Likelihood of Return to Duty Is Low After Meniscal Allograft Transplantation in an Active-duty Military Population.

Likelihood of Return to Duty Is Low After Meniscal Allograft Transplantation in an Active-duty Military Population. Clin Orthop Relat Res. 2020 Apr;478(4):722-730 Authors: Antosh IJ, Cameron KL, Marsh NA, Posner MA, DeBerardino TM, Svoboda SJ, Owens BD Abstract BACKGROUND: Meniscal allograft transplantation (MAT) is considered a viable surgical treatment option in the symptomatic, postmeniscectomy knee and as a concomitant procedure with ACL revision and articular cartilage repair. Although promising outcomes have recently been reported in active and athletic populations, MAT has not been well-studied in the high-demand military population. QUESTIONS/PURPOSES: (1) What proportion of active-duty military patients who underwent MAT returned to full, unrestricted duty? (2) What demographic and surgical variables, if any, correlated with return to full, unrestricted duty? METHODS: Between 2005 and 2015, three fellowship-trained sports surgeons (TMD, SJS, BDO) performed 110 MAT procedures in active-duty military patients, of which 95% (104 patients) were available for follow-up at a minimum 2 years (mean 2.8 ± SD 1.1 year). During the study period, indications for MAT generally included unicompartmental pain and swelling in a postmeniscectomized knee and as a concomitant procedure when a meniscal-deficient compartment was associated with either an ACL revision reconstruction or cartilage repair. Demographic and surgical variables were collect...
Source: Clinical Orthopaedics and Related Research - Category: Orthopaedics Authors: Tags: Clin Orthop Relat Res Source Type: research

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Authors: Pickell M, Jejurikar N, Anil U, Salata M, Davidson PA, Jazrawi LM, Strauss EJ Abstract Meniscal tears are common injuries that may result in functionally limiting pain, swelling, and mechanical symptoms. The management of meniscal pathology has evolved as surgeons' understanding of the important role the menisci play in normal knee kinematics increases. Recent emphasis on partial meniscectomy, expanding indications for meniscal repair, and the increased use of meniscal allograft transplantation have helped improve the outcomes of patients with a meniscal tear who undergo treatment. Orthopaedic surgeons sho...
Source: Instructional Course Lectures - Category: Orthopaedics Tags: Instr Course Lect Source Type: research
itz C Abstract BACKGROUND: Focal cartilage lesions are common pathologies of weight-bearing joints. Clinical presentation ranges from asymptomatic patients to severe, pain-related movement deficits. Moreover, focal chondral lesions are risk factors for the development of osteoarthritis. There are various treatment options involving both surgical and nonsurgical treatments. Musculoskeletal radiologists should be aware of the various surgical options as well as the postsurgical imaging characteristics to depict whether the encountered imaging findings reflect the normal postoperative course or are indicative of a&nb...
Source: Der Radiologe - Category: Radiology Authors: Tags: Radiologe Source Type: research
ConclusionsPost-meniscectomy pain syndrome and post-meniscectomy knee OA are common findings after meniscus resection. Short-term pain relief is provided by non-surgical management, mid-term pain relief by meniscus scaffolds, and long-term relief by MAT, though each has differing indications. In later stages, osteotomies and joint replacements are indicated.Level of evidenceIV.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Abstract Articular cartilage defects, caused by trauma, osteoarthritis, or other diseases, always lead to severe joint pain and joint dysfunction. Without access to progenitor cells and the supply of blood and nutrients, the impaired articular cartilage would be short of the capability to self-repair. Although the present clinical treatments, including autogenous and allograft osteochondral transplantation, and microfracture technique, and so forth, have shown some efficacies, their drawbacks, such as donor insufficiency and poor-integrated with adjacent tissue, limit the satisfactory repair of articular cartilage...
Source: Biomacromolecules - Category: Biochemistry Authors: Tags: Biomacromolecules Source Type: research
Publication date: Available online 25 February 2019Source: Arthroscopy TechniquesAuthor(s): James Gwosdz, Alexander Rosinski, Moyukh Chakrabarti, Brittany M. Woodall, Nicholas Elena, Patrick J. McGahan, James L. ChenAbstractOsteochondritis dissecans (OCD) has been recognized for over 100 years yet still poses treatment challenges owing to both the avascular nature of articular cartilage and the inability to generate hyaline cartilage. The knee is most commonly involved, and without repair, patients have chronic knee pain, loose bodies, and early-onset osteoarthritis. There are a number of surgical techniques for repai...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
J Knee Surg DOI: 10.1055/s-0038-1676959Meniscal injuries in the young, active patient are often challenging injuries for the orthopaedic surgeon whose goal is to provide pain-free return to play/military duty and preserve maximal meniscal integrity. In the U.S. military, the incidence rate of meniscal tears is almost 10 times higher than that of the civilian population; although, the rates of reoperation following meniscal repair are fairly similar. The decision to pursue meniscal debridement versus repair is multifactorial depending on tear characteristics, concomitant injury, patient characteristics, and goals. Meniscal ...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Special Focus Section Source Type: research
J Knee Surg DOI: 10.1055/s-0037-1618592The treatment of patellofemoral cartilage defects presents several distinct challenges when compared with cartilage restoration techniques used for other compartments of the knee due to the unique anatomy and distribution of forces. The etiologies of patellofemoral articular cartilage lesions include acute traumatic instability injuries, such as dislocation and subluxation, osteochondritis dissecans, and chronic degenerative changes. Regardless of the etiology, untreated patellofemoral cartilage lesions can contribute to activity-limiting anterior knee pain. The goal of patellofemoral...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Special Focus Section Source Type: research
Two well-established first-line surgical treatment options exist for symptomatic meniscus tears: surgical repair and partial menisectomy. Generally considered a salvage procedure, meniscus allograft transplantation is a surgical treatment option for patients who have experienced the failure of multiple previous surgeries with symptomatic meniscal insufficiency and post-menisectomy syndrome. If primary surgical techniques fail, meniscal allograft transplantation can be performed with the goal of restoring normal knee kinematics and function while minimizing swelling and pain for patients
Source: Research in gerontological nursing - Category: Geriatrics Authors: Source Type: research
Publication date: Available online 28 August 2017 Source:Arthroscopy Techniques Author(s): Kevin C. Wang, Brian R. Waterman, Eric J. Cotter, Rachel M. Frank, Brian J. Cole Isolated, full-thickness articular cartilage lesions of the glenohumeral joint can cause pain, mechanical symptoms, and impaired function. Reports on operative management of these injuries with arthroscopic techniques, such as marrow stimulation, have shown improvement in patient symptoms. In cases where the subchondral bone is involved, osteochondral allograft (OCA) transplantation has shown positive results for contained, focal cartilage defects. The ...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
CONCLUSIONS: We found no evidence from randomised controlled trials on allograft transplantation or drilling. The very low quality evidence from RCTs comparing mosaicplasty with microfracture is insufficient to draw conclusions on the relative effects of these two interventions for treating isolated cartilage defects of the knee in adults. Of note is that treatment failure, with recurrence of symptoms, occurred with both procedures. Further research is needed to define the best surgical option for treating isolated cartilage defects. We suggest the greatest need is for multi-centre RCTs comparing reconstructive procedures ...
Source: Cochrane Database of Systematic Reviews - Category: Journals (General) Authors: Tags: Cochrane Database Syst Rev Source Type: research
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