scholarly journals The Meniscus Deficient Knee: Options for Repair and Reconstruction

2021 ◽  
Author(s):  
Matthew Brown
Keyword(s):  
Surgical Technique ◽  
Knee Pain ◽  
Tibial Plateau ◽  
Partial Resection ◽  
Meniscus Transplant ◽  
Deficient Knee ◽  
Meniscus Surgery

The preservation of the structure of the meniscus despite a tear has been widely discussed in the literature. However, meniscectomy continues to be the most-performed meniscus surgery. In a percentage of patients, knee pain and swelling, as well as tibial plateau bony edema, follow meniscus resection; this panoply of symptoms is known as “post-meniscectomy syndrome”. The management of this condition requires meniscus transplant in case of total meniscectomy or a meniscus scaffold in the case of a partial resection. This chapter aims to discuss the indication, surgical technique, and outcomes of collagen meniscus implants (CMI) for partial resections and meniscus transplants for full resections.

scholarly journals MENISCUS TRANSPLANT: IS STILL A STEP FORWARD FOR GOOD RESULTS IN CARTILAGE LESION PROGRESSION AND KNEE PAIN?

2021 ◽  
Vol 68 (1) ◽  
pp. 56-59
Author(s):  
Dan G. Cojocaru ◽  
◽  
Gheorghe Bogdan Hogea ◽  
Sorin Florescu ◽  
Jenel Marian Patrascu Jr. ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Knee Joint ◽  
Knee Pain ◽  
Traumatic Injury ◽  
Cartilage Lesion ◽  
Meniscal Tears ◽  
Real Challenge ◽  
Meniscus Transplant ◽  
Meniscus Injuries

Meniscus injuries are the most common traumatic conditions of the knee. If until the early 2000s, menisci were considered structures of no major importance in the knee joint, subsequent studies have shown their importance in the biomechanics of the knee. Their role is not only for the natural suspension of the joint, but also for the protection of the cartilage or the achievement of the efficient and uniform circulation of the synovial fluid. Therefore, disruption of this joint balance can lead, in the absence of a well-conducted treatment, to premature knee wear. Most of the time, these meniscal tears are accompanied by associated lessions, ligaments or more severely cartilaginous lessions, creating a real challenge for the physician, specially for young pacients. There are many conservative treatments of the damaged meniscus, imagined precisely in the idea of preserving the menisci as much as possible. However, this is not always possible, especially due to the type of traumatic injury.

scholarly journals Partial resection of the posterior wall for hip dislocation in severe acetabular protrusio

2020 ◽  
Vol 1 (7) ◽  
pp. 431-437
Author(s):  
Hugo A. Rodriguez ◽  
Felipe Viña ◽  
Meilyn A. Muskus
Keyword(s):  
Femoral Head ◽  
Surgical Technique ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
Posterior Wall ◽  
Partial Resection ◽  
Hip Arthroplasties ◽  
Acetabular Protrusio

Aims In elderly patients with osteoarthritis and protrusio who require arthroplasty, dislocation of the hip is difficult due to migration of the femoral head. Traditionally, neck osteotomy is performed in situ, so this is not always achieved. Therefore, the purpose of this study is to describe a partial resection of the posterior wall in severe protrusio. Methods This is a descriptive observational study, which describes the surgical technique of the partial resection of the posterior wall during hip arthroplasty in patients with severe acetabular protrusio operated on between January 2007 and February 2017. Results In all, 49 hip arthroplasties were performed. The average age of patients was 60 years, and idiopathic was the most frequent aetiology of protrusio. All patients were treated with femoral head autograft and no intra- or postoperative complications were reported. No patients required revision surgery. Conclusion Partial resection of the posterior wall demonstrated to be a safe surgical technique with 100% survival in a follow-up to ten years in total hip arthroplasty due to severe acetabular protrusio. Cite this article: Bone Joint Open 2020;1-7:431–437.

A safe surgical technique for the partial resection of the ruptured spleen. A clinical report

Injury ◽  
1999 ◽  
Vol 30 (10) ◽  
pp. 693-697 ◽  
Author(s):  
I Tulikoura ◽  
J Lassus ◽  
Y.T Konttinen ◽  
T Juutilainen ◽  
S Santavirta
Keyword(s):  
Surgical Technique ◽  
Partial Resection ◽  
Clinical Report ◽  
Ruptured Spleen

ACCURACY OF SPECT IMAGING FOR ARTHROSCOPICALLY CONFIRMED MENISCAL TEARS IN PATIENTS WITH ACUTE KNEE PAIN AND NO RADIOGRAPHIC ARTHRITIS

2014 ◽  
Vol 17 (01) ◽  
pp. 1450006
Author(s):  
Barak Haviv ◽  
Shlomo Bronak ◽  
Rafael Thein
Keyword(s):  
Knee Pain ◽  
Tibial Plateau ◽  
Meniscal Tear ◽  
Arthroscopic Surgery ◽  
Emission Computed Tomography ◽  
Meniscal Tears ◽  
Plain Radiographs ◽  
The Mean ◽  
Spect Scan ◽  
Acute Knee

Purpose: To evaluate the accuracy of single photon emission computed tomography (SPECT) compared with arthroscopy in the diagnosis of acute knee pain due to meniscal tear. Methods: Patients with knee pain that persisted for less than six months with normal plain radiographs that had arthroscopic surgery following SPECT scan were included. The main scintigraphic criterion for diagnosing a tear of the meniscus was tibial plateau activity on the planar image with at least a half crescent of peripheral tibial plateau uptake. The accuracy of SPECT in detecting meniscal tears was calculated according to the arthroscopic findings as the gold standard. Results: There were 68 patients in the study (46 males and 22 females). The mean age was 45.3 (17–72) years and the mean time between SPECT scan and surgery was 3.5 (1–6) months. The overall sensitivity of SPECT was 90%, specificity 70%, NPV 54%, PPV 95% and accuracy 87%. Conclusion: SPECT was found to be an accurate imaging technique in the diagnosis of symptomatic meniscal tears in patients with acute knee pain and unremarkable plain radiographs. Thus, SPECT may be helpful in selecting candidates for arthroscopy.

scholarly journals Fatigue failure of the femoral component of a total knee arthroplasty: a case report and review of the literature

2020 ◽  
Author(s):  
W Greeff ◽  
RDV Greeff ◽  
CT Frey ◽  
V Singh
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Case Report ◽  
Surgical Technique ◽  
Femoral Component ◽  
Knee Pain ◽  
Fatigue Failure ◽  
Knee Arthroplasty ◽  
English Literature ◽  
Total Knee

ABSTRACT INTRODUCTION: Reports of fatigue failure of the femoral component of a total knee arthroplasty (TKA) is scanty in the literature. As a result, there are no clearly defined risk factors to aid us in predicting fatigue failure of an implant. Furthermore, these patients may present with non-specific knee pain, which may or may not be well tolerated, depending on the stability of the implant. We report a case of fatigue failure of a poorly cemented femoral component of a TKA in a 72-year-old female, approximately seven years after the initial surgery CASE REPORT: A 72-year-old female presented to our tertiary level arthroplasty unit with new-onset knee pain approximately seven years after undergoing a TKA at our unit. She reported hearing a crack six months earlier, while standing up from a seated position. She had initially presented to her local clinic, but the pathology was missed. She received revision surgery at our institution and was doing well at early follow-up. DISCUSSION: We reviewed the literature on fatigue failure of femoral components in TKA in an attempt to define risk factors. We also summarised all cases of femoral component fatigue failure in the English literature. CONCLUSION: Although femoral component fatigue failure in TKA is rare, the majority of cases have attributed the failure to poor surgical technique. Despite this, certain implants have been failing more often than others, and proposed mechanisms for this exist. Orthopaedic surgeons need to be aware of which implant designs are prone to failure, as well as how meticulous surgical technique can reduce the chances of fatigue failure. Level of evidence: Level 5 Keywords: femoral component, total knee arthroplasty, fatigue failure, stress fracture

Geometric implications of the tibial wedge osteotomy for the treatment of cranial cruciate ligament disease in dogs

2007 ◽  
Vol 20 (03) ◽  
pp. 169-174 ◽  
Author(s):  
B. A. Smith ◽  
A. P. Black ◽  
C. J. Bailey
Keyword(s):  
Surgical Technique ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Wedge Osteotomy ◽  
Ligament Injuries ◽  
Cranial Cruciate Ligament ◽  
Tibial Plateau Slope ◽  
Cranial Cruciate Ligament Disease ◽  
Preoperative Radiograph

SummaryThe tibial wedge osteotomy (TWO), a procedure that reduces the tibial plateau slope, has become an established surgical technique for the treatment of cranial cruciate ligament injuries in dogs, yet variation from the desired postoperative tibial plateau slope of 6° has been noted. The objectives of this study were to investigate the geometric implications of this procedure and to identify factors that affect the postoperative angles. The records of 35 consecutive cases that had a TWO performed were reviewed and comparisons were made between the alignment of the cortices and level of the osteotomy using duplicated tracings of a preoperative radiograph. The existing method for calculating the size of wedge to be removed was found to result in a postoperative slope greater than the expected 6°. Our results indicate that the desired postoperative angle is more likely to be achieved if the cranial cortices are aligned and the osteotomy is performed proximally.

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