Allograft ◽

Radial Tear ◽

Significant Injury ◽

Cranial Cruciate Ligament Rupture

This case describes the clinical features and the favourable clinical outcome after a lateral meniscal allograft transplant and stifle stabilisation in a dog that suffered a significant injury to its stifle, which included irreparable injury to the lateral meniscus, cranial cruciate ligament rupture and medial collateral rupture. The lateral meniscus was extensively damaged having avulsed from its peripheral attachments and with a radial tear across 70 per cent of its mid-body. After four years, the owners reported that the dog continued with an active lifestyle and only occasionally required non-steroidal anti-inflammatory analgesics for sporadic episodes of mild lameness after vigorous exercise.

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