Treatment of Knee Meniscus Pathology: Rehabilitation, Surgery, and Orthobiologics

The meniscal tear treatment paradigm traditionally begins with conservative measures such as physical therapy with referral for operative management for persistent or mechanical symptoms. As a result, the partial meniscectomy is performed more than any other orthopedic procedure in the United States. This treatment paradigm has shifted as recent literature supports the attempt to preserve or repair the meniscus whenever possible given its importance for the structural integrity of the knee joint and the risk of early osteoarthritis associated after meniscus excision.
Source: PM and R - Category: Rehabilitation Authors: Source Type: research

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Conclusion: In most cases, chronic injuries are far more common than acute tears. Because of the nonspecific and slowly progressive symptoms, patients are often misdiagnosed with radiculopathy, osteoarthritis, or trochanteric bursitis. Patients typically present to the clinic with an insidious onset of dull pain over the lateral hip. This pain is often worse when lying on the affected side. Certain gluteal-focused movements, such as climbing stairs, may exacerbate the pain. To our knowledge, our report is only the third case of acute traumatic tear of the gluteus medius and gluteus minimus reported in the literature. P...
Source: Ochsner Journal - Category: General Medicine Tags: Ochsner J Source Type: research
Did you ever wonder why medical research seems to flip-flop so often? Eggs used to be terrible for your health; now they’re not so bad. Stomach ulcers were thought to be due to stress and a “type A personality” but that’s been disproven. I was taught that every postmenopausal woman should take hormone replacement therapy to prevent heart disease and bone loss; now it’s considered way too risky. It can make you question every bit of medical news you hear. But maybe that’s not such a bad thing. Questioning what you read or hear is reasonable. And maybe medical reversals — when new re...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Medical Research Prevention Tests and procedures Source Type: blogs
Discussion The anterior cruciate ligament (ACL) “is an intra-articular but extrasynovial collagenous structure with limited healing capacity that originates in the posteromedial aspect of the lateral femoral condyle and crosses into anteromedially to insert anterior into the intercondylar eminence of tibial articular surface.” It plays an important part as a mechanoreceptor particularly as a proprioceptor. Its main role is to prevent excessive anterior tibial translation, limits varus/valgus stress when the knee is in full extension and some rotary movements of the knee. There are ~120,000 surgeries per year m...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
ConclusionThe variability in patient characteristics, co-interventions, outcome reporting, and length of follow-up in studies on irreparable rotator cuff tears without osteoarthritis complicates sound comparison of treatments. Clinically important treatment effects were seen for all 11 different treatment modalities.Level of evidenceIV.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Conditions:   Acetabular Labrum Tear;   Femoro Acetabular Impingement;   Hip Arthroscopy;   Physical Therapy;   Osteoarthritis, Hip Interventions:   Procedure: Hip Arthroscopy Surgery with Acetabular Labral Repair;   Procedure: Physical Therapy Focused on the Hip and Hemi-pelvis Sponsor:   Massachusetts General Hospital Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Publication date: Available online 29 March 2019Source: Diagnostic and Interventional ImagingAuthor(s): D. Filippiadis, G. Charalampopoulos, A. Mazioti, E. Alexopoulou, T. Vrachliotis, E. Brountzos, N. Kelekis, A. KelekisAbstractOsteoarthritis of the knee is the most common cause of chronic knee pain being more prevalent in middle-aged and elderly patients. Symptomatic patients complain of pain and mobility impairment. Therapeutic armamentarium includes physical therapy, oral pharmacologic therapy, intra-articular injections, nerve ablation or modulation, trans-catheter arterial embolization, minimally invasive arthroscopi...
Source: Diagnostic and Interventional Imaging - Category: Radiology Source Type: research
r H Abstract OBJECTIVE: Repair of the lateral ligament complex of the ankle joint; identification and treatment of intra-articular pathologies. INDICATIONS: Symptomatic chronic lateral ankle instability. Treatment of osteochondral lesions associated with lateral ankle instability. CONTRAINDICATIONS: Osteoarthritis of the ankle joint, risk factors such as peripheral occlusive disease, diabetic foot syndrome, complex regional pain syndrome. SURGICAL TECHNIQUE: Diagnostic arthroscopy of the ankle joint utilizing anterolateral and -medial portals; identification and treatment of intra-articular patholog...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research
Authors: Feeley BT, Lau BC Abstract Partial meniscectomy for meniscus tears is one of the most common procedures performed by orthopaedic surgeons. Much research has been done to evaluate the biomechanical consequences and clinical outcomes from meniscus débridement. Biomechanically, as the portion of the meniscus that is removed increases, greater contact pressures are experienced by the cartilage, which leads to altered knee mechanics. The use of partial meniscectomy to manage degenerative meniscus tears in knees with mild preexisting arthritis and mechanical symptoms may be beneficial; however, its routin...
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
Publication date: Available online 7 September 2018Source: PM&RAuthor(s): Paul S. Chirichella, Steven Jow, Stephen Iacono, Hannah E. Wey, Gerard A. MalangaAbstractThe meniscal tear treatment paradigm traditionally begins with conservative measures such as physical therapy with referral for operative management for persistent or mechanical symptoms. As a result, the partial meniscectomy is performed more than any other orthopedic procedure in the United States. This treatment paradigm has shifted as recent literature supports the attempt to preserve or repair the meniscus whenever possible given its importance for the struc...
Source: PMandR - Category: Rehabilitation Source Type: research
A 64-year-old woman with a history of morbid obesity presented to the Emergency Department (ED) after a mechanical fall while undergoing physical therapy. She reported a “popping” sensation in her left knee. Recent surgical history included a contralateral quadriceps tendon repair in her right knee nearly 3 weeks prior, after rupture suffered during a fall at home. Past medical history was significant for hyperlipidemia for which she was taking atorvastatin dai ly, and chronic knee osteoarthritis for which she received local steroid injections on multiple occasions.
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Visual Diagnosis in Emergency Medicine Source Type: research
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