The adjustable guide can be set to a 5 mm, 7.5 mm, or 10 mm offset from the posterior tibia for socket creation using a 6 mm or 7 mm FlipCutter ® drill to create a 5 mm- to 10 mm-deep socket. An Interview with Dr. Frank A. Cordasco. Am J Sports Med 1992; 20 (2) 176-181. The clinical importance of meniscal tears demonstrated by magne@c resonance imaging However, when a concomitant ACL reconstruction (ACLR) is performed, the rehabilitation should follow the designated ACLR postoperative protocol. Book a Consult For patients outside of the Bay Area 415-563-3110. Epidemiology. Loss of the meniscus has been linked to increased contact pressures on the adjacent articular cartilage and progression of degenerative changes in the knee. Many different factors influence the post-operative meniscal repair rehabilitation outcomes, including type and location of the meniscal tear and repair. meniscal tears are common in young patients with sports-related injuries and older patients as a degenerative condition. Show: Recommended. 2013;21(4):204–213. Consider taking a more conservative approach to range of motion, weight bearing, and rehab progression with more complex tears, all-inside meniscal repairs, and meniscal transplants. Menu. 1,9 • Partial menisectomy is the operative resection of the mobile portion of irreparable types of lesions. Meniscal Repair There are two types of cartilage in the knee, articular cartilage and meniscus cartilage. Authors Catherine Laible 1 , Drew A Stein, Daniel N Kiridly. Selecting the most appropriate treatment for a given patient involves both patient factors (e.g., age, co-morbidities and compliance) and tear characteristics (e.g., location of tear/age/reducibility of tear). Younger and elderly patients typically sustain different types of tears. Skip to main content 415-563-3110. 53. 52. Meniscal tears are the failure of the fibrocartilaginous menisci of the knee. Bhatia S, LaPrade CM, Ellman MB, LaPrade RF. meniscal repairs in young patients by arthrography, magnetic resonance imaging (MRI), and second look arthroscopy have proven that a high number of the tears have incomplete healing.17,18 Bach et al analyzed failures of 300 meniscal repairs and found that younger patients fail earlier than older patients.19 While there is literature Reviewed by a board-certified physician. J Am Acad Orthop Surg. Cannon WD, Vittori JM. Meniscal repair may be supplemented (as needed) with autologous substances in the form of fibrin clot to im-prove the healing environment. Learn more about the rehab, recovery time, & exercise protocols for Meniscus repair surgery. The role of meniscal root pathology and radial meniscal tear in medial meniscal extrusion. Articular cartilage is made up of collagen, proteoglycans and water and lines the end of the bones that meet to form a joint. There have been advances in both surgical techniques (e.g., techniques for root tear repair… Specific signs of a retorn meniscus following meniscal repair are similar to those of a retorn meniscus after partial meniscectomy: increased signal intensity extending through the site of repair on T2-weighted images, displaced meniscal fragments, and abnormal signal intensity at a site distant from the site of repair (, 6). The incidence of healing in arthroscopic meniscal repairs in anterior cruciate ligament-reconstructed knees versus stable knees. most common indication for knee surgery. The Thessaly test is the most sensitive and specific clinical test to diagnose meniscal injury. Am J Sports Med 1994; 22 (6): 797-802 ↑ Cannon WD, Jr., Vittori JM. inside-out meniscal repair, or all-inside meniscal repair. Meniscus repair surgery rather than removal may be done on torn knee cartilage when the tear is not central. Meniscal repair. All Time. Spindler KP, McCarty EC, Warren TA, Devin C, Connor JT. Medial meniscal root tears are often, but not always, seen in older patients, females, and more obese individuals, and tend to be the result of age-related degenerative changes in the meniscus and lower-energy mechanisms. Yoon KH, Park KH. … Factors affecting success include tear age, location and pattern, age of the patient, as well as any associated injuries. 19 Primarily, the focus is to prevent excessive weightbearing and joint compressive forces that could lead to undue traction and shearing stress, resulting in disruption of meniscal healing. higher risk in ACL deficient knees. • Meniscal repair: Typically in indicated for lesions within 3mm of the vascular zone; normal contour and greater than 7mm. The vertical lasso and horizontal lasso techniques introduced in this article not only address the limitations of the aforementioned repair methods but also provide a reproducible way in which to provide the advantage of circumferential compression (Justin Saliman, M.D., oral communication, December 2013) and repair to meniscal tear patterns typically thought to be poor candidates for repair. The decision by the surgeon to repair or remove is based primarily on the location of the meniscal tear. Rotate the drill guide to the optimal position on the … Factors that effect healing. Miller and others published Arthroscopic meniscal repair | Find, read and cite all the research you need on ResearchGate In cases of isolated ramp lesions, a standard meniscal repair rehabilitation protocol should be followed. Posterior Meniscal Root Repairs – Outcomes of an Anatomic Transtibial Pull-Out Technique Meniscal Ramp Lesions A Novel Repair Method for Radial Tears of the Medial Meniscus Posterior Meniscus Root Tears: Associated Pathologies to Assist as Diagnostic Tools Recent Advances in Posterior Meniscal Root Repair Techniques Am J Sports Med 2010; 38(8):1542-1548 5) Bhaacharyya T, Gale D, Dewire P, et al. Am J Sports Med. Affiliation 1 New York University Hospital for Joint Diseases, New York, NY, USA. Treatment options for meniscal tears fall into three broad categories; non-operative, meniscectomy or meniscal repair. This way, meniscal repair techniques have significantly developed in recent years. For patients outside of the Bay Area. Meniscal repair J Am Acad Orthop Surg. The incidence of healing in arthroscopic meniscal repairs in anterior cruciate ligament-reconstructed knees versus stable knees. 4) Stein T, Mehling AP, Welsch F, et al. Main navigation. This led to earlier treatments aiming at the removal of … The menisci are important load bearers and shock absorbers in the knee. If meniscal tissue is torn and/or trimmed, then the more meniscal tissue is lost, the less of a shock absorber there is in the knee and the more likely the patient is to end up getting increased wear and tear in the joint, and eventually arthritis. Torn Meniscus PPT - Free download as Powerpoint Presentation (.ppt), PDF File (.pdf), Text File (.txt) or view presentation slides online. Position this specially designed adjustable drill guide and marking hook over the back of the tibia for reproducible meniscal root repair. Prospective comparison of arthroscopic medial meniscal repair technique: inside-out suture versus entirely arthroscopic arrows. Meniscal PowerPoint PPT Presentations. Skeletal Radiol. It is a minimally invasive procedure often undergone as an outpatient. … Tenuta JJ, Arciero RA. 1992;20(2):176–181. For example, longitudinal tears are often amenable to repair, whereas horizontal and radial tears may require partial meniscectomy. Medial meniscal tears are among the most common injuries to the knee joint. A subset of tears known as “root tears” involves the insertion of the posterior horn of the meniscus to the bone. Knee Surg Relat Res 2014; 26:68. Br J Sports Med 2020; 54:652. [ 6, 17 - 19] Characteristic differences have been observed between medial and lateral tears. Arthroscopic evaluation of meniscal repairs. Related Content: Knee arthroscopy is a minimally invasive technique that allows orthopedic surgeons to assess - and in most cases, treat - a range of conditions affecting the knee joint. Meniscal repair. Meniscal injury is common, and the medial meniscus is more frequently injured. Tears are noted by how they look, as well as where the tear occurs in the meniscus. The technique of meniscal repair begins with identi-fying whether the tear is repairable. Meniscal tears are best evaluated with MRI. 2013 Apr;21(4):204-13. doi: 10.5435/JAAOS-21-04-204. Since early reports of meniscus repair in the 1980s, considerable attention has been made to improve surgical techniques, understand appropriate indications, and enhance Meniscal scaffolds . For example, longitudinal tears are often amenable to repair, whereas There are several types and can occur in an acute or chronic setting. A meniscal repair is a surgical procedure to repair a torn meniscus via keyhole surgery. Routinely, we place the patient in a knee brace, limit the patient's weight-bearing status to 25%, and allow knee range of motion from 0° to 90° during the first 6 weeks. Meniscal Repair: Overview: Meniscal tears occur in different ways. Meniscal root tears: significance, diagnosis, and treatment. Posterior Meniscal Root Repairs Outcomes of an Anatomic Transtibial Pull-Out Technique Robert F. LaPrade,*yz MD, PhD, Lauren M. Matheny,y MPH, Samuel G. Moulton,y BA, Evan W. James,y MD, and Chase S. Dean,y MD Investigation performed at the Steadman Philippon Research Institute, Vail, Colorado, USA Arthroscopic evaluation of meniscal repairs. Request PDF | On Jan 1, 2001, M.D. Knee Arthroscopy for ACL Reconstruction, Meniscal Repair, and Other Knee Problems. Contact us. Powerpoint presentation about 5 minutes long on a surgery I witnessed. Common tears include longitudinal, parrot-beak, flap, bucket handle, and mixed/complex. Long-term outcome aer arthroscopic meniscal repair versus arthroscopic par@al meniscectomy for traumac meniscal tears. tear include discoid meniscus, meniscal flounce, a meniscal ossicle, and chondrocalcinosis. Goals for isolated meniscal ramp repair include edema control, knee range of motion, and quadriceps-activation exercises, which are initiated on the first day postoperatively. Search. Optimal diagnosis and management is essential to prevent long term sequelae. The site, length, excursion or stability, reducibility, and viability in terms Abram SGF, Hopewell S, Monk AP, et al. 2004 Oct. 33(10):569-74. . When a meniscal tear is identified, accurate description and classification of the tear pattern can guide the referring clinician in patient education and surgical planning. Search. Repair is also more successful with an intact or reconstructed ACL, vs. an ACL deficient knee. Preservation of meniscal tissue and function is paramount for long-term joint function, especially in younger patients who are athletically active. Meniscal injuries have posed a challenging problem for many years, especially considering that historically the meniscus was considered to be a structure with no important role in the knee joint. Arthroscopic partial meniscectomy for meniscal tears of the knee: a systematic review and meta-analysis. Download PDF. Pathophysiology. When a meniscal tear is identified, accu-rate description and classification of the tear pattern can guide the referring clinician in patient education and surgical planning. The primary function of the articular cartilage is to provide a smooth gliding surface for joint motion. A meniscal repair protocol is employed postoperatively.

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