Meniscal Root Injuries.

Meniscal Root Injuries. J Am Acad Orthop Surg. 2019 Nov 04;: Authors: Krych AJ, Hevesi M, Leland DP, Stuart MJ Abstract Meniscal root tears are an increasingly recognized injury leading to notable functional limitations, potential rapid cartilage deterioration of the affected compartment, and subsequent risk of total knee arthroplasty if left untreated. Repair of these tears is advised when articular cartilage remains intact because both medial and lateral meniscus root repairs have demonstrated favorable results. Recent literature demonstrates decreased rates of osteoarthritis and arthroplasty after medial meniscus root repair compared with partial meniscectomy and nonsurgical management. The transtibial pull-out repair technique is most commonly used and provides a biomechanically strong suture construct with standard and familiar knee arthroscopy portals. Furthermore, repair has recently been shown to be economically effective by decreasing overall societal healthcare costs when compared with more conservative management strategies. This review outlines the evaluation, treatment, and documented outcomes of meniscal root repair, which is imperative to the preservation of knee function and maintaining quality of life. PMID: 31693530 [PubMed - as supplied by publisher]
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

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To compare the preoperative and 1- and 2-year postoperative Knee injury and Osteoarthritis Outcome Score (KOOS) subscale scores between isolated anterior cruciate ligament reconstruction (ACLR) and ACLR with additional medial meniscus (MM) and/or lateral meniscus (LM) resection or repair.
Source: Arthroscopy - Journal of Arthroscopic and Related Surgery - Category: Surgery Authors: Source Type: research
AbstractPurposeThe purpose of this study was to evaluate the clinical outcomes and meniscus healing after arthroscopic repair of horizontal-cleavage meniscus tears, compared with vertical-longitudinal meniscus tears.MethodsThis was a retrospective review of a consecutive series of 52 meniscal repairs for horizontal-cleavage tears (n = 27) or vertical-longitudinal tears (n = 25); the groups were compared with respect to clinical symptoms and meniscal healing. Arthroscopic meniscal repair was performed using the inside-out technique with a marrow-stimulating technique. Clinical symptoms were evalu...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Publication date: Available online 16 November 2019Source: Orthopaedics &Traumatology: Surgery &ResearchAuthor(s): Christophe Mathoulin, Mathilde GrasAbstractScapholunate ligament tear is most frequently encountered in the aftermath of trauma in supination and extension of the wrist. It generates chronic instability, leading to osteoarthritis. It may be associated with fracture of the distal epiphysis of the radius or of the scaphoid. These lesions are often difficult to diagnose, especially in early stages. Treatment of chronic scapholunate ligament lesions before onset of osteoarthritis is a challenge for the sur...
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
AbstractThe medial meniscus (MM) posterior root has important functions in preventing an excessive loading stress during knee motion and degeneration of the articular cartilage. Although the transtibial pullout repair has become the gold standard for MM posterior root tears (MMPRTs), MM extrusion remains. In addition, during knee extension to deep flexion, the MM posterior segment in the MMPRT knee has been shown to translate toward the posteromedial direction, causing a notable MM posterior extrusion. Thus, the reduction in the MM posteromedial extrusion is one of the important postoperative outcomes to restore the menisc...
Source: European Journal of Orthopaedic Surgery and Traumatology - Category: Orthopaedics Source Type: research
Publication date: Available online 11 October 2019Source: Arthroscopy TechniquesAuthor(s): Joseph N. Liu, Troy G. Shields, Anirudh K. Gowd, Nirav H. AminAbstractBone marrow lesions (BMLs) in the knee represent focal edema caused by subchondral bone attrition and microfractures to the trabecular bone. These lesions are poor prognostic indicators for several orthopaedic procedures but also have been associated with the progression of osteoarthritis. Current research is aimed at treating BMLs with the intent to improve the overall structural integrity of the subchondral bone and delay the need for arthroplasty. The injection ...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
Abstract Femoroacetabular impingement is a cause of hip pain in young adults as a result of premature dynamic contact between the femur and acetabulum that occurs within the physiological range of hip motion. Diagnosis is made by patient history, clinical examination and radiographic findings. Cross-sectional imaging with computed tomography and magnetic resonance arthrography may be necessary in selected patients. Femoroacetabular impingement can be treated non-operatively with physiotherapist-led conservative care including analgesia and intra-articular steroid injections. Arthroscopic hip surgery aiming to rest...
Source: British Journal of Hospital Medicine - Category: Internal Medicine Authors: Tags: Br J Hosp Med (Lond) Source Type: research
J Knee Surg DOI: 10.1055/s-0039-1697623The aim of this study was to identify the effect of cartilage lesion in the lateral compartment of the knee on the surgical outcome of medial open-wedge high tibial osteotomy (MOWHTO). A total of 172 consecutive patients who underwent MOWHTO were evaluated retrospectively. Among the patients who underwent second-look arthroscopic assessment, 30 patients with lateral compartment cartilage lesion (group 1: ≥ grade 2 cartilage lesion according to the International Cartilage Repair Society [ICRS] grading system) and 64 patients with normal or near-normal lateral compartme...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
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
Fresh osteochondral allografting has gained popularity as a useful technique for managing difficult cartilage repair problems and, in revision situations, is a treatment of choice when other procedures such as microfracture, osteochondral autograft transfer, and cell-based therapies fail. However, it is a challenge when an allograft fails. Absent substantial progression of osteoarthritis, revising with another allograft results in a reasonable chance of "success" (but a high likelihood of further surgery along the way).
Source: Arthroscopy - Journal of Arthroscopic and Related Surgery - Category: Surgery Authors: Tags: Editorial Commentary Source Type: research
Femoroacetabular impingement (FAI) is generally agreed to be one of the main causes of hip osteoarthritis later in life. There is a strong association between certain sports and hip arthroscopy with labral repair and osteochondroplasty for FAI. Some sports, such as ice hockey, soccer, and basketball, place substantial mechanical demands on the hip, thus causing more hip injuries in athletes who participate in them. Sports medicine physicians caring for athletes playing “hip-intense” sports should have a low index of suspicion for FAI, even if the initial injury is described only as a groin strain.
Source: Arthroscopy - Journal of Arthroscopic and Related Surgery - Category: Surgery Authors: Tags: Editorial Commentary Source Type: research
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