scholarly journals Arthroscopic partial medial meniscectomy

2011 ◽  
Vol 68 (9) ◽  
pp. 774-778 ◽  
Author(s):  
Zarko Dasic ◽  
Dragan Radoicic
Keyword(s):  
Medial Meniscus ◽  
International Knee Documentation Committee ◽  
Recreational Sports ◽  
Medial Meniscectomy ◽  
Meniscal Lesions ◽  
Meniscus Tears ◽  
Ikdc Score ◽  
The Mean ◽  
Bucket Handle ◽  
Repair Techniques

Background/Aim. Meniscal injuries are common in professional or recreational sports as well as in daily activities. If meniscal lesions lead to physical impairment they usually require surgical treatment. Arthroscopic treatment of meniscal injuries is one of the most often performed orthopedic operative procedures. Methods. The study analyzed the results of arthroscopic partial medial meniscectomy in 213 patients in a 24-month period, from 2006, to 2008. Results. In our series of arthroscopically treated medial meniscus tears we noted 78 (36.62%) vertical complete bucket handle lesions, 19 (8.92%) vertical incomplete lesions, 18 (8.45%) longitudinal tears, 35 (16.43%) oblique tears, 18 (8.45%) complex degenerative lesions, 17 (7.98%) radial lesions and 28 (13.14%) horisontal lesions. Mean preoperative International Knee Documentation Committee (IKDC) score was 49.81%, 1 month after the arthroscopic partial medial meniscectomy the mean IKDC score was 84.08%, and 6 months after mean IKDC score was 90.36%. Six months after the procedure 197 (92.49%) of patients had good or excellent subjective postoperative clinical outcomes, while 14 (6.57%) patients subjectively did not notice a significant improvement after the intervention, and 2 (0.93%) patients had no subjective improvement after the partial medial meniscectomy at all. Conclusion. Arthroscopic partial medial meniscetomy is minimally invasive diagnostic and therapeutic procedure and in well selected cases is a method of choice for treatment of medial meniscus injuries when repair techniques are not a viable option. It has small rate of complications, low morbidity and fast rehabilitation.

Preoperative Meniscal Extrusion Predicts Unsatisfactory Clinical Outcomes and Progression of Osteoarthritis after Isolated Partial Medial Meniscectomy: A 5-Year Follow-Up Study

2020 ◽  
Author(s):  
João V. Novaretti ◽  
Diego C. Astur ◽  
Elton L.B. Cavalcante ◽  
Camila C. Kaleka ◽  
Joicemar T. Amaro ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Medial Meniscus ◽  
International Knee Documentation Committee ◽  
Meniscal Extrusion ◽  
Optimal Cutoff ◽  
Medial Meniscectomy ◽  
The Mean ◽  
Medial Meniscus Extrusion ◽  
Meniscus Extrusion

AbstractThe objective of this study was to examine the association between preoperative meniscal extrusion of patients undergoing partial medial meniscectomy with clinical outcomes and progression of osteoarthritis and to determine the extent of meniscal extrusion associated with unsatisfactory clinical outcomes and progression of osteoarthritis. Ninety-five patients who underwent partial medial meniscectomy with a minimum follow-up of 5 years were retrospectively reviewed. Preoperative meniscal extrusion was evaluated with magnetic resonance imaging. Patients were assessed preoperatively and postoperatively with Lysholm and International Knee Documentation Committee (IKDC) subjective scores for clinical outcomes and with IKDC radiographic scale for osteoarthritis. An ANOVA (Analysis of Variance) was used to analyze the variations in meniscal extrusion and the clinical and radiological outcomes. A regression analysis was performed to identify factors that affect preoperative medial meniscus extrusion and that influence results after partial meniscectomy. An optimal cutoff value for meniscal extrusion associated with unsatisfactory clinical outcomes and progression of osteoarthritis was established. Significance was set at p < 0.05. The mean ± SD preoperative and postoperative Lysholm scores were 59.6 ± 15.5 versus 83.8 ± 13.1 (p < 0.001) and the mean preoperative and postoperative IKDC subjective scores were 59.4 ± 16.8 versus 82.0 ± 15.8 (p < 0.001). Meniscal extrusion greater than 2.2 mm (sensitivity, 84%; specificity, 81%) and 2.8 mm (sensitivity, 73%; specificity, 85%) was associated with unsatisfactory (poor/fair) Lysholm and IKDC subjective scores, respectively. The progression of osteoarthritis, characterized as a change of at least one category on the IKDC radiographic scale, occurred when meniscal extrusion was greater than 2.2 mm (sensitivity, 63%; specificity, 75%). Patients with higher body mass index (BMI) had significantly greater meniscal extrusion that patients with normal BMI (p < 0.001). The medial meniscus was more extruded in patients with horizontal and root tears. In conclusion, patients with preoperative meniscal extrusion of 2.2 mm or greater had unsatisfactory clinical outcomes and progression of osteoarthritis after partial medial meniscectomy at a minimum of 5 years follow-up. Higher BMI and horizontal and root tears were associated with greater preoperative meniscal extrusion.

Comparison of Cases with Anterior Cruciate Ligament Reconstruction Accompanied by Simultaneous Medial Meniscus Bucket Handle Tear Repair and Isolated Medial Meniscus Bucket Handle Tear Repair

2021 ◽  
Author(s):  
Yavuz Akalın ◽  
Özgür Avcı ◽  
Savaş İ. İnce ◽  
Nazan Çevik ◽  
İsmail G. Şahin ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Success Rate ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Meniscus Tears ◽  
The Mean ◽  
Anterior Cruciate ◽  
Bucket Handle Tear ◽  
Bucket Handle

AbstractThe aim of this study was to evaluate the success of the all-inside repair technique for medial bucket-handle meniscus tear (BHMT) and the factors affecting healing. A total of 36 patients with BHMT who were operated between 2012 and 2018 and completed final follow-up examinations were included in the study. Functional evaluation was made with the International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score. Healing was evaluated on magnetic resonance imaging (MRI) slices. The patients were evaluated with respect to the effect on healing of factors such as demographic data, body mass index (BMI), smoking status, anterior cruciate ligament tear reconstruction (ACLTR) applied at the same time as BHMT repair, and the tear being chronic or acute. The mean age of the patients was 28.6 ± 8.6 years (range,18–46 years), the mean follow-up period was 25.8 ± 13.9 months (range, 13–59 months), and BMI was mean 25.6 ± 3.5 kg/m2 (range, 20.1–30.5 kg/m2). The meniscus tears were acute in 16 (44.4%) patients and chronic in 20 (55.6%). ACLTR was applied together with BHMT repair in 25 patients. The hybrid technique, as the outside-in technique in addition to the all-inside technique, was applied to 12 (33.3%) patients, where there was seen to be extension to the anterior horn. The failure rate was determined as 27.8% according to the postoperative MRI evaluation and the Barrett criteria. No positive or negative statistically significant effect on healing was determined of chronic BHMT or of simultaneous application of ACLTR (p = 1.00 and 0.457, respectively). Cigarette smoking and high BMI were determined to have a statistically significant negative effect on healing (p = 0.026 and 0.007, respectively). In conclusion, it can be seen that the success of the all-inside technique for BHMT remains controversial. Due to the features of the application, it can be used in meniscus tears of the posterior horn only. In the current study, with the success rate of 72.2% of the all-inside technique in meniscus body tears, it was seen that a high success rate could not be achieved.

scholarly journals Mid-term evaluation of clinical and functional outcomes after arthroscopic medial longitudinal and bucket-handle meniscus repair

2021 ◽  
Vol 32 (2) ◽  
pp. 363-370
Author(s):  
Raşit Özcafer ◽  
Ferdi Dırvar ◽  
Abdülhamit Mısır ◽  
Yaşar Maksut Dinçel ◽  
Mehmet Özbey Büyükkuşçu ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Meniscal Repair ◽  
Control Group ◽  
Meniscal Tears ◽  
Significant Difference ◽  
Ikdc Score ◽  
The Mean ◽  
Bucket Handle Tear ◽  
Bucket Handle

Objectives: The aim of this study was to evaluate clinical and functional outcomes following the arthroscopic medial meniscal repair. Patients and methods: A total of 50 patients (42 males, 8 females; mean age: 32.9±7.6 years; range, 17 to 48 years) who underwent arthroscopic repair for longitudinal and bucket-handle medial meniscal tears between March 2005 and October 2011 were retrospectively evaluated. The patients were divided into two groups as those having a longitudinal tear (patient group, n=31) and having a bucket-handle tear (control group, n=19). Preoperative and final follow-up functional outcomes were evaluated using the Lysholm Knee Score (LKS), International Knee Documentation Committee (IKDC) score, Tegner Activity Scale (TAS) score, and Knee Injury and Osteoarthritis Outcome Score (KOOS). Results: The mean follow-up was 61.7±22.8 (range, 36 to 110) months. The mean preoperative LKS, IKDC score, TAS, and KOOS scores were significantly improved at the final postoperative follow-up (p<0.05). There was no significant difference in functional outcome scores between longitudinal and bucket-handle repairs (p>0.05), and isolated repairs and concomitant meniscal repair and anterior cruciate ligament reconstruction (p>0.05). Conclusion: Arthroscopic meniscal repair provides similar mid-term functional and clinical outcomes for longitudinal and bucket-handle medial meniscal tears. Concomitant meniscal repair does not seem to affect meniscal healing.

scholarly journals Arthroscopic-assisted Treatment of Popliteus Tendinitis

2020 ◽  
Author(s):  
Biao Chen ◽  
Hankun Liu ◽  
Haitao Chen ◽  
Liaobin Chen ◽  
Hua Wang
Keyword(s):  
Clinical Outcomes ◽  
International Knee Documentation Committee ◽  
Lateral Approach ◽  
Popliteus Tendon ◽  
Ikdc Score ◽  
The Mean ◽  
Improved Function ◽  
Tegner Score ◽  
Lost To Follow Up

Abstract Background: Popliteus tendinitis is an unusual factor to cause pain of the knee joint in its posterolateral compartment. There are few reports that the arthroscopy used for the treatment of refractory and symptomatic popliteus tendinitis. This study aimed to evaluate the effect of arthroscopic treatment of popliteus tendinitis via an auxiliary extreme lateral approach and to investigate the pathogenesis and treatment of popliteus tendinitis.Methods: From 2014 to 2018, arthroscopic popliteus tendon ablation was performed in 15 patients (15 knees) with popliteus tendinitis via an auxiliary extreme lateral approach. Clinical outcomes were assessed using the Lysholm knee scoring scale, the Tegner score, the International Knee Documentation Committee (IKDC) score and the visual analogue scale (VAS) pain score at the 24-month follow-up after surgery.Results: A total of 15 patients (mean age, 51.1 ± 7.1 years) were included; they had a mean body mass index of 23.8 ± 2.1. The minimum follow-up period was 24 months. Comparing the postoperative state to the preoperative state, the mean postoperative Lysholm score, Tegner score, and IKDC score improved significantly from 70.0 ± 5.0, 3.0 ± 0.9, and 62.3 ± 5.5 to 89.3 ± 4.2, 4.6 ± 0.61, and 80.5 ± 4.4, respectively (p < 0.01). The preoperative VAS score for pain improved from 4.3 ± 0.7 to 0.9 ± 0.6 (p < 0.01). No patients were lost to follow-up.Conclusion: Following arthroscopic-assisted treatment, all the patients with popliteus tendinitis achieved satisfactory clinical outcomes in terms of pain relief and improved function.

scholarly journals Bilateral, Simultaneous Medial Meniscus Bucket Handle Tears in a 23-Year-Old Female

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Brett Walker ◽  
Andrew Limbert
Keyword(s):  
Medial Meniscus ◽  
Weight Bearing ◽  
Treatment Options ◽  
Meniscal Tear ◽  
Meniscal Tears ◽  
Automobile Accident ◽  
Meniscus Tears ◽  
Pubmed Search ◽  
Bucket Handle

Traumatic tears of the meniscus are well reported in the literature. Rarely, bilateral meniscal tears occur. A PubMed search found that only three cases of bilateral medial meniscus bucket handle type tears have been reported. Treatment options range from partial meniscectomy to repair of the meniscal tear. Repair is reported to be more successful in the vascular red-red or red-white zones. We present the case of a 23-year-old female who sustained simultaneous bilateral medial meniscus bucket handle type tears in an automobile accident. She was treated in a staged fashion with knee arthroscopy. Her meniscus tears were both found to be in the vascularized zone and meniscal tear repair was conducted. At two weeks postoperatively, she had excellent resolution of her symptoms and has returned to pain-free weight-bearing. She has remained pain-free at six-month follow-up.

scholarly journals Significant Increase in the Rate of Meniscal and Chondral Injuries Between Primary and Revision Anterior Cruciate Ligament Reconstruction. (188)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0030
Author(s):  
Adnan Saithna ◽  
Charles Pioger ◽  
Johnny Rayes ◽  
Ibrahim Haidar ◽  
Thomas FRADIN ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Chondral Lesions ◽  
Revision Acl Reconstruction ◽  
Meniscal Lesions ◽  
The Mean ◽  
Anterior Cruciate ◽  
Primary Acl Reconstruction

Objectives: Anterior cruciate ligament (ACL) injuries are often associated with meniscal and chondral lesions. Meniscal lesions are present in up to 50% of ACL injured knees, and chondral lesions occur with an incidence of 20% to 40% in acute ACL-injured knees. The major importance of this lies in the fact that menisectomy and severe chondral damage are important predictors of poor outcomes including the subsequent development of knee osteoarthritis. Furthermore, patient reported outcomes following revision ACL reconstruction remain inferior to primary ACL reconstruction and this may, at least in part, be due to an increased incidence and severity of meniscal and chondral injuries. Although multiple studies have demonstrated that meniscal and chondral lesions are generally present at a higher rate at the time of revision ACL reconstruction when compared to primary ACL reconstruction, large studies following individual patients through primary and revision ACL reconstruction and tracking the change in the occurence of these injuries are scarce. The primary objective of this study was to determine the proportion of patients with meniscal and chondral injuries at the time of primary ACL reconstruction and determine how this rate changed by the time they underwent revision ACL reconstruction. The hypothesis was that the proportion of patients with meniscal and/or chondral lesions would be significantly greater at revision ACL reconstruction when compared to the primary procedures. Methods: Consecutive patients who underwent primary and then revision ACL reconstruction between March 1999 and February 2018 were identified using a single center registry. Patient characteristics, and intraoperative data from each procedure were collected and analyzed. This specifically included the occurrence and type of meniscal and chondral pathology. Descriptive statistics were used to evaluate the study sample using medians, descriptive data analysis was conducted depending on the nature of the criteria. Comparison between variables were assessed with student’s t test for quantitative variables and Mcnemar test for categorical variables. Statistical significance was set a t p<0.05. Results: 213 consecutive patients underwent both primary ACL reconstruction and then revision surgery during the study period. The average time from primary ACLR to Revision was 46.8 ± 36.6 months (range 5-181).The mean age of patients at primary ACLR was 22.21±7.21 years. The mean age of patients at revision ACLR 26.1 ± 8.3 years. The mean IKDC for the entire population was 85.53 ± 11.59, The mean ACL-RSI score was 71.89 ± 23.95. The mean Lysholm score was 91.77±10.24. The proportion of patients with chondral lesions significantly increased from 7% at primary ACL to 15.5% at revision ACL (p < 0.05). Meniscal lesions also significantly increased from 44.6 % at primary ACLR to 70% at revision ACLR (p < 0.05). There was no significant difference in the rate of lateral meniscal lesions (11.7 vs 13.1, p > 0.05). However, the proportion of patients with a medial meniscus lesion (25.4 vs 36.2, p < 0.05) and bimeniscal lesions (7.5 vs 20.7, p < 0.05) increased significantly at revision ACL reconstruction. Conclusions: The proportion of patients with meniscal and//or chondral injuries at the time of revision ACL reconstruction is significantly higher than at the time of primary ACL reconstruction. Specifically, the rate of medial meniscus and bimeniscal injuries is significantly higher in patients undergoing revision ACL reconstruction

scholarly journals Evaluation of functional outcome of bucket handle medial meniscus repair along with anterior cruciate ligament reconstruction

2020 ◽  
Vol 6 (3) ◽  
pp. 499
Author(s):  
Akshay Jain ◽  
Adhir Jain ◽  
Manjeet Singh ◽  
Prateek Pathak
Keyword(s):  
Anterior Cruciate Ligament ◽  
Functional Outcomes ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Meniscal Repair ◽  
Meniscus Repair ◽  
Meniscus Tears ◽  
Anterior Cruciate ◽  
Bucket Handle

<p class="abstract"><strong>Background:</strong> Bucket-handle meniscus tears (BHMT) are often displaced and unstable and comprise nearly 10% of all meniscus tears and commonly affect the young male population. Displacement of the free segment can lead to significant pain and disability, necessitating reduction and surgical treatment. The aim of present prospective longitudinal cohort study was to evaluate the functional outcomes of bucket handle medial meniscus repair along with anterior cruciate ligament (ACL) reconstruction at 2 years follow up.</p><p class="abstract"><strong>Methods:</strong> Between January 2017 to December 2018, 30 patients who underwent ACL reconstruction along with bucket handle medial meniscus repair were included in the study. Meniscus repair was done using the all inside, outside in, inside out or hybrid techniques. All patients were evaluated clinically at pre op and at 2 year follow up using knee injury and osteoarthritis outcome score and compared. Meniscal healing was assessed clinically using Barrett’s criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> The study comprised 30 patients with a mean age of 27.47 years (range from 13 to 49 years) with 66.67% males. According to clinical examination and Barrett criteria’s the clinical failure rate was 6.67% (2 out of 30 patients) who underwent partial menisectomy later. We also compared functional outcomes of sedentary and active peoplesand also between meniscal repair of less than 3 cm and more than 3 cm’s. There was no statistically significant difference in the functional outcomes in both the groups; however range of motion was significantly higher in tear length 3 cm or less compared to more than 3 cm.</p><p class="abstract"><strong>Conclusions:</strong> Meniscal repair should be aggressively considered in young pa­tients to enhance functional recovery and durability of the knee joint, if the meniscus is reparable.</p>

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