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Journal articles on the topic 'Meniscectomy'
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Jeong, Hwa-Jae, Seung-Hee Lee, and Chun-Suk Ko. "Meniscectomy." Knee Surgery & Related Research 24, no. 3 (2012): 129–36. http://dx.doi.org/10.5792/ksrr.2012.24.3.129.
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Doral, Mahmut Nedim, Egemen Turhan, Gürhan Dönmez, et al. "Meniscectomy." Techniques in Knee Surgery 9, no. 3 (2010): 150–58. http://dx.doi.org/10.1097/btk.0b013e3181ef516d.
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Martens, M. A., M. Backaert, E. Heyman, and J. C. Mulier. "Partial arthroscopic meniscectomy versus total open meniscectomy." Archives of Orthopaedic and Traumatic Surgery 105, no. 1 (1986): 31–35. http://dx.doi.org/10.1007/bf00625657.
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Erickson, Brandon J., Peter N. Chalmers, John D’Angelo, et al. "Performance and Return to Sports After Meniscectomy in Professional Baseball Players." American Journal of Sports Medicine 50, no. 4 (2022): 1006–12. http://dx.doi.org/10.1177/03635465221074021.
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Background: Meniscal injuries are common in athletes across many sports. How professional baseball players respond to partial meniscectomy is not well documented. Purpose/Hypothesis: The purpose was to determine the performance and return-to-sports (RTS) rate in professional baseball players after arthroscopic partial knee meniscectomy and compare the results of partial medial meniscectomy versus partial lateral meniscectomy. The hypothesis was that there would be a high RTS rate in professional baseball players after partial meniscectomy with no difference in the RTS rate or timing of RTS between players who underwent partial medial meniscectomy versus partial lateral meniscectomy. Study Design: Cohort study; Level of evidence, 3. Methods: All professional baseball players who underwent arthroscopic partial meniscectomy between 2010 and 2017 were identified using the Major League Baseball Health and Injury Tracking System database. Demographic and performance data (before and after injury) for each player were recorded. The RTS rate and timing of RTS were then compared between players who underwent partial medial meniscectomy versus partial lateral meniscectomy. Results: A total of 168 knees (168 players) underwent arthroscopic partial meniscectomy (mean age, 25 ± 5 years; 46% medial meniscectomy, 45% lateral meniscectomy, and 9% both medial and lateral meniscectomy). The most common mechanism of injury was fielding in the infield on natural grass. Injuries were spread evenly across positions: 18% catchers, 24% infielders, 20% outfielders, and 38% pitchers. The overall RTS rate was 80% (76% returned to the same or a higher level, and 4% returned to a lower level). For performance, pitchers saw significant decreases in usage but significant improvements in performance using the advanced statistics of fielding independent pitching ( P < .001) and wins above replacement ( P = .011). Hitters saw significant decreases in usage but increases in efficiency as seen by improvements in wins above replacement ( P = .003). Of the 79 athletes who returned during the same season, the median time to return to play was 42 days. Conclusion: The RTS rate after meniscectomy in professional baseball players was 80%. Player efficiency improved after surgery in pitchers and position players. No difference in the RTS rate or timing of RTS existed between players who underwent partial medial meniscectomy versus partial lateral meniscectomy.
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van der Graaff, Sabine J. A., Max Reijman, Duncan E. Meuffels, and Marc A. Koopmanschap. "Cost-effectiveness of arthroscopic partial meniscectomy versus physical therapy for traumatic meniscal tears in patients aged under 45 years." Bone & Joint Journal 105-B, no. 11 (2023): 1177–83. http://dx.doi.org/10.1302/0301-620x.105b11.bjj-2023-0107.r1.
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AimsThe aim of this study was to evaluate the cost-effectiveness of arthroscopic partial meniscectomy versus physical therapy plus optional delayed arthroscopic partial meniscectomy in young patients aged under 45 years with traumatic meniscal tears.MethodsWe conducted a multicentre, open-labelled, randomized controlled trial in patients aged 18 to 45 years, with a recent onset, traumatic, MRI-verified, isolated meniscal tear without knee osteoarthritis. Patients were randomized to arthroscopic partial meniscectomy or standardized physical therapy with an optional delayed arthroscopic partial meniscectomy after three months of follow-up. We performed a cost-utility analysis on the randomization groups to compare both treatments over a 24-month follow-up period. Cost utility was calculated as incremental costs per quality-adjusted life year (QALY) gained of arthroscopic partial meniscectomy compared to physical therapy. Calculations were performed from a healthcare system perspective and a societal perspective.ResultsA total of 100 patients were included: 49 were randomized to arthroscopic partial meniscectomy and 51 to physical therapy. In the physical therapy group, 21 patients (41%) received delayed arthroscopic partial meniscectomy during follow-up. Over 24 months, patients in the arthroscopic partial meniscectomy group had a mean 0.005 QALYs lower quality of life (95% confidence interval -0.13 to 0.14). The cost-utility ratio was €-160,000/QALY from the healthcare perspective and €-223,372/QALY from the societal perspective, indicating that arthroscopic partial meniscectomy incurs additional costs without any added health benefit.ConclusionArthroscopic partial meniscectomy is arthroscopic partial meniscectomy is unlikely to be cost-effective in treating young patients with isolated traumatic meniscal tears compared to physical therapy as a primary health intervention. Arthroscopic partial meniscectomy leads to a similar quality of life, but higher costs, compared to physical therapy plus optional delayed arthroscopic partial meniscectomy.Cite this article: Bone Joint J 2023;105-B(11):1177–1183.
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Young, Edmond P., Priscilla H. Chan, Heather A. Prentice, Karun Amar, Andrew P. Hurvitz, and Najeeb A. Khan. "Aseptic Revision and Reoperation Risks After Meniscectomy at the Time of Anterior Cruciate Ligament Reconstruction." American Journal of Sports Medicine 49, no. 5 (2021): 1296–304. http://dx.doi.org/10.1177/0363546521997101.
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Background: An intact meniscus is considered a secondary stabilizer of the knee after anterior cruciate ligament reconstruction (ACLR). While loss of the meniscus can increase forces on the anterior cruciate ligament graft after reconstruction, it is unclear whether this increased loading affects the success of the graft after ACLR. Purpose: To identify the risk of subsequent knee surgery when meniscectomy, either partial or total, is performed at the time of index ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: We conducted a matched cohort study using data from the Kaiser Permanente Anterior Cruciate Ligament Reconstruction Registry. Patients were identified who had a primary ACLR performed between January 1, 2005 and December 31, 2016, with up to 12 years of follow-up. The study sample comprised patients with ACLR who had a lateral meniscectomy (n = 2581), medial meniscectomy (n = 1802), or lateral and medial meniscectomies (n = 666). For each meniscectomy subgroup, patients with ACLR alone were matched to patients with a meniscectomy on a number of patient and procedure characteristics. After the application of matching, Cox proportional hazards regression was used to evaluate the risk of aseptic revision, while competing risks regression was used to evaluate the risk of cause-specific ipsilateral reoperation between meniscectomy and ACLR alone. Analysis was performed for each meniscectomy subgroup. Results: After the application of matching, we failed to observe a difference in aseptic revision risk for patients with ACLR and a meniscectomy—lateral (hazard ratio [HR], 0.80; 95% CI, 0.63-1.02), medial (HR, 0.95; 95% CI, 0.70-1.29), or both (HR, 1.25; 95% CI, 0.77-2.04)—as compared with ACLR alone. When compared with patients who had ACLR alone, patients with a lateral meniscectomy had a higher risk for subsequent lateral meniscectomy (HR, 1.89; 95% CI, 1.18-3.02; P = .008), and those with a medial meniscectomy had a lower risk for manipulation under anesthesia (HR, 0.13; 95% CI, 0.02-0.92; P = .041). Conclusion: No difference in aseptic revision risk was observed for patients undergoing primary ACLR between groups with and without meniscectomy at the time of index surgery. Partial lateral meniscectomy at the time of index ACLR did associate with a higher risk of subsequent lateral meniscectomy.
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Van Dijk, Niek. "Arthroscopic meniscectomy." Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine 1, no. 3 (2016): 123. http://dx.doi.org/10.1136/jisakos-2016-000065.
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Pickles, D. M., and C. R. Bellenger. "Load-Bearing in the Ovine Medial Tibial Condyle: Effect of Meniscectomy." Veterinary and Comparative Orthopaedics and Traumatology 06, no. 02 (1993): 100–104. http://dx.doi.org/10.1055/s-0038-1633027.
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SummaryTotal removal of a knee joint meniscus is followed by osteoarthritis in many mammalian species. Altered load-bearing has been observed in the human knee following meniscectomy but less is known about biochemical effects of meniscectomy in other species. Using pressure sensitive paper in sheep knee (stifle) joints it was found that, for comparable loads, the load-bearing area on the medial tibial condyle was significantly reduced following medial meniscectomy. Also, for loads of between 50 N and 500 N applied to the whole joint, the slope of the regression of contact area against load was much smaller. Following medial meniscectomy, the ability to increase contact area as load increased was markedly reduced.The load bearing area on the medial tibial condyle was reduced following meniscectomy.
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Bernard, Christopher D., Nicholas I. Kennedy, Adam J. Tagliero, et al. "Medial Meniscus Posterior Root Tear Treatment: A Matched Cohort Comparison of Nonoperative Management, Partial Meniscectomy, and Repair." American Journal of Sports Medicine 48, no. 1 (2019): 128–32. http://dx.doi.org/10.1177/0363546519888212.
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Background: There are limited data comparing the outcomes of similarly matched patients with a medial meniscus posterior root tear (MMPRT) treated with nonoperative management, partial meniscectomy, or repair. Purpose/Hypothesis: The purpose was to compare treatment failure, clinical outcome scores, and radiographic findings for a matched cohort of patients who underwent either nonoperative management, partial meniscectomy, or transtibial pull-through repair for an MMPRT. We hypothesized that patients who underwent meniscus root repair will have lower rates of progression to arthroplasty than patients who were treated with nonoperative management or partial meniscectomy. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent transtibial medial meniscus posterior horn root repair were matched by meniscal laterality, age, sex, and Kellgren-Lawrence (K-L) grades to patients treated nonoperatively or with a partial meniscectomy. Progression to arthroplasty rates, International Knee Documentation Committee and Tegner scores, and radiographic outcomes were analyzed between groups. Results: Forty-five patients were included in this study (15 nonoperative, 15 partial meniscectomy, 15 root repair). Progression to arthroplasty demonstrated significant differences among treatment groups at a mean of 74 months (nonoperative, 4/15; partial meniscectomy, 9/15; meniscal repair, 0/15; P = .0003). The meniscus root repair group had significantly less arthritic progression, as measured by change in K-L grade from pre- to postoperatively (nonoperative, 1.0; partial meniscectomy, 1.1; meniscal repair, 0.1; P = .001). Conclusion: Meniscus root repair leads to significantly less arthritis progression and subsequent knee arthroplasty compared with nonoperative management and partial meniscectomy in a matched cohort based on patient characteristics.
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Duethman, Nicholas C., Ryan R. Wilbur, Bryant M. Song, et al. "Lateral Meniscal Tears in Young Patients: A Comparison of Meniscectomy and Surgical Repair." Orthopaedic Journal of Sports Medicine 9, no. 10 (2021): 232596712110460. http://dx.doi.org/10.1177/23259671211046057.
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Background: Meniscal tears are common in active patients, but treatment trends and surgical outcomes in young patients with lateral meniscal tears are lacking. Purpose: To evaluate treatment trends, outcomes, and failure rates in young patients with lateral meniscal tears. Study Design: Cohort study; Level of evidence, 3. Methods: Patients aged ≤25 years treated surgically for isolated lateral meniscal tears from 2001 to 2017 were identified. Treatment trends were compared over time. International Knee Documentation Committee (IKDC) scores and failure rates were compared by treatment modality (meniscectomy vs meniscal repair). Failure was defined as reoperation, symptomatic osteoarthritis, or a severely abnormal IKDC score. Univariate regression analyses were performed to predict failure and IKDC scores based on treatment, type and location of tear, or extent of meniscectomy. Results: Included were 217 patients (226 knees) with a mean age of 17.4 years (range, 7-25 years); of these patients, 144 knees (64%) were treated with meniscectomy and 82 knees (36%) with meniscal repair. Treatment with repair increased over time compared with meniscectomy ( P < .001). At a minimum 2-year follow-up (mean, 6.1 ± 3.9 years), 107 patients (110 knees) had IKDC scores, and analysis indicated that although scores in both groups improved from pre- to postoperatively (repair: from 69.5 ± 13.3 to 97.4 ± 4.3; meniscectomy: from 75.7 ± 9.0 to 97.3 ± 3.9; P < .001 for both), improvement in IKDC score was greater after repair (27.9 ± 13.9) versus meniscectomy (21.6 ± 9.4) ( P = .005). Included in the failure analysis were 184 patients (192 knees) at a mean follow-up of 8.4 ± 4.4 years. The rates of reoperation, symptomatic osteoarthritis, and failure were not significantly different between the meniscectomy and repair groups. Conclusion: An increase was seen in the rate of isolated lateral meniscal tear repair in young patients. IKDC score improvement was greater after repair than meniscectomy, although postoperative IKDC scores were similar. Symptomatic arthritis, reoperation, and failure rates were similar between groups; however, there was a trend for increased arthritis symptoms in patients treated with meniscectomy, especially total meniscectomy. Treatment modality, type and location of tear, and amount of meniscus removed were not predictive of final IKDC scores or failure.
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Chung, Kyu Sung, Jeong Ku Ha, Ho Jong Ra, Woo Jin Yu, and Jin Goo Kim. "Root Repair Versus Partial Meniscectomy for Medial Meniscus Posterior Root Tears: Comparison of Long-term Survivorship and Clinical Outcomes at Minimum 10-Year Follow-up." American Journal of Sports Medicine 48, no. 8 (2020): 1937–44. http://dx.doi.org/10.1177/0363546520920561.
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Background: The importance of repair in medial meniscus posterior root tears (MMPRTs) has been increasingly recognized because it restores hoop tension. However, no study has compared the long-term outcomes between meniscectomy and repair. Hypothesis: Survivorship and clinical outcomes of repair would be better than those of meniscectomy after long-term follow-up. Study Design: Cohort study; Level of evidence, 3. Methods: Between 2005 and 2009, patients with MMPRTs who had been followed up for at least 10 years after partial meniscectomy (n = 18) or pullout repair (n = 37) were recruited. Clinical assessments, including the Lysholm score and International Knee Documentation Committee (IKDC) subjective score, were evaluated preoperatively and at the final follow-up. The final results in each group were compared with the preoperative results, and the final results of the groups were compared. Clinical failure was defined as conversion to total knee arthroplasty (TKA), and the final clinical scores were assessed just before TKA. Kaplan-Meier survival analysis was used to investigate the survival rates of surgical procedures. Results: Mean ± SD follow-up period was 101.4 ± 45.9 and 125.9 ± 21.2 months in the meniscectomy and repair groups, respectively ( P = .140). The mean Lysholm and IKDC scores, respectively, in the meniscectomy group were 50.8 ± 7.7 and 37.6 ± 7.0 preoperatively and 58.2 ± 22.1 and 44.4 ± 19.0 postoperatively ( P = .124; P = .240). In the repair group, the mean Lysholm score and IKDC score, respectively, significantly increased from 52.3 ± 10.9 and 41.0 ± 9.6 preoperatively to 77.1 ± 24.0 and 63.7 ± 20.6 postoperatively ( P < .001; P < .001). The final Lysholm and IKDC scores in the repair group were significantly better than those in the meniscectomy group ( P = .004; P = .003). In cases of clinical failure, 10 patients (56%) in the meniscectomy group and 8 patients (22%) in the repair group converted to TKA in the follow-up period ( P = .016). According to Kaplan-Meier analysis, the 10-year survival rates for the meniscectomy and repair groups were 44.4% and 79.6%, respectively ( P = .004). Conclusion: In MMPRTs, root repair was superior to partial meniscectomy in terms of clinical results for at least 10 years of follow-up. From a long-term perspective, repair with restoration of hoop tension is more effective management than meniscectomy.
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Ro, Kyung-Han, Jun-Ho Kim, Jae-Won Heo, and Dae-Hee Lee. "Clinical and Radiological Outcomes of Meniscal Repair Versus Partial Meniscectomy for Medial Meniscus Root Tears: A Systematic Review and Meta-analysis." Orthopaedic Journal of Sports Medicine 8, no. 11 (2020): 232596712096207. http://dx.doi.org/10.1177/2325967120962078.
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Background: Given the superiority of meniscal repair over partial meniscectomy according to biomechanical data, the clinical outcomes of meniscal repair are likely to be better than those of partial meniscectomy for a medial meniscus root tear (MMRT). Purpose/Hypothesis: This review was designed to compare the clinical and radiological results between meniscal repair and partial meniscectomy for MMRTs. It was hypothesized that meniscal repair would result in better clinical and radiological results compared with partial meniscectomy. Study Design: Systematic review; Level of evidence, 4. Methods: Studies were included in the review if they (1) included patients with MMRTs who underwent primary arthroscopic meniscal repair or partial meniscectomy and (2) analyzed validated patient-reported outcomes and/or radiological evaluations. Summary odds ratios (ORs) with 95% CIs were calculated to compare partial meniscectomy with meniscal repair for each outcome. Results: A total of 13 studies were included. The mean duration of follow-up was 33.5 and 47.2 months in the meniscal repair group and partial meniscectomy group, respectively. The change in the Lysholm score from preoperatively to postoperatively was statistically significantly in favor of meniscal repair (OR, 2.20 [95% CI, 1.55-3.12]), while no difference was found with respect to the change in the Tegner score between the 2 surgical approaches (OR, 1.21 [95% CI, 0.65-2.24]). The prevalence of postoperative severe knee osteoarthritis (OR, 0.31 [95% CI, 0.17-0.54]) as well as that of reoperations (OR, 0.05 [95% CI, 0.01-0.19]) were significantly in favor of meniscal repair. Conclusion Better outcomes were seen after meniscal repair compared with partial meniscectomy for MMRTs, with greater improvements in Lysholm scores, and lower rates of progression to knee osteoarthritis, and lower reoperation rate.
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Janks, Ellis. "Post-meniscectomy rehabilitation." South African Journal of Physiotherapy 39, no. 2 (2019): 42–47. http://dx.doi.org/10.4102/sajp.v39i2.898.
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Removal of the semi-lunar cartilage/s (menisci) of the knee is a common surgical procedure. Surgeons recognize the importance of an exercise programme supervised by a physiotherapist, in order to obtain the best post-operative rehabilitation. However, the best method of post-operative rehabilitation has been a controversial issue. Controlled studies to determine the relative effectiveness of different treatment regimens are reviewed. Substantial research is being carried out to determine the physiological effects of surgical procedures, subsequent immobilization and different forms of exercise on the leg. These are discussed and considered in formulating the ideal post-meniscectomy rehabilitation programme. The effects and importance of isokinetic exercise is emphasized.
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Shirasawa, Kenzo, Hidetoshi Naito, Wataru Kawano, Koushi Nishino, Toshiyuki Ando, and Yoshiyasu Murakawa. "Aftertreatment of meniscectomy." Orthopedics & Traumatology 34, no. 4 (1986): 1296–99. http://dx.doi.org/10.5035/nishiseisai.34.1296.
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Hinkin, Daniel T. "Arthroscopic partial meniscectomy." Operative Techniques in Orthopaedics 5, no. 1 (1995): 28–38. http://dx.doi.org/10.1016/s1048-6666(95)80044-1.
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Kitziger, Kurt J., and Jesse C. DeLee. "Failed Partial Meniscectomy." Clinics in Sports Medicine 9, no. 3 (1990): 641–60. http://dx.doi.org/10.1016/s0278-5919(20)30714-6.
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Kohn, Dieter, and Berend T. Berendsen. "Arthroscopic lateral meniscectomy." Orthopaedics and Traumatology 1, no. 4 (1992): 270–77. http://dx.doi.org/10.1007/bf02620367.
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Sochacki, Kyle R., Kunal Varshneya, Jacob G. Calcei, et al. "Comparing Meniscectomy and Meniscal Repair: A Matched Cohort Analysis Utilizing a National Insurance Database." American Journal of Sports Medicine 48, no. 10 (2020): 2353–59. http://dx.doi.org/10.1177/0363546520935453.
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Background: Meniscal repair leads to improved patient outcomes compared with meniscectomy in small case series. Purpose: To compare the reoperation rates, 30-day complication rates, and cost differences between meniscectomy and meniscal repair in a large insurance database. Study Design: Cohort study; Level of evidence, 3. Methods: A national insurance database was queried for patients who underwent meniscectomy (Current Procedural Terminology [CPT] code 29880 or 29881) or meniscal repair (CPT code 29882 or 29883) in the outpatient setting and who had a minimum 2-year follow-up. Patients without confirmed laterality and patients who underwent concomitant ligament reconstruction were excluded. Reoperation was defined by ipsilateral knee procedure after the index surgery. The 30-day postoperative complication rates were assessed using the International Classification of Diseases, 9th Revision, Clinical Modification codes. The cost of the procedures per patient was calculated. Propensity score matching was utilized to create matched cohorts with similar characteristics. Statistical comparisons of cohort characteristics, reoperations, postoperative complications, and payments were made. All P values were reported with significance set at P < .05. Results: A total of 27,580 patients (22,064 meniscectomy and 5516 meniscal repair; mean age, 29.9 ± 15.1 years; 41.2% female) were included in this study with a mean follow-up of 45.6 ± 21.0 months. The matched groups were similar with regard to characteristics and comorbidities. There were significantly more patients who required reoperation after index meniscectomy compared with meniscal repair postoperatively (5.3% vs 2.1%; P < .001). Patients undergoing meniscectomy were also significantly more likely to undergo any ipsilateral meniscal surgery ( P < .001), meniscal transplantation ( P = .005), or total knee arthroplasty ( P = .001) postoperatively. There was a significantly higher overall 30-day complication rate after meniscal repair (1.2%) compared with meniscectomy (0.82%; P = .011). The total day-of-surgery payments was significantly higher in the repair group compared with the meniscectomy group ($7094 vs $5423; P < .001). Conclusion: Meniscal repair leads to significantly lower rates of reoperation and higher rates of early complications with a higher total cost compared with meniscectomy in a large database study.
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Deledda, Davide, Federica Rosso, Umberto Cottino, Davide Bonasia, and Roberto Rossi. "Results of meniscectomy and meniscal repair in anterior cruciate ligament reconstruction." Joints 03, no. 03 (2015): 151–57. http://dx.doi.org/10.11138/jts/2015.3.3.151.
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Meniscal tears are commonly associated with anterior cruciate ligament (ACL) injuries. A deficient medial meniscus results in knee instability and could lead to higher stress forces on the ACL reconstruction.Comparison of results in meniscectomy and meniscal repairs revealed worse clinical outcomes in meniscectomy, but higher re-operation rates in meniscal repairs. Our aim was to review the results of ACL reconstruction associated with meniscectomy or meniscal repair.
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Azam, Mohsin, and Ravi Shenoy. "The Role of Arthroscopic Partial Meniscectomy in the Management of Degenerative Meniscus Tears: A Review of the Recent Literature." Open Orthopaedics Journal 10, no. 1 (2016): 797–804. http://dx.doi.org/10.2174/1874325001610010797.
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Background:The use of arthroscopic partial meniscectomy for middle aged to older adults with knee pain is one of the most common surgical procedures with approximately 150,000 knee arthroscopies being carried out in the United Kingdom each year, and about five times that number in the United States. Despite this, the procedure remains controversial. The aim of this paper is to provide a comprehensive review of the role of arthroscopic meniscectomy in patients with degenerative meniscus tears and suggest recommendations for clinical practice.Methods:A thorough literature search was performed using available databases, including Pubmed, Medline, EMBASE and the Cochrane Library to cover important randomised control trials surrounding the use of arthroscopic partial meniscectomy.Results:The majority of randomised control trials suggest that arthroscopic partial meniscectomy is not superior to conservative measures such as exercise programmes. Furthermore, one randomised control trial found that arthroscopic partial meniscectomy was not even superior to sham surgery.Conclusion:There is significant overtreatment of knee pain with arthroscopic partial meniscectomy when alternative, less invasive and less expensive treatment options are equally effective. First-line treatment of degenerative meniscus tears should be non-operative therapy focused on analgesia and physical therapy to provide pain relief as well as improve mechanical function of the knee joint. Arthroscopic partial meniscectomy should be considered as a last resort when extensive exercise programmes and physiotherapy have been tried and failed.
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Bellenger, C. R., P. Ghosh, Y. Numata, C. Little, and D. S. Simpson. "The Effect of Total Meniscectomy versus Caudal Pole Hemimeniscectomy on the Stifle Joint of the Sheep." Veterinary and Comparative Orthopaedics and Traumatology 12, no. 02 (1999): 56–63. http://dx.doi.org/10.1055/s-0038-1632463.
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SummaryTotal medial meniscectomy and caudal pole hemimeniscectomy were performed on the stifle joints of twelve sheep. The two forms of meniscectomy produced a comparable degree of postoperative lameness that resolved within two weeks of the operations. After six months the sheep were euthanatised and the stifle joints examined. Fibrous tissue that replaced the excised meniscus in the total meniscectomy group did not cover as much of the medial tibial condyle as the residual cranial pole and caudal fibrous tissue observed following hemimeniscectomy. The articular cartilage from different regions within the joints was examined for gross and histological evidence of degeneration. Analyses of the articular cartilage for water content, glycosaminoglycan composition and DNA content were performed. The proteoglycan synthesis and release from explanted articular cartilage samples in tissue culture were also measured. There were significant pathological changes in the medial compartment of all meniscectomised joints. The degree of articular cartilage degeneration that was observed following total meniscectomy and caudal pole meniscectomy was similar. Caudal pole hemimeniscectomy, involving transection of the meniscus, causes the same degree of degeneration of the stifle joint that occurs following total meniscectomy.The effect of total medial meniscectomy versus caudal pole hemimeniscectomy on the stifle joint of sheep was studied experimentally. Six months after the operations gross pathology, histopathology, cartilage biochemical analysis and the rate of proteoglycan synthesis in tissue culture were used to compare the articular cartilage harvested from the meniscectomised joints. Degeneration of the articular cartilage from the medial compartment of the joints was present in both of the groups. Caudal pole hemimeniscectomy induces a comparable degree of articular cartilage degeneration to total medial meniscectomy in the sheep stifle joint.
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Bernard, Christopher, Adam Tagliero, Matthew LaPrade, et al. "Medial Meniscus Posterior Root Tear Treatment: A matched cohort comparison of non-operative management, partial meniscectomy and repair." Orthopaedic Journal of Sports Medicine 8, no. 7_suppl6 (2020): 2325967120S0036. http://dx.doi.org/10.1177/2325967120s00368.
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Objectives: Meniscal root disruption results in a loss of hoop strain resistance, increased articular cartilage contact pressure, and acceleration of degenerative changes. There is limited data comparing the outcomes of similarly matched patients with a medial meniscus posterior root tear treated with non-operative management, partial meniscectomy, or repair. The purpose of this study is to compare treatment failure, clinical outcome scores, and radiographic findings for a matched cohort of patients who underwent either non-operative management, partial meniscectomy, or transtibial pull-through repair for a medial meniscus posterior root tear (MMPRT). Our hypothesis is that patients who underwent meniscus root repair will have lower rates of progression to arthroplasty than patients who were treated with non-operative management or partial meniscectomy. Methods: Patients who underwent transtibial medial meniscus posterior horn root repair were matched by meniscus laterality, age, sex and K-L grades to patients treated non-operatively or with a partial meniscectomy. Progression to arthroplasty rates, IKDC and Tegner scores, and radiographic outcomes were analyzed between groups. Results: Forty-five patients were included in this study (15 non-operative, 15 partial meniscectomy, 15 root repair). Progression to arthroplasty demonstrated significant differences among treatment groups at a mean 74 months (non-operative 4/15, partial meniscectomy 9/15, meniscus repair 0/15, p=.0003). The meniscus root repair group had significantly less arthritic progression, as measured by change in K-L grade from pre-op to post-op (non-operative 1.0, partial mensicectomy 1.1, and meniscus repair 0.1, p=.001). Conclusion: Meniscus root repair leads to significantly less arthritis progression and subsequent knee arthroplasty compared to non-operative management and partial meniscectomy in a demographically matched cohort.
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Bottomley, J., and O. Al-Dadah. "ARTHROSCOPIC MENISCECTOMY AND MENISCAL REPAIR: COMPARISON OF CLINICAL OUTCOMES." Orthopaedic Proceedings 105-B, SUPP_7 (2023): 7. http://dx.doi.org/10.1302/1358-992x.2023.7.007.
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Meniscal tears are the most common injury in the knee, affecting 66/100,000 people/year. Surgical treatment includes arthroscopic meniscectomy or meniscal repair. Little is known regarding medium-term outcomes following these procedures in isolated meniscal tears. This study aims to quantitatively evaluate patients with meniscal tears, and those who have undergone meniscectomy and meniscal repair using validated patient reported outcome measures (PROMs), further exploring factors which affect surgical outcomes.This observational study screened 334 patients who underwent arthroscopic surgery at South Tyneside Hospital since August 2013. 134 patients with isolated meniscal tears were invited to complete postal PROMs. A combination of patient notes and radiological imaging was used to collect information of interest including age, gender, knee-laterality, injured meniscus, tear pattern, procedure performed, complications, and associated injuries.A total of 115 patients (pre-operative patients with current meniscal tear (n=36), meniscectomy (n=63), meniscal repair (n=16)) were included in the analysis with 96% successful PROM completion. Both meniscectomy and meniscal repairs (mean 55-months follow-up) showed better outcomes than pre-operative patients with meniscal tears. Meniscal repairs demonstrated superior outcomes across all PROMs when compared to meniscectomy, with a greater mean overall KOOS score of 17.2 (p=0.009). Factors including higher pre-operative Kellgren-Lawrence Grade, pre-operative articular cartilage lesions and bilateral meniscectomies were shown to negatively influence outcomes.Both meniscectomy and meniscal repair maintain clinical benefit at mean 55-months follow-up, affirming their use for treatment of meniscal tears. When feasible, meniscal repair should be performed preferentially over meniscectomy in isolated meniscal tears. Identified predictive factors allow adequate treatment stratification in specific patient groups.
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Indelli, Pier Francesco, John A. Szivek, Andrew Schnepp, and William A. Grana. "Load-Bearing at the Meniscofemoral Joint: An in vitro Study in the Canine Knee." Duke Orthopaedic Journal 1, no. 1 (2011): 39–43. http://dx.doi.org/10.5005/jp-journals-10017-1006.
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ABSTRACT Background The role of the menisci on tibial load transmission and stress distribution has been extensively studied, but few studies have focused on the meniscofemoral joint during physiologic weightbearing. The objective of this study was to determine the contact areas and local contact stresses at the meniscofemoral interface during physiologic range of motion and axial-loading in the canine knee and to determine the influence of a partial or total meniscectomy. Methods Both fresh-frozen knees of 3 hound-type canines were tested in a universal testing machine configured for an axial-load of 90-120 N. Measurement of the contact area and the local contact stress were done at three different knee angles (30; 50; 70) and with both menisci intact, after partial meniscectomy, and after total meniscectomy. Pressure distribution was estimated by using pressure sensitive film inserted above the menisci. Results After partial meniscectomy, contact areas at 50° of knee flexion decreased approximately 25% on both femoral condyles, and local contact stress increased 30% on the medial femoral condyle but remained unchanged on the lateral. After total meniscectomy, contact areas at 50° of knee flexion decreased approximately 75% on both femoral condyles, and local contact stress increased approximately 60% on the medial compartment and 100% on the lateral compartment. Conclusions These data suggest that a conservative partial meniscectomy leaves the meniscus with an inferior weight distribution function; decreasing, but not canceling the protection on the femoral hyaline cartilage. A dramatic decrease of contact area followed by an increase of local contact stress was noted after a total meniscectomy. The clinical value of this study is to emphasize the biomechanical value of surgical procedures addressing the repair of damaged menisci.
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Ekhtiari, Seper, Moin Khan, Jacob M. Kirsch, Patrick Thornley, Christopher M. Larson, and Asheesh Bedi. "Most elite athletes return to competition following operative management of meniscal tears: a systematic review." Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine 3, no. 2 (2018): 110–15. http://dx.doi.org/10.1136/jisakos-2017-000181.
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ImportanceMeniscal injuries are common among athletes. When operative management is indicated, the decision between meniscal repair and meniscectomy is not always clear, particularly in elite athletes.ObjectiveThe aim of this systematic review was to (1) compare outcomes for partial meniscectomy and repair for the management of meniscus tears in elite athletes and (2) describe return-to-play (RTP) rates and complications for each operation.Evidence reviewMEDLINE, Embase and PubMed were searched from inception through to 5 March 2017. All studies were screened in duplicate for eligibility. Data extracted included demographics, surgical technique and RTP rate and timeline.FindingsTen studies (725 athletes) were included involving 355 elite athletes undergoing meniscal repair (111 patients) or partial/total meniscectomy (244). The majority of athletes were men (82.8%) and had a mean age of 25.0 years (14–38). Athletes were followed for a mean of 5.3 years (range=3 months to 18.4 years). American football was the most common sport (153 athletes), followed by soccer (69) and basketball (67). Athletes undergoing meniscal repair demonstrated a pooled mean RTP time of 7.6 months in comparison to 4.3 months for those undergoing partial meniscectomy (P<0.0001). Of athletes undergoing meniscal repair, 86.5% RTP at their preoperative level, compared with 80.4% of athletes undergoing partial meniscectomy (P=0.24). Following meniscectomy, athletes who were taller, drafted in higher rounds and had played or started more games preoperatively were less likely to suffer negative career impacts postoperatively. Satisfaction rates (92% vs 76%) and clinical scores (8.8 vs 6.9, P=0.05) were higher among recreational than elite athletes.ConclusionAthletes undergoing partial meniscectomy RTP sooner than those undergoing meniscal repair. Both operations are safe and the majority of athletes RTP at their preoperative level of competition following either operation. Further research is required to identify when each option is preferable in this population.RelevanceBased on the currently available evidence, meniscectomy and meniscal repair are both viable options for elite athletes with meniscal injuries. Each method has small advantages and disadvantages compared with the other, and thus a shared decision should be made with the athlete.Level of evidenceLevel IV, systematic review of level III and IV studies.
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Kawashima, Fumiyoshi, and Hiroshi Takagi. "Examination of refractory discoid lateral meniscus injury." Journal of Orthopaedic Surgery 29, no. 2 (2021): 230949902110220. http://dx.doi.org/10.1177/23094990211022043.
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Background: Lateral discoid meniscus (LDM) should be treated and preserved with saucerization and/or suture repair. However, repair of the meniscal hoop structure is sometimes difficult due to displacement or large defects. In this study, we aimed to examine tear patterns based on the Ahn classification in those requiring meniscal repair and those undergoing subtotal meniscectomy. Methods: Twenty-three patients were evaluated (mean age, 27.4 years; mean follow-up period, 2.5 years). The following were evaluated: displacement morphology based on the Ahn classification, site of tear under arthroscopy, morphology, surgical procedure, Lysholm score at final postoperative follow-up, and clinical outcome of meniscus using Barrett’s criteria. Result: There were 16 knees without displacement (saucerization with suture repair, 13 knees; subtotal meniscectomy, 3 knees) and 10 knees with displacement (reduction with suture repair, 3 knees; subtotal meniscectomy, 7 knees). Subtotal meniscectomy was performed more often in cases with dislocation, especially in the central shift type as defined by the Ahn classification. The mean Lysholm score was 65.0 points preoperatively and 95.3 points postoperatively. Twenty-three knees (88%) were postoperatively categorized under the Barrett’s criteria as healing and 3 knees (12%) were categorized as non-healing. The number of non-healing cases that underwent subtotal meniscectomy was relatively small (1 of 10 knees), and the short-term results were not poor. Conclusion: Localized peripheral longitudinal tears tended to be repairable even with displacement, while peripheral tears covering the entire meniscus or with severe defects/tears in the body of the meniscus tended to be difficult to repair, leading to subtotal meniscectomy.
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Modi, Parth K., Samuel R. Kaufman, Tudor Borza, et al. "Medicare Accountable Care Organizations and Use of Potentially Low-Value Procedures." Surgical Innovation 26, no. 2 (2018): 227–33. http://dx.doi.org/10.1177/1553350618816594.
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Objective. To evaluate the effect of Accountable Care Organizations (ACOs) on the use of vertebroplasty and arthroscopic partial meniscectomy, 2 procedures for which randomized controlled trials suggest similar outcomes to sham surgery and therefore may provide low value. Medicare Shared Savings Program ACOs aim to improve quality and decrease health care spending. Reducing the use of potentially low-value procedures can accomplish both of these goals. Methods. We performed a retrospective cohort study of patients who underwent potentially low-value orthopedic procedures (vertebroplasty and partial meniscectomy) and a control (hip fracture) from 2010 to 2015 using a 20% sample of national Medicare claims. We performed an interrupted time-series analysis using linear spline models to evaluate the count of each procedure per 1000 patients, stratified by ACO participation. Results. We identified 76 256 patients who underwent arthroscopic partial meniscectomy, 44 539 patients who underwent vertebroplasty, and 50 760 patients who underwent hip fracture admission. Arthroscopic partial meniscectomy rates decreased, vertebroplasty rates remained stable, and hip fracture rates increased for both groups during the study period, with similar trends among ACO and non-ACO patients. After January 1, 2013, ACO and non-ACO populations had similar trends for vertebroplasty (ACO incidence rate ratio [IRR] = 1.15 [1.08-1.23] vs non-ACO IRR = 1.11 [1.05-1.16]), meniscectomy (ACO IRR = 1.06 [1.01-1.12] vs non-ACO IRR = 1.03 [0.99-1.07]), and hip fracture (ACO IRR = 1.08 [1.01-1.14] vs non-ACO IRR = 1.08 [1.03-1.13]). Conclusions. ACOs were not associated with a reduction in the frequency of vertebroplasty and arthroscopic partial meniscectomy.
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Grassi, Alberto, Stefano Di Paolo, Gian Andrea Lucidi, Luca Macchiarola, Federico Raggi, and Stefano Zaffagnini. "The Contribution of Partial Meniscectomy to Preoperative Laxity and Laxity After Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction: In Vivo Kinematics With Navigation." American Journal of Sports Medicine 47, no. 13 (2019): 3203–11. http://dx.doi.org/10.1177/0363546519876648.
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Background: Limited in vivo kinematic information exists on the effect of clinical-based partial medial and lateral meniscectomy in the context of anterior cruciate ligament (ACL) reconstruction. Hypothesis: In patients with ACL deficiency, partial medial meniscus removal increases the anteroposterior (AP) laxity with compared with those with intact menisci, while partial lateral meniscus removal increases dynamic laxity. In addition, greater postoperative laxity would be identified in patients with partial medial meniscectomy. Study design: Cross-sectional study; Level of evidence, 3. Methods: A total of 164 patients with ACL tears were included in the present study and divided into 4 groups according to the meniscus treatment they underwent: patients with partial lateral meniscectomy (LM group), patients with partial medial meniscectomy (MM group), patients with partial medial and lateral meniscectomy (MLM group), and patients with intact menisci who did not undergo any meniscus treatment (IM group). A further division in 2 new homogeneous groups was made based on the surgical technique: 46 had an isolated single-bundle anatomic ACL reconstruction (ACL group), while 13 underwent a combined single-bundle anatomic ACL reconstruction and partial medial meniscectomy (MM-ACL group). Standard clinical laxities (AP translation at 30° of knee flexion, AP translation at 90° of knee flexion) and pivot-shift (PS) tests were quantified before and after surgery by means of a surgical navigation system dedicated to kinematic assessment. The PS test was quantified through 3 different parameters: the anterior displacement of the lateral tibial compartment (lateral AP); the posterior acceleration of the lateral AP during tibial reduction (posterior acceleration); and finally, the area included by the lateral AP translation with respect to the flexion/extension angle (area). Results: In the ACL-deficient status, the MM group showed a significantly greater tibial translation compared with the IM group ( P < .0001 for AP displacement at 30° [AP30] and 90° [AP90] of flexion) and the LM group ( P = .002 for AP30 and P < .0001 for AP90). In the PS test, the area of LM group was significantly larger (57%; P = .0175) than the one of the IM group. After ACL reconstruction, AP translation at 30° was restored, while the AP90 remained significantly greater at 1.3 mm ( P = .0262) in the MM-ACL group compared with those with intact menisci. Conclusion: Before ACL reconstruction, partial medial meniscectomy increased AP laxity at 30° and 90° and lateral meniscectomy increased dynamic PS laxity with respect to intact menisci. Anatomic single-bundle ACL reconstruction decreased laxities, but a residual anterior translation of 1.3 mm at 90° remained in patients with partial medial meniscectomy, with respect to those with intact menisci.
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Tucker, Lue-Yen, Amy Vieira, and David Ding. "Poster 246: Comparison of Meniscectomy versus Repair in Bucket Handle Meniscus Tears: Analysis of a Large, Contained Cohort Study." Orthopaedic Journal of Sports Medicine 10, no. 7_suppl5 (2022): 2325967121S0080. http://dx.doi.org/10.1177/2325967121s00807.
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Objectives: o evaluate the long-term risk of subsequent ipsilateral knee surgery in patients who underwent a bucket handle meniscus repair (BHMR) versus meniscectomy and assess risk factors associated with subsequent knee surgical intervention. Methods: We performed an electronic health records search for all patients who underwent arthroscopic knee meniscus surgery (repair and meniscectomy) from 2011 to 2018. Natural language processing was used to search for terms of interest in the long operative notes to determine if these surgeries were performed for bucket handle meniscus tears. These patients comprised our initial cohort. Study subjects were followed for at least one year and up to five years with censoring at death, membership disenrollment, or 12/31/2019. Baseline patient characteristics and outcomes (i.e., subsequent operative procedures, deep surgical site infections, and deep venous thrombosis) were evaluated via a database review. The primary outcome was subsequent ipsilateral knee surgeries and secondary outcomes included contralateral knee surgeries, deep surgical site infections, and venous thrombotic events. Multivariable logistic regression analyses were used to model for subsequent surgical treatment of the ipsilateral knee. Survival analyses were performed using the Kaplan-Meier method. We then performed a subset analysis for patients 30-50 years-old. Results: The mean follow-up time was 3.9 years (standard deviation [SD] 1.3 years). A total of 1359 patients underwent meniscus repair and 1537 patients underwent meniscectomy for a bucket-handle meniscus tear. The mean age was 27 (SD 10.9) years for the repair group versus 37.5 (SD 13.1) for the meniscectomy group (P<0.001). BMI was significantly lower in the meniscus repair compared to the meniscectomy group (P<0.001). BHMR was significantly more likely to be performed during a concomitant ipsilateral ACL reconstruction than a meniscectomy (44.2% vs 30.1%, P<0.001). During the follow-up period, a total of 656 subsequent ipsilateral procedures were performed in 393 (13.6%) patients. Patient who underwent initial BHMR were at a significantly higher risk to undergo subsequent meniscus repair (4.3% vs 1%, P<0.001), meniscus debridement (12.1% vs 3.3%, P<0.001), and ACL reconstruction (7.4% vs 2.9%, P<0.001) compared to initial meniscectomy. Multivariate analysis showed that BHMR, younger age, and lower BMI were risk factors in subsequent ipsilateral surgery. After adjusting for patient demographic and clinical characteristics, subset analysis showed for age 30-50 year-old patients, undergoing a BHMR versus a meniscectomy led to a 2.3-times higher risk of subsequent surgery, with a 5.3-times higher risk of subsequent meniscus repair and a 3.2-times risk of subsequent meniscectomy. Conclusions: BHMR is more often performed in younger, lower BMI individuals especially during a concomitant ACL reconstruction. BHMR are more likely to undergo subsequent surgeries which decreases with regards to increasing age. Subset analyses showed increasing risk for subsequent surgeries with BHMR versus meniscectomy in the age 30-50 years-old cohort.
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Marigi, Erick M., Lucas K. Keyt, Matthew D. LaPrade, et al. "Surgical Treatment of Isolated Meniscal Tears in Competitive Male Wrestlers: Reoperations, Outcomes, and Return to Sport." Orthopaedic Journal of Sports Medicine 9, no. 1 (2021): 232596712096922. http://dx.doi.org/10.1177/2325967120969220.
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Background: Wrestlers are highly active, young athletes prone to meniscal injuries that often require surgery. However, there is a lack of data evaluating the results of meniscal repair or partial meniscectomy in this cohort. Purpose: To describe the outcomes (subjective function, return to play, complications, reoperation rates, and progression of osteoarthritis) for treatment (meniscectomy or repair) of meniscal injuries in a cohort of competitive wrestlers. Study Design: Case series; Level of evidence, 4. Methods: All competitive wrestlers (high school, collegiate, or professional leagues) with a history of a meniscal injury and isolated meniscal surgery at a single institution between 2001 and 2017 were retrospectively identified. Failure was defined as a reinjury of the operative meniscus by clinical or advanced imaging examination, reoperation, or any additional surgical treatment of the meniscus after the index procedure. All patients were contacted for determination of reinjury rates, current sport status, and International Knee Documentation Committee and Tegner activity scores. Results: Of 85 male wrestlers with isolated meniscal tears, 34% underwent a meniscal repair, and 66% received a partial meniscectomy. Index surgery failed for 9.4% of the cohort. Among wrestlers treated with initial meniscal repair, 21% required a subsequent partial meniscectomy at a mean 2.2 years, and of those treated with partial meniscectomy, 3% underwent a second operation ( P < .001). All secondary operations were revision partial meniscectomies occurring at a mean 3.2 years (95% CI, 0.01-6.4 years) after the index procedure. At final follow-up, 89% of patients were able to return to sport, with 65% returning to wrestling competition. There was significant improvement in the Tegner score from a mean 6.5 (95% CI, 5.9-7.2) preoperatively to 8.3 (95% CI 8.0-8.6) postoperatively ( P < .001). Conclusion: The reoperation rate after meniscal surgery in wrestlers was quite low, but only 65% returned to competitive wrestling. Meniscal repair and partial meniscectomy improved patient-reported outcomes and activity levels at short-term follow-up. However, 21% of wrestlers treated with initial meniscal repair required a subsequent partial meniscectomy at a mean 2.2 years.
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Faucett, Scott C., Benjamin Peter Geisler, Jorge Chahla, et al. "Meniscus Root Repair vs Meniscectomy or Nonoperative Management to Prevent Knee Osteoarthritis After Medial Meniscus Root Tears: Clinical and Economic Effectiveness." American Journal of Sports Medicine 47, no. 3 (2018): 762–69. http://dx.doi.org/10.1177/0363546518755754.
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Background: Medial meniscus root tears are a common knee injury and can lead to accelerated osteoarthritis, which might ultimately result in a total knee replacement. Purpose: To compare meniscus repair, meniscectomy, and nonoperative treatment approaches among middle-aged patients in terms of osteoarthritis development, total knee replacement rates (clinical effectiveness), and cost-effectiveness. Study Design: Meta-analysis and cost-effectiveness analysis. Methods: A systematic literature search was conducted. Progression to osteoarthritis was pooled and meta-analyzed. A Markov model projected strategy-specific costs and disutilities in a cohort of 55-year-old patients presenting with a meniscus root tear without osteoarthritis at baseline. Failure rates of repair and meniscectomy procedures and disutilities associated with osteoarthritis, total knee replacement, and revision total knee replacement were accounted for. Utilities, costs, and event rates were based on literature and public databases. Analyses considered a time frame between 5 years and lifetime and explored the effects of parameter uncertainty. Results: Over 10 years, meniscus repair, meniscectomy, and nonoperative treatment led to 53.0%, 99.3%, and 95.1% rates of osteoarthritis and 33.5%, 51.5%, and 45.5% rates of total knee replacement, respectively. Meta-analysis confirmed lower osteoarthritis and total knee replacement rates for meniscus repair versus meniscectomy and nonoperative treatment. Discounted 10-year costs were $22,590 for meniscus repair, as opposed to $31,528 and $25,006 for meniscectomy and nonoperative treatment, respectively; projected quality-adjusted life years were 6.892, 6.533, and 6.693, respectively, yielding meniscus repair to be an economically dominant strategy. Repair was either cost-effective or dominant when compared with meniscectomy and nonoperative treatment across a broad range of assumptions starting from 5 years after surgery. Conclusion: Repair of medial meniscus root tears, as compared with total meniscectomy and nonsurgical treatment, leads to less osteoarthritis and is a cost-saving intervention. While small confirmatory randomized clinical head-to-head trials are warranted, the presented evidence seems to point relatively clearly toward adopting meniscus repair as the preferred initial intervention for medial meniscus root tears.
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St-Pierre, Diane M. M. "Rehabilitation Following Arthroscopic Meniscectomy." Sports Medicine 20, no. 5 (1995): 338–47. http://dx.doi.org/10.2165/00007256-199520050-00005.
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Rangger, Christoph, Anton Kathrein, Thomas Klestil, and Wulf Glötzer. "Partial Meniscectomy and Osteoarthritis." Sports Medicine 23, no. 1 (1997): 61–68. http://dx.doi.org/10.2165/00007256-199723010-00006.
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Bolano, Luis E., and William A. Grana. "Isolated arthroscopic partial meniscectomy." American Journal of Sports Medicine 21, no. 3 (1993): 432–37. http://dx.doi.org/10.1177/036354659302100318.
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McDermott, I. D., and A. A. Amis. "The consequences of meniscectomy." Journal of Bone and Joint Surgery. British volume 88-B, no. 12 (2006): 1549–56. http://dx.doi.org/10.1302/0301-620x.88b12.18140.
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Dasic, Zarko, and Dragan Radoicic. "Arthroscopic partial medial meniscectomy." Vojnosanitetski pregled 68, no. 9 (2011): 774–78. http://dx.doi.org/10.2298/vsp1109774d.
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Background/Aim. Meniscal injuries are common in professional or recreational sports as well as in daily activities. If meniscal lesions lead to physical impairment they usually require surgical treatment. Arthroscopic treatment of meniscal injuries is one of the most often performed orthopedic operative procedures. Methods. The study analyzed the results of arthroscopic partial medial meniscectomy in 213 patients in a 24-month period, from 2006, to 2008. Results. In our series of arthroscopically treated medial meniscus tears we noted 78 (36.62%) vertical complete bucket handle lesions, 19 (8.92%) vertical incomplete lesions, 18 (8.45%) longitudinal tears, 35 (16.43%) oblique tears, 18 (8.45%) complex degenerative lesions, 17 (7.98%) radial lesions and 28 (13.14%) horisontal lesions. Mean preoperative International Knee Documentation Committee (IKDC) score was 49.81%, 1 month after the arthroscopic partial medial meniscectomy the mean IKDC score was 84.08%, and 6 months after mean IKDC score was 90.36%. Six months after the procedure 197 (92.49%) of patients had good or excellent subjective postoperative clinical outcomes, while 14 (6.57%) patients subjectively did not notice a significant improvement after the intervention, and 2 (0.93%) patients had no subjective improvement after the partial medial meniscectomy at all. Conclusion. Arthroscopic partial medial meniscetomy is minimally invasive diagnostic and therapeutic procedure and in well selected cases is a method of choice for treatment of medial meniscus injuries when repair techniques are not a viable option. It has small rate of complications, low morbidity and fast rehabilitation.
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Pizzo, Wilson Del, and James M. Fox. "Results of Arthroscopic Meniscectomy." Clinics in Sports Medicine 9, no. 3 (1990): 633–39. http://dx.doi.org/10.1016/s0278-5919(20)30713-4.
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Macnicol, M. F., and N. P. Thomas. "THE KNEE AFTER MENISCECTOMY." Journal of Bone and Joint Surgery. British volume 82-B, no. 2 (2000): 157–59. http://dx.doi.org/10.1302/0301-620x.82b2.0820157.
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McNicholas, M. J., D. I. Rowley, D. McGurty, et al. "Total meniscectomy in adolescence." Journal of Bone and Joint Surgery. British volume 82-B, no. 2 (2000): 217–21. http://dx.doi.org/10.1302/0301-620x.82b2.0820217.
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Pengas, I. P., A. Assiotis, W. Nash, J. Hatcher, J. Banks, and M. J. McNicholas. "Total meniscectomy in adolescents." Journal of Bone and Joint Surgery. British volume 94-B, no. 12 (2012): 1649–54. http://dx.doi.org/10.1302/0301-620x.94b12.30562.
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Lavender, Chad, Dana Lycans, Syed Ali Sina Adil, Adam Kopiec, and Thomas Schmicker. "Incisionless Partial Medial Meniscectomy." Arthroscopy Techniques 9, no. 3 (2020): e375-e378. http://dx.doi.org/10.1016/j.eats.2019.11.003.
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BRAGIMOV, Sadulla Yusupovich, and Xurshid Rabbimkulovich BEGIMOV. "RESULTS OF ARTHROSCOPIC MENISCECTOMY." Journal of biomedicine and practice 7, no. 2 (2022): 352–58. https://doi.org/10.5281/zenodo.6589578.
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The purpose of the study. Arthroscopic diagnosis in meniscal injuries and demonstrating the advantages of arthroscopic meniscectomy. Materials and methods. During the year, 429 patients with various injuries of the meniscus of the knee joint were observed in the Department of Large Orthopedics of the Samarkand Branch of the Republican Specialized Traumatology Scientific-Practical Medical Center of Orthopedics (RITOIATMSF). All of these underwent arthroscopic meniscectomy. The results of the study. Of these, 269 (62.7%) were men and 160 (37.3%) were women. The right knee meniscus was 254 (59.2%), the left knee meniscus was 110 (25.6%) and both knees. menisci were 65 (15.2%). Depending on the type of damage: Ruchka-leyka 136 (31.7%), longitudinal 122 (28.4%), clotted type 114 (26.6%), horizontal type 57 (13.3). damage to the peripheral part was 324 (75.5%) and damage to the central part was 165 (24.5%). Conclusions. According to our research, 94% of the results are excellent and show good results - the method of diagnosis and treatment of meniscal injuries using arthroscopy is highly effective, less traumatic to the internal elements of the joint, clearly shows pathology, does not keep the patient in the hospital, activates the patient faster and achieves relatively good results.
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Keeling, Laura, Alexandra Galel, Cooper Ehlers, David Wang, and Edward Chang. "Outcomes of Meniscal Repair versus Meniscectomy in Patients with Concomitant ACL and Bucket Handle Meniscus Tears (200)." Orthopaedic Journal of Sports Medicine 9, no. 10_suppl5 (2021): 2325967121S0030. http://dx.doi.org/10.1177/2325967121s00309.
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Objectives: Bucket handle meniscus tears often present concurrently with tears of the anterior cruciate ligament (ACL). However, little is known regarding the influence of demographic factors on surgical decision-making, or on outcomes following treatment of bucket handle meniscus tears in ACL-deficient patients. Furthermore, no study has compared outcomes in this population between patients undergoing meniscectomy versus repair. The purpose of this study was therefore to determine if there is a difference in outcomes between patients presenting with concomitant ACL and bucket handle meniscus tears treated with meniscal repair versus meniscectomy. A secondary aim of this study was to discover if there is an association between the decision to perform a meniscus repair or meniscectomy based on demographic factors. Methods: In this institutional review board-approved retrospective study, we evaluated 62 patients presenting with ACL tear who were found to have a bucket handle meniscus tear preoperatively or at the time of ACL reconstruction. Of those, 30 patients underwent partial meniscectomy, while 32 underwent meniscal repair. Primary outcome measures included ACL and meniscal retear rates, as well as patient-reported outcome measures (PROMs). Documented PROMs included the International Knee Documentation Committee (IKDC), Single Assessment Numeric Evaluation (SANE), and ACL-Return to Sport after Injury (ACL-RSI) scores. Demographic and patient-specific factors evaluated included age, body mass index (BMI), smoking status, and location of meniscus tear. Results: Of 62 patients presenting for ACL reconstruction with concomitant bucket handle meniscus tear, a total of 34 patients with greater than one year (mean 22.4 month) follow-up were included. 14 patients underwent repair, and 20 underwent meniscectomy. No significant differences were noted in IKDC (p = 0.36), delta IKDC (p = 0.18), SANE (p = 0.61), or ACL-RSI (p = 0.67) scores between the repair and meniscectomy groups at final follow-up. No significant differences were found in ACL (p = 1.00) or meniscus (p = 0.49) retear rates between the two groups. Younger age, lower BMI, and tear location (red-red zone) were significantly associated with the decision to perform meniscal repair over meniscectomy (p < 0.05). Conclusions: Among patients presenting with concomitant ACL and bucket handle meniscus tears, we found no difference in patient-reported outcomes or retear rates in patients undergoing meniscal repair versus meniscectomy. Demographic and patient-specific factors including age, BMI, and tear location may influence surgical decision-making when determining the optimal treatment of bucket handle meniscus tears in this population.
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Wu, W. Howard, Thomas Hackett, and John C. Richmond. "Effects of Meniscal and Articular Surface Status on Knee Stability, Function, and Symptoms after Anterior Cruciate Ligament Reconstruction." American Journal of Sports Medicine 30, no. 6 (2002): 845–50. http://dx.doi.org/10.1177/03635465020300061501.
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Background Concomitant injuries to secondary structures have been proposed as a major cause of failure of anterior cruciate ligament reconstruction. Purpose Our purpose was to determine the relationship between meniscal status at the time of anterior cruciate ligament reconstruction and ultimate long-term function and stability. Study Design Prospective cohort study. Methods We prospectively studied 63 patients for an average of 10.4 years after arthroscopically assisted bone-patellar tendon-bone anterior cruciate reconstruction. All surgeries were performed between 1988 and 1991; concomitant meniscal surgery was performed if necessary. Subjects were divided into subgroups relative to the integrity of their menisci at the end of the reconstruction procedure (intact meniscus, partial meniscectomy, complete meniscectomy). Results Patients who had undergone any degree of meniscal resection reported significantly more subjective complaints and activity limitations than those with intact menisci. Subjective International Knee Documentation Committee and Lysholm scores were lower in the meniscectomy subgroups than in the meniscus-intact group. Objective testing revealed a significantly lower ability to perform the single-legged hop in the meniscectomy subgroups. Ligament stability based on instrumented laxity measurements was not significantly different between the subgroups. Radiographic abnormalities were also more common in the subgroups that had undergone meniscectomy. Conclusions The menisci should be repaired if at all possible, especially in the setting of anterior cruciate ligament reconstruction, for optimal functional outcome and patient satisfaction.
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Alzubady, Ihssan. "Arthroscopic partial meniscectoy( Short term clinical result)." AL-QADISIYAH MEDICAL JOURNAL 7, no. 11 (2017): 45–52. http://dx.doi.org/10.28922/qmj.2011.7.11.45-52.
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A Prospective clinical study , done in the orthopedic department of Aldiwanyia teaching hospital in the last year after introduction of arthroscopy in our hospital, including 30 patients with isolated traumatic meniscus injury , all of them are male, mean age was (27.5)year. All patients were under clinical assessment and MRI examination prior to the surgery to exclude other intra-articular lesion (cruciate ligaments injury or cartilage damage). Surgery done for them, which including diagnostic arthroscopy to confirm the diagnosis and then, partial arthroscopic meniscectomy done( 19 patients, medial partial meniscectomy. 11 patients, lateral partial meniscectomy). Each knee was classified 3 months after surgery as excellent, good, fair and poor result using criteria based on Hoover classification. There were 16 patients with excellent result (53.3%), 8 patients with good result(26.6%), 3 patients with fair result (10%),and 3 patients with poor result(1o%). From overall results, we conclude that, that, our arthroscopic partial meniscectomy gives comparable results with the same surgery done outside our country, on short term follow up.
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Smith, Patrick A., Will A. Bezold, Cristi R. Cook, et al. "Kinematic Analysis of Lateral Meniscal Oblique Radial Tears in Anterior Cruciate Ligament–Reconstructed Knees: Untreated Versus Repair Versus Partial Meniscectomy." American Journal of Sports Medicine 50, no. 9 (2022): 2381–89. http://dx.doi.org/10.1177/03635465221102135.
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Background: Lateral meniscal oblique radial tears (LMORTs) affect joint and meniscal stability in anterior cruciate ligament (ACL)–deficient knees. Purpose: To determine the clinically relevant kinematics associated with the most common posterior horn LMORT lesion types, types 3 (LMORT3) and 4 (LMORT4), untreated versus arthroscopic repair versus partial meniscectomy in combination with ACL reconstruction (ACLR). Study: Controlled laboratory study. Methods: Sixteen cadaveric knees underwent robotic testing for anterior drawer and pivot-shift simulations at multiple knee flexion angles in ACL-intact and ACL-deficient states, followed by sequential testing of arthroscopic ACLR, LMORT3 lesion, LMORT3 repair, and partial meniscectomy (n = 8). The same testing sequence was performed for LMORT4 lesions (n = 8). Results: ACLR restored kinematics in ACL-deficient knees to intact levels for all metrics tested. For anterior drawer, ACLR + LMORT3 tear and partial meniscectomy resulted in significantly greater anterior translation compared with ACL-intact at all angles ( P < .05) and compared with ACLR at 60° and 90° ( P < .014). For pivot shift, compared with ACL-intact knees, ACLR + LMORT3 tear resulted in significantly more anterior translation at 15° ( P = .041); and for ACLR + partial meniscectomy, at both 0° and 15° ( P < .03). ACLR + LMORT4 tear and partial meniscectomy resulted in significantly greater anterior translation for anterior drawer ( P < .04) and pivot-shift testing ( P < .05) compared with intact and ACLR knees at all angles tested. ACLR + LMORT3 repair and ACLR + LMORT4 repair restored kinematics to ACLR and intact levels at all angles tested. ACLR + LMORT3 tear ( P < .008) and both LMORT4 tear and partial meniscectomy ( P < .05) resulted in increased meniscal extrusion compared with intact and ACLR statuses at all tested angles for anterior drawer and pivot shift, while repairs restored meniscal stability to ACLR and intact levels. Conclusion: Untreated LMORT tears increased anterior translation, pivot shift, and meniscal extrusion after ACLR, while partial meniscectomy further exacerbated these detrimental effects in this cadaveric model. In contrast, arthroscopic side-to-side repair of LMORT lesions effectively restored measured knee kinematics. Clinical Relevance: LMORT lesions are common with ACL tears and adversely affect joint stability and meniscal extrusion. This study highlights the importance of repair of LMORT 3 and 4 lesions at the time of ACLR.
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Duethman, Nicholas, Lucas Keyt, Ryan Wilbur, Bryant Song, Matthew LaPrade, and Aaron Krych. "Midterm Outcomes of Isolated Lateral Meniscus Tears in Young Patients (167)." Orthopaedic Journal of Sports Medicine 9, no. 10_suppl5 (2021): 2325967121S0028. http://dx.doi.org/10.1177/2325967121s00289.
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Objectives: The current literature lacks evidence to guide treatment of isolated lateral meniscus tears in young patients. Accordingly, the purpose of this study was to describe our institutional experience in young patients with lateral meniscus tear with regard to i) treatment trends in meniscectomy and repair ii) long-term patient reported and radiographic outcomes, and iii) failure rates and associated patient and treatment factors. Methods: Patients <26 years of age who underwent surgery for lateral meniscus tears between 2001 and 2017. Patients with ligamentous injury or prior surgeries in the same knee were excluded. Records were reviewed to obtain patient demographics, injury characteristics, surgical details, reoperation rates, repeat imaging, and patient outcome scores. Statistical analysis compared treatment trends over time. Patient reported outcomes (PROs), imaging outcomes, and failure rates were compared by treatment modality. Failure was defined as reoperation, symptomatic osteoarthritis, or IKDC <75. Simple logistic regressions were calculated to predict failure and IKDC based on treatment, type of tear, location of tear, or amount of meniscus removed. Results: 226 knees in 217 patients were identified with average clinical follow-up of 3.2 years. Our cohort consisted of 158 male patients, and average age was 17.4 years (7-25). 138 patients (144 knees) were treated with meniscectomy (partial to complete) (64%) and 79 patients (82 knees) were treated with repair (36%). Repair rates compared to meniscectomy (any degree) increased over time with 63% of lateral meniscus tears from 2013-2017 treated with repair compared to 23% from 2001 -2004 ( P = <.0001). IKDC scores in the meniscectomy group increased from 76.3 ± 9.1 pre-operatively to 97.2 ± 3.9 post-operatively ( P = <.0001) and increased in the repair group from 71.0 ± 11.5 pre-operatively to 97.4 ± 4.1 post-operatively ( P = <.0001).The change in IKDC score was greater in repair (26.0 ± 12.3) than meniscectomy (21.1 ± 9.8) ( P = .002). Reoperation rates in meniscectomy (20%) and repair (20%) were similar ( P = .910). Pre-operative IKDC scores were lower in the repair group ( P = .001), but final IKDC scores were similar ( P = 0.695). Symptomatic OA was noted in 17 patients in the meniscectomy group (22%) and 5 patients in the repair group (11%) ( P = .121). The failure rate was similar between meniscectomy (35%) and repair (28%) ( P = .307). Regression equations evaluating treatment modality, type and location of tear, and amount of meniscus removed did not reach significance in predicting IKDC or failure. Conclusions: In this cohort of young patients with isolated lateral meniscus tears, rate of repair increased over time. IKDC scores improved more in the repair group compared to the meniscectomy patients, however IKDC scores obtained at final follow-up were similar. Rates of symptomatic OA, reoperation, and failure were similar between groups. Treatment modality, type and location of tear, and amount of meniscus removed were not predictive of final IKDC or failure.
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Peña, Estefania, Begoña Calvo, Miguel Angel Martinez, Daniel Palanca, and Manuel Doblaré. "Why lateral meniscectomy is more dangerous than medial meniscectomy. A finite element study." Journal of Orthopaedic Research 24, no. 5 (2006): 1001–10. http://dx.doi.org/10.1002/jor.20037.
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Brooks, Charles N. "Rating Repeat Partial Meniscectomies, Unoperated Meniscal Tears, and Meniscal Repairs." Guides Newsletter 26, no. 1 (2021): 3–6. http://dx.doi.org/10.1001/amaguidesnewsletters.2021.janfeb01.
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Abstract Rating repeat partial meniscectomies, unoperated meniscal tears, and meniscal repairs requires thoughtful clinical assessment and application of directives provided in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). Although the AMA Guides provide a specific impairment value for a partial meniscectomy, repeat meniscectomies may result in further impairment not to exceed the maximum value assigned for a total meniscectomy.
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Nishida, Yohei, Yusuke Hashimoto, Kumi Orita, Kazuya Nishino, Takuya Kinoshita та Hiroaki Nakamura. "Intra-Articular Injection of Stromal Cell-Derived Factor 1α Promotes Meniscal Healing via Macrophage and Mesenchymal Stem Cell Accumulation in a Rat Meniscal Defect Model". International Journal of Molecular Sciences 21, № 15 (2020): 5454. http://dx.doi.org/10.3390/ijms21155454.
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The stromal-cell-derived factor-1α (SDF-1) is well-known for playing important roles in the regeneration of tissue by enhancing cell migration. However, the effect of SDF-1 in meniscal healing remains unknown. The purpose of this study is to investigate the effects of intra-articular injection of SDF-1 on meniscus healing in a rat meniscal defect model. The intra-articular SDF-1 injection was performed at meniscectomy and one week later. Macroscopic and histological assessments of the reparative meniscus were conducted at one, two and six weeks after meniscectomy in rats. In the macroscopic evaluation, the SDF-1 group showed an increase in the size of the reparative meniscus at six weeks after meniscectomy compared to the phosphate-buffered saline (PBS) injection (no-treatment) group. Histological findings showed that intra-articular injection of SDF-1 enhanced the migration of macrophages to the site of the regenerative meniscus at one and two weeks after meniscectomy. CD68- and CD163-positive cells in the SDF-1 group at one week after meniscectomy were significantly higher than in the no-treatment group. CD163-positive cells in the SDF-1 group at two weeks were significantly higher than in the no-treatment group. At one week after meniscectomy, there were cells expressing mesenchymal-stem-cell-related markers in the SDF-1 group. These results indicate the potential of regenerative healing of the meniscus by SDF-1 injection via macrophage and mesenchymal stem cell accumulation. In the present study, intra-articular administration of SDF-1 contributed to meniscal healing via macrophage, CD90-positive cell and CD105-positive cell accumulation in a rat meniscal defect model. The SDF-1–CXCR4 pathway plays an important role in the meniscal healing process. For potential clinical translation, SDF-1 injection therapy seems to be a promising approach for the biological augmentation in meniscal injury areas to enhance healing capacity.