scholarly journals Study of reliability of meniscus damage signs using high intensity 1,5 tesla mri compared to the results of arthroscopic interventions in acute and obsolete knee injury

2020 ◽  
Vol 24 (3) ◽  
pp. 425-432
Author(s):  
Y.O. Hrubar ◽  
M.Y. Hrubar ◽  
I.Y. Kuziv ◽  
O. V. Kuziv
Keyword(s):  
Knee Joint ◽  
High Intensity ◽  
Medial Meniscus ◽  
Human Life ◽  
Lateral Meniscus ◽  
The Body ◽  
Posterior Horn ◽  
Anterior Horn ◽  
Steady Increase ◽  
Orthopedic Procedure

Annotation. Among the large joints, the knee joint is most often injured, which is due to the peculiarities of its structure and functional loads in the process of human life. The most common injuries are meniscus damages of the knee joint, that is the evidence of steady increase in the number of partial arthroscopic meniscectomies, which have become the most common orthopedic procedure. Diagnosis of meniscus damage is based on the results of clinical examination, sonography and MRI. Increasing the resolution of MRI machines, improving the technique of their implementation allows to improve the quality of diagnosis of meniscus ruptures and improve the results of surgical arthroscopic interventions on the knee joint. The aim of the study – to demonstrate the capabilities of high-intensity 1.5 Tesla MRI and to study the reliability of MRI signs of meniscus damage in comparison with the results of arthroscopic interventions in acute and chronic knee joint injury. The work is based on the results of MRI examinations and arthroscopic interventions of 247 patients with acute and chronic knee joint injuries aged 14 to 59 years. Medial meniscus damage was diagnosed in 206 (83.41%) patients. Lateral meniscus ruptures were diagnosed in 34 patients (13.76%). Simultaneous damage of both menisci was found in 7 (2.83%) patients. It was found that ruptures of the medial meniscus by location were: the root of the posterior horn of the medial meniscus in 4 (1.94%) patients, ruptures of the posterior horn in 82 (39.81%) patients. Injury of the posterior horn with the transition to the body of the meniscus was diagnosed in 117 (56.79%) patients. Anterior horn ruptures were detected in 3 (1.46%) patients. With ruptures of the lateral meniscus: damage of the root of the posterior horn of the lateral meniscus was found in 2 (5.88%) patients, damage of the posterior horn in 9 (26.47%) patients. Posterior horn rupture with transition to the body of the meniscus was diagnosed in 19 (55.89%) patients. Isolated ruptures of the anterior horn were found in 4 (11.76%) patients. Simultaneous damage to both menisci was found in 7 (2.83%) patients. 206 (83.40%) partial meniscectomies were performed during arthroscopic interventions and meniscus suturings were performed over 41 (16.60%) patients. In order to identify meniscus damage and their location during MRI knee joint investigations 21 pseudo-positive and 18 pseudo-negative cases of diagnosis were revealed. The sensitivity of MRI for defining damage and localization of meniscus rupture was 91,7%, specificity 92,6%, diagnostic accuracy 94,8%. Discrepancies in the evaluation of meniscal damage most often occurred in cases of their combined ruptures and degenerative changes in the menisci.

scholarly journals Morphometric analysis of menisci of adult human knee joint in North Indian population

2017 ◽  
Vol 5 (2) ◽  
pp. 569
Author(s):  
Jyoti Rohila ◽  
Suresh Kanta Rathee ◽  
Suresh Kumar Dhattarwal ◽  
Zile Singh Kundu
Keyword(s):  
Knee Joint ◽  
Indian Population ◽  
Medial Meniscus ◽  
Lateral Meniscus ◽  
The Body ◽  
Human Knee ◽  
Human Knee Joint ◽  
Meniscal Replacement ◽  
Adult Humans ◽  
Elastic Thread

Background: Of the synovial joints in the body knee joint is the largest. Each meniscus is a piece of fibrocartilage with a thickened outside edge and a thin inner edge so that it is wedge-shaped in cross section. The purpose of the present study was to establish database on standard dimensions in knee menisci of adults of north Indian population.Methods: The sample for this study was collected from April, 2012 to June, 2013. For this study, 200 menisci (100 right and left each) of 50 adult humans were taken for analysis. Measurements were done with the help of non-elastic thread and digital vernier calipers. All dissections were performed in a systematic fashion.Results: The width of the lateral meniscus was significantly different form medial meniscus with lateral and medial menisci widest in middle and posterior third respectively. The middle one third of both lateral and middle menisci was the thickest.Conclusions: It is always good to have a set of anatomical morphometric parameters of the menisci like the width and thickness. The measurements of suitable grafts may provide a more acceptable meniscal replacement in the future.

The prevalence and characteristics of a subcortical cystic lesion at the subspinous region of the knee

2017 ◽  
Vol 59 (1) ◽  
pp. 97-104 ◽  
Author(s):  
Ji Ye Son ◽  
Young Cheol Yoon ◽  
Wook Jin ◽  
Jang Gyu Cha
Keyword(s):  
Bone Marrow ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Cyst Formation ◽  
Posterior Horn ◽  
Anterior Horn ◽  
Cruciate Ligaments ◽  
Magnetic Resonance Imaging Mri ◽  
Subcortical Cysts

Background Although we observed that subcortical cysts near the attachment of the meniscus or cruciate ligaments are frequently seen with a tear or degeneration of the adjacent meniscus and/or cruciate ligament, there is no large study describing the prevalence, distribution, and associated findings of these cysts. Purpose To evaluate the prevalence and distribution of subcortical cysts near the attachments of the meniscus or cruciate ligaments and evaluate pathologies of the meniscus or cruciate ligaments using magnetic resonance imaging (MRI). Material and Methods We reviewed 1009 knee MRIs for the presence of subcortical cysts near the meniscus or cruciate ligament attachments and evaluated their size, location, edema of the adjacent bone marrow, and integrities of the medial and lateral meniscus and anterior and posterior cruciate ligaments. Results The 110 cysts were found in either the middle (n = 56), posterior (n = 52), or anterior (n = 2) subspinous regions. Sixty-two were at meniscal root insertion, including seven at the lateral meniscus anterior horn, five at the lateral meniscus posterior horn, 48 at the medial meniscus posterior horn, and two at the medial meniscus anterior horn. All were associated with an adjacent meniscal pathology. Of the 34 cysts at the anterior cruciate ligament (ACL) insertion, 28 had ACL pathology. Nine cysts had surrounding edema in the adjacent bone marrow. Conclusion Subcortical cysts at the subspinous region of the knee were seen in 9.6% of knee MRI examinations. Most were in close proximity to the meniscal or cruciate ligaments with associated pathologies, suggesting that abnormal stress on the bone induces cyst formation.

Evaluation of Meniscal Tissue after Meniscal Repair Using Ultrahigh Field MRI

2020 ◽  
Author(s):  
Beate Stelzeneder ◽  
Bernhard Michael Trabauer ◽  
Silke Aldrian ◽  
David Stelzeneder ◽  
Vladimir Juras ◽  
...  
Keyword(s):  
T2 Mapping ◽  
Lateral Meniscus ◽  
Posterior Horn ◽  
Anterior Horn ◽  
7 Tesla ◽  
Control Group ◽  
White Zone ◽  
Meniscal Tissue ◽  
Lateral Posterior

AbstractThe study evaluates the meniscal tissue after primary meniscal suturing using 7-Tesla (T) magnetic resonance imaging with T2* mapping at 6 and 12 months after surgery to investigate the differences between repaired meniscal tissue and healthy meniscal tissue in the medial and lateral compartment. This prospective study included 11 patients (9m/2f) with a mean age of 30.6 years (standard deviation 9.0). Patients with a meniscal tear that was treated arthroscopically with meniscus suturing, using an all-inside technique, were included. All patients and seven healthy volunteers were imaged on a 7-T whole-body system. T2* mapping of the meniscus was applied on sagittal slices. Regions-of-interest were defined manually in the red and white zone of each medial and lateral meniscus to measure T2*-values. In the medial posterior and medial anterior horn similar T2*-values were measured in the red and white zone at 6- and 12-month follow-up. Compared with the control group higher T2*-values were found in the repaired medial meniscus. After 12-months T2*-values decreased to normal values in the anterior horn and remained elevated in the posterior horn. In the red zone of the lateral posterior horn a significant decrease in the T2*-values (from 8.2 milliseconds to 5.9 milliseconds) (p = 0.04), indicates successful repair; a tendency toward a decrease in the white zone between the 6 and 12 months follow-up was observed. In the red zone of the lateral anterior horn the T2*-values decreased significantly during follow-up and in the white zone of the lateral anterior horn T2*-values were comparable. In comparison to the control group higher T2*-values were measured at 6-months; however, the T2*-values showed comparable values in the repaired lateral meniscus after 12 months. The T2* mapping results of the current study indicated a better healing response of the red zone of the lateral posterior horn compared with the medial posterior horn.

MR imaging of meniscal subluxation in the knee

1997 ◽  
Vol 38 (5) ◽  
pp. 876-879 ◽  
Author(s):  
M. J. Breitenseher ◽  
S. Trattni ◽  
I. Dobrocky ◽  
C. Kukla ◽  
S. Nehrer ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Knee Joint ◽  
Tibial Plateau ◽  
Medial Meniscus ◽  
Lateral Meniscus ◽  
Joint Effusion ◽  
Normal Position ◽  
Rare Finding ◽  
Asymptomatic Volunteers ◽  
The Mean

Purpose: The aim of this study was to establish diagnostic criteria for meniscal subluxation, and to determine whether there was any connection between meniscal subluxation and other common meniscal and knee-joint abnormalities. Material and Methods: The normal position of the meniscal body was assessed in 10 asymptomatic volunteers. MR signs of meniscal subluxation were evaluated retrospectively in 60 symptomatic patients with pain in the knee, impaired mobility, and/or joint swelling who had no clear diagnosis after the evaluation of case history, clinical examination, and radiography. The criterion for subluxation of the meniscus was defined as a distance of ≥3 mm between the peripheral border of the meniscus and the edge of the tibial plateau. Results: In the volunteers, the mean distance from the medial meniscus to the edge of the tibial plateau was 0.07 mm, and that from the lateral meniscus was 0 mm. In 55 symptomatic patients without meniscal subluxation, the mean distance from.the meniscus to the edge of the tibial plateau was 0.27 mm. Five patients (8%) had evidence of meniscal subluxation, 4 in the medial meniscus and one in the lateral meniscus. The most commonly associated knee abnormality was joint effusion in 5 knees and osteoarthritis in 2 knees. Conclusion: Meniscal subluxation was not a rare finding with MR imaging in patients with painful knees. Meniscal subluxation was associated with other knee abnormalities such as joint effusion or osteoarthritis.

scholarly journals Regarding the subject of degradation of femoral medial condyle cartilaginous tissue in damaged knee joint medial meniscus

2018 ◽  
Vol 35 (6) ◽  
pp. 16-22
Author(s):  
A. S. Denisov ◽  
D. P. Zagorak
Keyword(s):  
Connective Tissue ◽  
Knee Joint ◽  
Body Mass ◽  
Medial Meniscus ◽  
The Body ◽  
Arthroscopic Treatment ◽  
Cartilaginous Tissue ◽  
Tissue Elasticity ◽  
Femoral Bone ◽  
Medial Condyle

Aim. To reveal the influence of patient’s connective tissue state and body mass on the development of damage of the cartilaginous tissue of femoral bone medial condyle in case of medial meniscus rupture. Materials and methods. The study included 85 patients, undergoing arthroscopic treatment of the knee joint in connection with damaged medial meniscus. The damage degree of femoral medial condyle cartilaginous tissue was estimated using Outerbridge classification (1961). The body mass was calculated by the body mass index kg/m2. To assess the connective tissue elasticity, “the method of express diagnosis of dysplastic state of connective-tissue structures in conditions of ambulatory traumatologo-orthopedic service” was used. Results. The present paper is devoted to a widespread problem – the damage of femoral medial condyle cartilaginous tissue in case of medial meniscus rupture. The aim of the study was to find out the influence of connective tissue state and body mass on the damage of the femoral medial condyle cartilaginous tissue. Seventy patients were examined. As a result of analysis, it was established that an excess body mass as well as low connective tissue elasticity provoke destruction of the cartilaginous tissue of femoral bone medial condyle. Patients with connective tissue dysplasia are more tolerant to cartilaginous tissue degradation. The risk group for cartilaginous tissue damage includes persons with low connective tissue elasticity and obesity. Conclusions. When medial meniscus is ruptured, most patients during the first 6 months after trauma experience damage of femoral medial condyle cartilaginous tissue. The most favorable for the outcome is the state when patients have a normal body mass. Dysplastic state of connective tissue somehow eliminates the damaging factor at the expense of elevated elasticity of cartilaginous tissue. The most unfavorable is the situation, when patients have excess body mass and low connective tissue elasticity. For this group of patients the most optimal variant is hospitalization and arthroscopic treatment taking into account urgent indications.

Different Regional Healing Rates with the Outside-In Technique for Meniscal Repair

1998 ◽  
Vol 26 (3) ◽  
pp. 446-452 ◽  
Author(s):  
Michiel F. van Trommel ◽  
Peter T. Simonian ◽  
Hollis G. Potter ◽  
Thomas L. Wickiewicz
Keyword(s):  
Medial Meniscus ◽  
Lateral Meniscus ◽  
Meniscal Repair ◽  
Current Method ◽  
Complete Healing ◽  
Posterior Horn ◽  
Resonance Imaging ◽  
Anterior Portion ◽  
Meniscus Tears

Fifty-one patients with meniscal repair using the outside-in technique were reassessed with second-look arthroscopic procedures (N 15), arthrographic examination (N 41), magnetic resonance imaging (N 36), or a combination of these techniques. Forty-one medial and 10 lateral menisci were repaired. The average clinical follow-up was 15 months (range, 3 to 80). Forty-five of 51 patients had tears that were located in or extended into the posterior horn of the medial or lateral meniscus. Complete healing occurred in 23 menisci (45%), partial healing was observed in 16 (15 medial, 1 lateral) (32%), and no healing occurred in 12 (24%). Remarkably, in all 15 patients who had tears extending from the posterior to the middle third of the medial meniscus that were partially healed, it was always the posterior third that had not fully healed. This finding is statistically significant. In addition, the middle third of these menisci had not fully healed in five patients. No healing occurred in the two patients with tears in the posterior third of the medial meniscus. Poor healing with the outside-in technique was observed in patients with tears into the posterior horn of the medial meniscus. For tears in the middle and anterior portion of the medial meniscus, as well as all lateral meniscus tears, the outside-in technique is our current method of choice.

scholarly journals Morphological characteristics of the auxiliary elements of the knee joint in normal and deforming arthrosis

2018 ◽  
Vol 20 (3) ◽  
pp. 175-179
Author(s):  
I V Gaivoronskiy ◽  
V V Hominets ◽  
A A Semenov ◽  
I A Goryacheva
Keyword(s):  
Articular Cartilage ◽  
Knee Joint ◽  
Medial Meniscus ◽  
Morphological Changes ◽  
Cruciate Ligament ◽  
Posterior Part ◽  
Morphological Characteristics ◽  
Relative Length ◽  
The Body ◽  
Morphological Studies

The results of morphological studies of auxiliary elements (patella, meniscus, cruciate ligament, synovial bags) of 60 knee joints of adult corpses, 30 of which were intact (without signs of deforming arthrosis) and 30 with signs of deforming arthrosis of stages III-IV are presented. It is established that the auxiliary apparatus undergoes significant changes in the progression of deforming arthrosis. In a greater degree degenerative changes prone articular cartilage of the patella and medial condyles of the knee joint. The affected areas were characterized by thinning of the articular cartilage or its complete absence, as well as the presence of osteophytes along the edges of the articular surfaces. The measurements of the relative length, width, and thickness of the meniscus also confirmed the fact of their substantial deformation and degeneration, mainly of the medial meniscus. The posterior part of the body and the horn of the medial meniscus were most susceptible to the destruction of the cartilaginous tissue and were accompanied by the erasure and disintegration of the inner margin. Synovial membranes with deforming arthrosis were thickened, compacted and locally hyperemic, had papillary growths, which indicates the presence of synovitis and fluid accumulation not only in the joint cavity but also in synovial bags, the sizes of which were significantly increased. Intra-articular ligaments are hyperemic, and fragments are noted. Pterygoid folds are enlarged, locally hyperemic, with a vascular pattern, elongated processes are visualized along the edges. Identified morphological changes in the progression of deforming arthrosis lead to trophic and metabolic disturbances of all structures of the knee joint. The results of the study of the auxiliary elements of the knee joint can be used as a control in the diagnosis of deforming arthrosis.

scholarly journals Cyto-, fi broarchitectonics and vascularization of the external (red) zone of the coypu’s meniscus

2020 ◽  
pp. 103-112
Author(s):  
V. Novak ◽  
O. Bevz ◽  
A. Melnychenko ◽  
N. Prysiazhniuk ◽  
Ye. Nechiporuk
Keyword(s):  
Knee Joint ◽  
Structural Organization ◽  
Medial Meniscus ◽  
Lateral Meniscus ◽  
Meniscus Repair ◽  
External Zone ◽  
Choice Of Treatment ◽  
A Chain ◽  
Meniscus Regeneration ◽  
Selection Of

Meniscus injuries are recognized as the cause of significant morbidity of the musculoskeletal system. Features of the structural organization of the various meniscus zones are a necessaryfor understanding pathologies associated with the knee joint. This will expand and deepen micromorphological knowledge and practically apply during the choice of treatment tactics for meniscus preservation, suturing during reconstructive meniscus repair, reduce the risk of vascular injuries, and make it possible to use tissue engineering for meniscus regeneration. Indeed, today it is known that only the preservation of menisci or a slight ectomy of the inner zone, which cannot be restored with signifi cant injury, can preserve the health and biomechanics of the knee joint. The aim of our work was to determine the characteristics of the cyto- and fi bromorphological characteristics, as well as the degree of vascularization of the external (red) zone of the lateral and medial menisci of the knee joint in foot-moving coypus. A complex of histological and neurohistological research methods was used in the work. The patented neurohistological method of impregnation is performed in its own algorithm. The selection of animals was carried out according to the type of specialization of the limb to the substrate. As a result of histological examination, it was found that cyto-fi broarchitectonics of the external (red) zone of the latera l and medial menisci of the coypus has general biological signs, and species-specifi city is characteristic of vascularization. The external (red) zone of the coypu’s meniscus is similar in st ructure to the dense, formed connective tissue. Cytoarchitectonics is represented by of the fi broblastic typecells: fi brocytes, fi broblasts and undiff erentiated stem cells, which are localized between collagen fi bers individually, in pairs, in a chain or in short rows. Fibroarchitectonics – tightly packed bundles of collagen fi bers with a pronounced parallel orientation. The medial meniscus has saturated zones of intraorgan vascular nutrition due to dilated, anastomosing capillary branches formed by perforations with perimeniscal broad-loop microcirculation nets that occupy large areas and form vascular fi elds, as well as numerous vascular glomeruli. In the lateral meniscus, the vascularization zone is characterized by limited capillary branches, interval and small penetration by capillaries of the meniscus red zone, and limited, localized perimeniscal nets. Key words: fi brocytes, fi broblasts, collagen fi bers, vascularization, vascular glomeruli, external zone, red zone, meniscus, knee joint, coypu.

scholarly journals MEDIAL MENISCAL TEAR

2021 ◽  
Vol 10 (4) ◽  
pp. 3340-3342
Author(s):  
Om C. Wadhokar
Keyword(s):  
Knee Joint ◽  
Medial Meniscus ◽  
Meniscal Tear ◽  
Lateral Meniscus ◽  
Meniscus Tear ◽  
Physiotherapy Treatment ◽  
Medial Side ◽  
Healthy Cartilage ◽  
Medial Meniscal Tear ◽  
Time Restriction

Knee joint is type of hinge joint Knee joint consist of medial menisci and lateral menisci. Menisci plays an important role to maintain healthy cartilage. Medial meniscus commonly injured than lateral meniscus due to it is relatively lack of mobility. A case of 32 year female is presented in this report. Patient complaints of pain in medial side of right knee joint, inability to stand for longer time, restriction in daily activities. McMurray test was done and diagnosed medial meniscus tear. Physiotherapy treatment is mentioned in this report. The study conclude that there is significant improvement in range of motion , muscle strength , can able to perform activities of daily living with the help of physiotherapy treatment without any surgical approach.

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