Return to Play and Player Performance After Meniscal Tear Among Elite-Level European Soccer Players: A Matched Cohort Analysis of Injuries From 2006 to 2016

Background: Meniscal injuries are extremely common in soccer athletes, and little is known about postrecovery performance. Purpose: To (1) identify characteristics associated with return to play (RTP) to the same league level and (2) evaluate long-term effects that injury and management approach may have on player performance. Study Design: Cohort study; Level of evidence, 3. Methods: Using publicly available records, we identified athletes who sustained meniscal tears across the 5 major European soccer leagues (English Premier League, Bundesliga, La Liga, Ligue 1, and Serie A) between 2006 and 2016. Injured athletes were matched to controls 1:2 by demographics and performance. Investigations included rate of RTP to the same league level, reinjury, player characteristics associated with RTP within 2 seasons, long-term availability, field time, and performance metrics standardized to 90 minutes of play during the next 4 seasons. Results: A total of 250 players sustaining meniscal tears were included, of which 106 (42%) received surgical management. Median absence was 57.5 days (interquartile range [IQR], 35-92) or 7 games (IQR, 4-12). Rate of RTP was 70%, and the reinjury rate 5% if a player could RTP. Age greater than 30 years was a negative predictor for RTP (odds ratio [OR], 0.62; P = .002), whereas higher preinjury goals per game (OR, 2.80; P = .04) and surgical management (OR, 1.38; P = .002) were positive predictors for RTP. Surgical management was associated with higher long-term availability ( P < .01). As compared with the control, there were no significant differences in field time or performance metrics after RTP, either overall or by player position. As compared with nonoperative management, defenders undergoing surgery demonstrated decreased field time. Attackers and midfielders demonstrated similar field time and performance regardless of management. Conclusion: RTP of elite soccer athletes sustaining meniscal tear is contingent on age, preinjury performance, and management approach. Those who RTP to the same league level can be expected to demonstrate equivalent field time, performance, and long-term availability as noninjured athletes.

Intra- and extra-capsular ganglia at the gastrocnemius origin and association with meniscal tears and severity of osteoarthritis of the knee joint

Background The association between size of ganglia or type of ganglia (intra-articular or extra-articular) and meniscal tears or severity of the osteoarthritis (OA) is not evaluated. Purpose To evaluate the prevalence, size, and location of intra- and extra-capsular ganglia at the gastrocnemius origin and to assess their associations with meniscal injury and grades of OA. Material and Methods This study included 301 consecutive patients who had knee pain and had undergone magnetic resonance imaging (MRI) of the knee. We evaluated presence of ganglia at the gastrocnemius muscle origin site and diagnosed whether it was an intra-capsular located or mixed-capsular located (intra-capsular and extra-capsular) and then measured the diameter of each ganglion. After two weeks, we evaluated whether articular cartilage injury existed. The presence of a meniscal tear was also recorded. Results A total of 186 patients (93%) had intra- and extra-capsular ganglia. Intra-capsular ganglia were found in 183 cases (91%) and mixed-capsular ganglia were found in 16 cases (8%). In cases with intra- and extra-capsular ganglia, more meniscal tears were found ( P = 0.029). Intra-capsular ganglia showed more meniscal tears ( P = 0.021). Intra-capsular ganglia were more likely to have high-grade OA ( P = 0.043). Patients who had a meniscal tear displayed larger-sized ganglia, especially of the intra-capsular type ( P = 0.044). Conclusion Patients with intra- and extra-capsular ganglia, especially of the intra-capsular type, are more likely to have meniscal injury and more severe OA. Patients with a meniscal tear or OA are more likely to have larger intra- and extra-capsular ganglia, especially of the intra-capsular type.

ACL Injuries and Meniscal Lesion: Hand in Hand?

Objective: To assess the incidence, nature and pattern of meniscal tear in ACL injury. Methodology: A retrospective study was conducted among the patients who were admitted and treated for ACL tear in Saveetha Medical And College And Hospital over a 2-year period from August 2019-August 2021. There were 52 patients admitted and treated for the same. The case records of each of the patients were reviewed to find the incidence of meniscal lesion in ACL tear and were then analyzed using appropriate statistical tests. Results: 52 patients with ACL tear were reviewed in this study. ACL tear was most commonly reported in younger age group of 20-29 (46.15%). Out of which, 19(36.54%) patients had meniscal tears. About 9(47.37%) patients had lateral meniscus tear, 6(31.58%) had medial meniscus tear and 4(21.05%) had bilateral meniscal tear. It was seen that bucket handle injury (n=12) was the most common meniscus tear overall. Radial tear was most specifically common in bilateral meniscus injury (N=4). Conclusion: Meniscal tears are the most common intra articular lesions associated with ACL tear. It was most commonly reported in the age group of 20-29. We found that the incidence of lateral meniscal tear was significantly higher in the patients rather than medial meniscal tear. Bucket handle injury was the most commonly reported tear in meniscal injury. Therefore, the surgeon needs to equip himself with the necessary meniscal repair instruments in his armamentarium

A Multi-Task Deep Learning Method for Detection of Meniscal Tears in MRI Data from the Osteoarthritis Initiative Database

We present a novel and computationally efficient method for the detection of meniscal tears in Magnetic Resonance Imaging (MRI) data. Our method is based on a Convolutional Neural Network (CNN) that operates on complete 3D MRI scans. Our approach detects the presence of meniscal tears in three anatomical sub-regions (anterior horn, body, posterior horn) for both the Medial Meniscus (MM) and the Lateral Meniscus (LM) individually. For optimal performance of our method, we investigate how to preprocess the MRI data and how to train the CNN such that only relevant information within a Region of Interest (RoI) of the data volume is taken into account for meniscal tear detection. We propose meniscal tear detection combined with a bounding box regressor in a multi-task deep learning framework to let the CNN implicitly consider the corresponding RoIs of the menisci. We evaluate the accuracy of our CNN-based meniscal tear detection approach on 2,399 Double Echo Steady-State (DESS) MRI scans from the Osteoarthritis Initiative database. In addition, to show that our method is capable of generalizing to other MRI sequences, we also adapt our model to Intermediate-Weighted Turbo Spin-Echo (IW TSE) MRI scans. To judge the quality of our approaches, Receiver Operating Characteristic (ROC) curves and Area Under the Curve (AUC) values are evaluated for both MRI sequences. For the detection of tears in DESS MRI, our method reaches AUC values of 0.94, 0.93, 0.93 (anterior horn, body, posterior horn) in MM and 0.96, 0.94, 0.91 in LM. For the detection of tears in IW TSE MRI data, our method yields AUC values of 0.84, 0.88, 0.86 in MM and 0.95, 0.91, 0.90 in LM. In conclusion, the presented method achieves high accuracy for detecting meniscal tears in both DESS and IW TSE MRI data. Furthermore, our method can be easily trained and applied to other MRI sequences.

A Longer Duration from Injury to Surgery is Associated with Preoperative Deterioration of an Isolated Meniscal Tear in Patients Aged 40 Years or Older

Background: It remains unclear what percentage of isolated meniscal tears deteriorates before surgery, especially in older patients. We aimed to evaluate the preoperative deterioration of an isolated meniscal tear in patients aged 40 years or older, and whether time from injury to surgery is associated with worsening of a meniscal tear.Methods: Patients aged 40 years or older who underwent arthroscopic surgery for isolated meniscal tear between 2014 and 2019 were retrospectively reviewed. The diagnostic magnetic resonance imaging (MRI) findings and arthroscopic findings were compared to evaluate the deterioration of meniscal tears. Predictors of the development of meniscal tears; patient demographic factors, duration from injury to surgery (injury to MRI and MRI to surgery), and image findings were assessed. Results: A total of 58 patients (58 knees) were included (mean age, 55.9 ± 8.5 years; male/female, 31/27). An isolated meniscal tear deteriorated in 28 (48.3%). In comparison of patients with and without deteriorated meniscal tear, significant differences were found in the MRI grade of meniscal tear (p = 0.03), duration from injury to MRI (164.2 ± 167.9 vs. 45.2 ± 48.7 days, p < 0.001), and from MRI to surgery (148.8 ± 91.1 vs. 67.6 ± 56.7 days, p < 0.001). A multivariate regression analysis showed that the duration from injury to MRI (odds ratio [OR], 1.03; p < 0.001) and from MRI to surgery (OR, 1.02; p < 0.001) were independent predictors of worsening of a meniscal tear. Conclusions: Approximately 50% of isolated meniscal tears deteriorated preoperatively in patients aged 40 years or older. The duration from injury to MRI and from MRI to surgery were independent predictors of the preoperative worsening of an isolated meniscal tear in this cohort.