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Article ; Online: Meniscal repair and reconstruction.

Jarit, Gregg J / Bosco, Joseph A

Bulletin of the NYU hospital for joint diseases

2010 Volume 68, Issue 2, Page(s) 84–90

Abstract: ... allografts, scaffolds, collagen implants, and repair enhancements. The common goal of these newer techniques ... to review the various techniques and history of meniscus repair as well as examine of the newer techniques ... with partial menisectomy, there are an increasing number of surgical techniques to repair or reconstruct ...

Abstract	Meniscus injuries are one of the most commonly encountered problems by orthopaedic surgeons today. Surgical techniques for the treatment of meniscal tears are evolving. While many tears can only be treated with partial menisectomy, there are an increasing number of surgical techniques to repair or reconstruct the meniscus. Because of the large increases in contact pressures across the articular cartilage due to loss of meniscal tissue, there has been increased focus on preventing the development of degenerative joint disease from meniscal injuries requiring partial or subtotal menisectomy. Some of these newer techniques include allografts, scaffolds, collagen implants, and repair enhancements. The common goal of these newer techniques is to preserve or restore as much normal, functioning meniscal tissue as possible. This review aims to review the various techniques and history of meniscus repair as well as examine of the newer techniques being introduced to reconstruct or replace the meniscus.
MeSH term(s)	Humans ; Knee Injuries/diagnosis ; Knee Injuries/surgery ; Lacerations ; Menisci, Tibial/surgery ; Orthopedic Procedures/adverse effects ; Tibial Meniscus Injuries ; Treatment Outcome
Language	English
Publishing date	2010
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	390411-8
ISSN	1936-9727 ; 2328-5273 ; 1936-9719 ; 0018-5647 ; 0883-9344 ; 2328-4633
ISSN (online)	1936-9727 ; 2328-5273
ISSN	1936-9719 ; 0018-5647 ; 0883-9344 ; 2328-4633
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Article: A Convergent Tibial Tunnel Technique for Concomitant Anterior Cruciate Ligament Reconstruction and Meniscal Root Repair.

Hui, Catherine / Salipas, Andrew / Cavanagh, Joseph

Arthroscopy techniques

2024 Volume 13, Issue 4, Page(s) 102918

Abstract: Modern arthroscopic knee-reconstruction techniques involve the use of multiple bone tunnels and ... to allow fixation of both anterior cruciate ligament graft and meniscal roots through convergence ... with meniscal root repairs or multiligament reconstructions. We describe a multiple tibial tunnel technique ...

Abstract	Modern arthroscopic knee-reconstruction techniques involve the use of multiple bone tunnels and fixation devices to restore the anatomy and stability of the knee after traumatic injury. In these injuries, however, tunnel collision can be problematic, especially when combining anterior cruciate ligament reconstruction with meniscal root repairs or multiligament reconstructions. We describe a multiple tibial tunnel technique to allow fixation of both anterior cruciate ligament graft and meniscal roots through convergence to a single tibial cortical aperture.
Language	English
Publishing date	2024-02-16
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2653101-X
ISSN	2212-6287
ISSN	2212-6287
DOI	10.1016/j.eats.2024.102918
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Article: Anchor-Based Meniscal Ramp Repair.

Benson, Elizabeth Marks / Wood, Audria / Harris, Chandler / Smith, Patrick / Xerogeanes, John / Casp, Aaron / Momaya, Amit

Arthroscopy techniques

2024 Volume 13, Issue 2, Page(s) 102846

Abstract: ... to describe an all-suture anchor-based repair of a meniscal ramp lesion, which confers several advantages over ... persistent pivot shift, and poorer outcomes after ACL reconstruction. The purpose of this article is ... Failure to repair the ramp lesion is associated with increased rotational laxity, tibial translocation ...

Abstract	Ramp lesions of the medial meniscus are underdiagnosed because of difficulty in visualizing via magnetic resonance imaging and during arthroscopy. They most often occur simultaneously with anterior cruciate ligament (ACL) injury but may also be associated with posterior plateau contusions, steeper medial tibial plateau slope, and excess varus alignment. Upwards of 24% of ACL reconstructions have concomitant ramp lesions. Failure to repair the ramp lesion is associated with increased rotational laxity, tibial translocation, persistent pivot shift, and poorer outcomes after ACL reconstruction. The purpose of this article is to describe an all-suture anchor-based repair of a meniscal ramp lesion, which confers several advantages over traditional repair techniques.
Language	English
Publishing date	2024-01-01
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2653101-X
ISSN	2212-6287
ISSN	2212-6287
DOI	10.1016/j.eats.2023.09.021
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Article ; Online: Clinical Outcomes of Different Management Techniques for Medial Meniscal Type 3 Ramp Lesions in Anterior Cruciate Ligament Reconstruction: A Comparative Analysis Between All-inside Repair, Suture Hook Repair, and Lesions Left In Situ.

Saint-Etienne, Adrien / Benhenneda, Rayane / Vieira, Thais Dutra / Fayard, Jean-Marie / Thaunat, Mathieu

The American journal of sports medicine

2024 Volume 52, Issue 5, Page(s) 1250–1257

Abstract: ... Tegner score, and meniscal repair failure rate.: Results: A total of 113 patients who underwent type 3 ... repair, and left in situ. The following data were collected preoperatively and at the last follow-up ... 20.4%) in the suture hook repair group, and 38 (33.6%) in the lesion left in situ group. There were ...

Abstract	Background: There is ongoing debate about the best way to manage ramp lesions at the time of anterior cruciate ligament (ACL) reconstruction (ACLR). Type 3 lesions are not visible by the transnotch approach without superior debridement, making the management debate even more problematic. Purpose/hypothesis: The purpose of this study was to evaluate the rate of secondary surgical interventions according to the management method of a type 3 ramp lesion concomitant with primary ACLR. The hypothesis was that the rate of secondary ACL or meniscal interventions would be higher in patients who underwent all-inside repair. Study design: Cohort study; Level of evidence, 3. Methods: A retrospective analysis of all patients who underwent primary ACLR with a type 3 ramp lesion between January 2012 and May 2020, regardless of the treatment method, was performed. The main criterion analyzed in this cohort was a secondary surgical intervention, defined as revision ACLR or a reintervention of the repaired meniscus. A survivorship analysis was performed to evaluate secondary surgical interventions in 3 groups: all-inside repair, suture hook repair, and left in situ. The following data were collected preoperatively and at the last follow-up: patient characteristics, time to surgery, side-to-side difference in laxity, pivot shift, Lysholm score, subjective International Knee Documentation Committee score, Knee injury and Osteoarthritis Outcome Score, Tegner score, and meniscal repair failure rate. Results: A total of 113 patients who underwent type 3 ramp lesion repair concomitant with ACLR were included: 52 (46.0%) in the all-inside repair group, 23 (20.4%) in the suture hook repair group, and 38 (33.6%) in the lesion left in situ group. There were 17 patients (15.0%) who underwent a secondary intervention because of ACL graft failure (n = 6) or meniscal repair failure (n = 15 [4 of whom underwent a concomitant ACL reintervention]). Overall, 62 patients (54.9%) underwent combined ACLR and anterolateral ligament reconstruction, while 51 patients (45.1%) underwent isolated ACLR. In the adjusted Cox model, the type of meniscal repair was not statistically significantly associated with secondary surgical interventions. The only risk factor for secondary surgical interventions in this cohort was isolated ACLR (hazard ratio, 8.077; Conclusion: The rates of secondary surgical interventions after medial meniscal type 3 ramp lesion repair concomitant with ACLR were similar regardless of the management method of the meniscal lesion. Despite not being associated with meniscal treatment, this rate was 8 times higher for patients who underwent isolated ACLR in this cohort; this is probably because of the protection that lateral extra-articular procedures provide to the ACL graft.
MeSH term(s)	Humans ; Retrospective Studies ; Cohort Studies ; Anterior Cruciate Ligament Injuries/surgery ; Anterior Cruciate Ligament Injuries/pathology ; Menisci, Tibial/surgery ; Menisci, Tibial/pathology ; Knee Joint/surgery ; Anterior Cruciate Ligament Reconstruction/methods ; Sutures
Language	English
Publishing date	2024-03-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	197482-8
ISSN	1552-3365 ; 0363-5465
ISSN (online)	1552-3365
ISSN	0363-5465
DOI	10.1177/03635465241232088
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Article ; Online: Comparison of anterior cruciate ligament reconstruction with and without concomitant meniscal repair

Arya A / Kumar SD / Rajkumar V / Sudhan SR

Journal of Medical and Scientific Research, Vol 11, Iss 4, Pp 315-

A prospective comparative study

2023 Volume 322

Abstract: ... injury, though commonly followed is menisectomy, meniscal repair has gained popularity and success ... which necessitates the analysis of outcome between ACL-R + meniscal repair and ACL-R + menisectomy as clear consensus ... lateral meniscus in south Indian population at a single center. Where meniscal repair (61) and menisectomy (partial ...

Abstract	Background: The treatment of anterior cruciate ligament (ACL) injury includes ACL reconstruction (ACL-R) or ligament preservation, where the former is considered the gold standard. But in meniscal injury, though commonly followed is menisectomy, meniscal repair has gained popularity and success which necessitates the analysis of outcome between ACL-R + meniscal repair and ACL-R + menisectomy as clear consensus have not been established so far in deciding the better overall procedure with respect to function. Methods: This is a prospective, comparative study done in 122 patients with ACL injury and medial/ lateral meniscus in south Indian population at a single center. Where meniscal repair (61) and menisectomy (partial/complete, n=61) with ACL-R were carried out and were evaluated pre-operatively, during the postoperative period at 6 weeks, 3 months, and 6 months of follow-up for function and compared. The primary outcome evaluated was pain and other symptoms like limping, giving way, swelling and locking were also noted and analysed using KOOS, IKDC and Lysholm scores. Results: The mean difference in KOOS score in postoperative period, at 3 and 6months were significantly higher among the ACL-R + meniscal repair group than the ACL-R + meniscectomy group which is statistically significant. Moreover the median percentage change in IKDC and Lysholm scores from baseline to postoperative 3 and 6 months were significantly higher in ACL-R + meniscal repair group than the other. Conclusion: The meniscal repair with ACL-R has a lower failure rate and shows better functional outcomes than the other group which underwent ACL-R and meniscectomy.
Keywords	anterior cruciate ligament reconstruction ; acl-r ; meniscectomy ; meniscal repair ; meniscal tear ; Medicine (General) ; R5-920
Subject code	796
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	KIMS Foundation and Research Center
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Meniscal Ramp Lesion Repair Without the Need for a Posteromedial Portal.

Gómez Cáceres, Abel / Mariño, Iskandar Tamimi / Martínez Malo, Francisco Javier / Riestra, Ignacio Vieitez / Idiart, Raphael Pierre

Arthroscopy techniques

2024 Volume 13, Issue 4, Page(s) 102902

Abstract: ... when these injuries are small and stable. They have historically been repaired using an outside-in technique using ... in anterior cruciate ligament reconstruction varies between 9% and 40% according to different studies. Ramp lesions cannot always be diagnosed ... all authors advocate systematically repairing ramp injuries of the medial meniscus, especially ...

Abstract	Medial meniscal ramp injury has gained the attention of orthopaedic surgeons in recent years. It consists of a tear of the peripheral insertion of the posterior horn of the medial meniscus. Its prevalence in anterior cruciate ligament reconstruction varies between 9% and 40% according to different studies. Ramp lesions cannot always be diagnosed using magnetic resonance imaging scans. To identify ramp lesions, the arthroscope should be introduced into the posteromedial compartment of the knee during the routine examination of the knee (Gillquist maneuver). Not all authors advocate systematically repairing ramp injuries of the medial meniscus, especially when these injuries are small and stable. They have historically been repaired using an outside-in technique using a hook-type suture passed through a posteromedial portal. In this study, we present our all-inside suture technique without the use of a posteromedial portal.
Language	English
Publishing date	2024-01-01
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2653101-X
ISSN	2212-6287
ISSN	2212-6287
DOI	10.1016/j.eats.2023.102902
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Article: Influence of Meniscal Repair vs. Meniscectomy on Anterior Cruciate Ligament Reconstruction in Terms of Knee Stability and Radiological Imaging.

Agarwal, Varun / Kale, Amit / Khandge, Ashwinkumar

Cureus

2023 Volume 15, Issue 8, Page(s) e43396

Abstract: ... the influence of meniscal repair as compared to meniscectomy on anterior cruciate ligament reconstruction ... repair was performed on 14 patients (group 1). At the end of six months in group 1, one patient out of 14 ... The study concluded that meniscus repair significantly increases anteromedial knee stability. It has been ...

Abstract	The menisci are essential components in the pathophysiology of knee osteoarthritis. Patients with meniscal lesions and an intact anterior cruciate ligament (ACL) undergoing meniscectomy exhibit a significantly increased prevalence of radiographic osteoarthritis. ACL reconstruction surgery enhances knee stability and mitigates the advancement of minor meniscal tears. The purpose of this study was to show the influence of meniscal repair as compared to meniscectomy on anterior cruciate ligament reconstruction in terms of knee stability and radiological imaging. This was a retrospective study performed in Dr. D.Y. Patil Hospital, Pimpri, Pune, on a sample size of 30 patients between December 2021 and January 2023. Patients were followed up clinically and radiologically post-operatively at six months and one year. ACL reconstruction with meniscectomy was performed on 16 patients (group 2), while ACL reconstruction with meniscus repair was performed on 14 patients (group 1). At the end of six months in group 1, one patient out of 14 had a grade 2 Lachman test positive, while seven patients out of 16 had a grade 2 Lachman test positive in group 2. It was a statistically insignificant value (p>0.05). Further, at the end of 12 months, X-ray evaluation of the femoral tunnel shows an average increment of 0.5 mm in Group 1, while an average femoral tunnel widening of 3 mm was observed in Group 2. It was statistically insignificant (p>0.05). The study concluded that meniscus repair significantly increases anteromedial knee stability. It has been shown that meniscectomy, when done along with ACL reconstruction, increases the chances of femoral tunnel widening, resulting in less graft bone integration.
Language	English
Publishing date	2023-08-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.43396
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Article ; Online: Posterior Cruciate Ligament Reconstruction With Quadriceps Tendon Autograft and Concomitant Meniscal Ramp Repair

Mark A. Glover BS / Thomas W. Mason BS / Benjamin S. Albertson MD / Nicholas A. Trasolini MD / Brian R. Waterman MD

Video Journal of Sports Medicine, Vol

2024 Volume 4

Abstract: ... All-inside meniscal ramp repair and quadriceps tendon autograft PCL reconstruction have been described in isolation ... over the tibial button. A medial meniscal ramp tear was also identified and repaired ... with a PCL rebound brace. Due to the meniscal ramp repair, toe touch weightbearing with the knee in extension ...

Abstract	Background: Quadriceps autograft, though well established for anterior cruciate ligament reconstruction, is underutilized in posterior cruciate ligament (PCL) reconstruction largely due to slow adoption. All-inside meniscal ramp repair and quadriceps tendon autograft PCL reconstruction have been described in isolation, but not concomitantly in a video journal. Indications: PCL reconstruction is indicated in grade 3 isolated tears with instability that have not improved with nonoperative management and in instances with associated injuries such as meniscal ramp tears, as observed in this 18-year-old division I football player. Graft selection is dependent upon surgeon and patient preference, with quadriceps autograft delivering a viable option with desirable long-term outcomes. Technique Description: A partial-thickness quadriceps tendon autograft was harvested, the remnant PCL stump was debrided, and a reamer was used to drill the all-inside tibial tunnel for traction suture passage. An accessory low anterolateral portal was utilized to drill the femoral tunnel for passage of the femoral traction stitch. Traction sutures were withdrawn, and the graft was passed into the tibia, docked into the femur, fixated with an interference screw, and tensioned over the tibial button. A medial meniscal ramp tear was also identified and repaired in all-inside fashion with a 90° SutureLasso, polydioxanone suture (PDS), and suturetape via standard arthroscopic knot tying. Following the procedure, the patient began a PCL reconstruction rehabilitation protocol with a PCL rebound brace. Due to the meniscal ramp repair, toe touch weightbearing with the knee in extension during ambulation was completed for 6 weeks. Physical therapy (PT) focused on early quadriceps and patellar mobilization as well as active-assisted range of motion exercises. Results: At 6 months postoperation, the patient continued to progress in PT without major concerns. A full recovery and return to sport are expected approximately 9 to 12 months after surgery, ...
Keywords	Sports medicine ; RC1200-1245 ; Orthopedic surgery ; RD701-811
Subject code	796
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Comparison of Functional Outcomes after Anterior Cruciate Ligament Reconstruction with Meniscal Repair for Unstable versus Stable Meniscal Tears.

Lee, Jin Hyuck / Lee, Gyu Bin / Chung, WooYong / Wang, Ji Won / Han, Sun Gyu / Rhim, Hye Chang / Han, Seung-Beom / Jang, Ki-Mo

Diagnostics (Basel, Switzerland)

2024 Volume 14, Issue 9

Abstract: ... anterior cruciate ligament reconstruction (ACLR) with meniscal repair for unstable (root and radial tears) and stable (longitudinal ... with ACLR with meniscal repair for unstable meniscal tears and 35 with ACLR with meniscal repair for stable ... horizontal, and bucket handle tears) meniscal tears. A total of 76 patients were randomly selected (41 ...

Abstract	This study aimed to compare functional outcomes including knee muscle strength in the quadriceps and hamstrings, and proprioception, assessed through dynamic postural stability (overall stability index [OSI]) and self-reported outcomes in the operated and non-operated knees between anterior cruciate ligament reconstruction (ACLR) with meniscal repair for unstable (root and radial tears) and stable (longitudinal, horizontal, and bucket handle tears) meniscal tears. A total of 76 patients were randomly selected (41 with ACLR with meniscal repair for unstable meniscal tears and 35 with ACLR with meniscal repair for stable meniscal tears) at three different time points (preoperative, 6 months, and 12 months). Repeated measures analysis of variance was used to investigate the differences in outcomes for between-subject and within-subject factors. In the operated knees, there were no significant differences for functional outcomes between the two groups (all
Language	English
Publishing date	2024-04-23
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics14090871
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Article ; Online: Steep Posterior Tibial Slope and Excessive Anterior Tibial Translation Are Associated With Increased Sagittal Meniscal Extrusion After Posterior Lateral Meniscus Root Repair Combined With Anterior Cruciate Ligament Reconstruction.

Zhang, Zheng-Zheng / Zhang, Hao-Zhi / Jiang, Chuan / Yang, Rui / Chen, Zhong / Song, Bin / Li, Wei-Ping

Arthroscopy, sports medicine, and rehabilitation

2024 Volume 6, Issue 2, Page(s) 100881

Abstract: ... anterior cruciate ligament reconstruction (ACLR) with type II posterior lateral meniscus root tear (PLMRT) repair and (2) identify ... in PTS, ATSLC, and coronal LME.: Conclusions: Clinical outcomes after type II PLMRT repair ... repair of type II PLMRT injuries, the presence of sagittal LME was associated with increased PTS and ...

Abstract	Purpose: To (1) evaluate the clinical and radiographic outcomes of patients with primary anterior cruciate ligament reconstruction (ACLR) with type II posterior lateral meniscus root tear (PLMRT) repair and (2) identify whether increased anterior tibial subluxation of the lateral compartment (ATSLC) and steeper posterior tibial slope (PTS) are associated with sagittal lateral meniscal extrusion (LME). Methods: Patients who underwent primary anatomic ACLR with concomitant type II PLMRTs using the all-inside side-to-side repair technique between November 2014 and September 2020 were identified. To be included, patients must have had a minimum of 2 years follow-up. All patients, including those with ATSLC and PTS and sagittal and coronal LME, were retrospectively reviewed clinically and radiologically. The patients were divided into 2 subgroups according to the occurrence of sagittal LME. Results: Forty patients were included in this study with a mean follow-up of 44 months (range, 24-94 months). In general, the postoperative parameters, including grade of pivot shift, side-to-side difference, ATSLC, Lysholm score, and International Knee Documentation Committee (IKDC) score, were significantly improved compared with the preoperative ones. However, postoperative sagittal LME was detected to be significantly larger than the preoperative one. Minimal clinically important difference (MCID) analysis for postoperative outcomes showed that the rate of patients who achieved MCID thresholds was 100% for Lysholm, 95% for IKDC, 42.50% for coronal LME, 62.50% for sagittal LME, 40% for ATSLC, and 100% for side-to-side difference. Further comparisons, where patients were divided into 2 subgroups according to the occurrence of sagittal LME, showed significant differences in PTS, ATSLC, and coronal LME. Conclusions: Clinical outcomes after type II PLMRT repair with primary ACLR were significantly improved, except for LME, at the 2-year postoperative follow-up. After repair of type II PLMRT injuries, the presence of sagittal LME was associated with increased PTS and ATSLC. Level of evidence: Level III, retrospective cohort study.
Language	English
Publishing date	2024-02-01
Publishing country	United States
Document type	Journal Article
ISSN	2666-061X
ISSN (online)	2666-061X
DOI	10.1016/j.asmr.2023.100881
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