macerated meniscus treatment
However, evaluation by absolute value alone may be limited due to differences in implant size, bone and cartilage condition, and individual patient characteristics. Here's what to expect from. Become a Gold Supporter and see no third-party ads. Osteoarthritis Cartilage 13(7):568574, Chan KKW, Sit RWS, Wu RWK, Ngai AHY (2014) Clinical, radiological and ultrasonographic findings related to knee pain in osteoarthritis. Osteoarthritis Cartilage. Am J Sports Med 47(12):28882894, Delinc P, Ghafil D (2012) Anterior cruciate ligament tears: conservative or surgical treatment? Orthop J Sports Med 9(3):2325967121989678, Koga H, Watanabe T, Horie M, Katagiri H, Otabe K, Ohara T et al (2017) Augmentation of the pullout repair of a medial meniscus posterior root tear by arthroscopic centralization. 3). Although in mild/moderate knee OA there is still no specific treatment targeting ME, the established conservative and operative treatment modalities seem equally successful in delaying the progression of OA and improving symptoms when ME is also present. WebOne of the main tests for meniscus tears is the McMurray test. A longitudinal tear is an example of this kind of tear. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. This post will carry two messages, both equally important. Chin Med J (Engl) 132(21):25502558, Goto N, Okazaki K, Akiyama T, Akasaki Y, Mizu-uchi H, Hamai S et al (2019) Alignment factors affecting the medial meniscus extrusion increases the risk of osteoarthritis development. https://doi.org/10.1055/s-0040-1710377, Monllau JC, Ibaez M, Masferrer-Pino A, Gelber PE, Erquicia JI, Pelfort X (2017) Lateral capsular fixation: an implant-free technique to prevent meniscal allograft extrusion. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. Degenerative lesions of the knee joint are more commonly present during concurrent ACLR with meniscectomy than with intact or repaired menisci. Arthrosc Tech 6(2):e269e274, Ahn JH, Kang HW, Yang TY, Lee JY (2016) Multivariate analysis of risk factors of graft extrusion after lateral meniscus allograft transplantation. Lateral wedge insoles have been found to reduce MME and could also supplement a conservative treatment of knee OA, as they could potentially delay the degenerative process [50]. However, it is still controversial whether meniscal pathology leads to osteoarthritis (OA), or vice versa. See this post to learn more about how a meniscus functions, As mentioned in my recent post, the majority of posterior horn tears are determined to be degenerative. occasionally a surgery we refer to as an arthroscopy. MPRT should be repaired earlier than 3months after diagnosis. 2023 BioMed Central Ltd unless otherwise stated. Am J Sports Med 42(10):23292337, Jauregui JJ, Wu ZD, Meredith S, Griffith C, Packer JD, Henn RF (2018) How should we secure our transplanted meniscus? an assessment by MRI and arthroscopy. Diagnosis and management of meniscal injury. PubMed Central Is the ketogenic diet right for autoimmune conditions? It is a very common injury, especially among people who play sports. 2017;12(1):e0170710. For these reasons, certain contraindications have been introduced (Table 2) [102, 103, 105,106,107,108,109]. Google Scholar, Kim SJ, Choi CH, Chun YM, Kim SH, Lee SK, Jang J et al (2017) Relationship between preoperative extrusion of the medial meniscus and surgical outcomes after partial meniscectomy. Moreover, extrusion of the LM does not improve after ACLR unless the meniscal tear is repaired [87, 92]. Based on these findings, they concluded that the all-inside repair of the radial tear of the LM could help maintain its dynamic behavior, thus reducing the biomechanical stress exerted on the adjacent cartilage [89]. While many studies have shown a positive association [35,36,37,38], other studies investigating the association between ultrasound features, including ME, and pain in a series of osteoarthritic knees found no correlation between pathological ME (>3mm) and pain in knee OA. Arthroscopy 30(11):14241429, Merkely G, Ogura T, Ackermann J, Mestriner AB, Minas T, Gomoll AH (2019) Open meniscal allograft transplantation with transosseous suture fixation of the meniscal body significantly decreases meniscal extrusion rate compared with arthroscopic technique. Winkler. Beaufils P, et al. Arthritis Rheum 64(6):18881898, Kim DH, Lee GC, Kim HH, Cha DH (2020) Correlation between meniscal extrusion and symptom duration, alignment, and arthritic changes in medial meniscus posterior root tear: research article. People with arthritis in their knees are also more prone to meniscus tears. Most people fully recover from a torn meniscus and can get back to doing their favorite activities without knee pain. Am J Roentgenol 216(5):13181328, Teichtahl AJ, Cicuttini FM, Abram F, Wang Y, Pelletier JP, Dodin P et al (2017) Meniscal extrusion and bone marrow lesions are associated with incident and progressive knee osteoarthritis. A torn meniscus is a very common knee injury. A doctor can do physical and imaging tests, such as an X-ray or MRI, to determine what kind of damage you have and discuss possible treatment options with you. In addition, given that the presence of severe ME promotes rapid progression of knee OA [44, 45], the importance of inhibiting this process and delaying the inevitable total knee replacement (TKR) is critical. Therefore, they suggested that this type of OA patient, with MME and varus malalignment with a low MPTA, could benefit primarily from an early intervention with high tibial osteotomy (HTO), thus delaying the progression of knee OA. It has been shown from studies that the risk for TKA after ACLR is seven timesgreater than in normal individuals [88]. The knee is the largest and most complex joint in the body, holding together the thigh bone, shin bone, fibula (on the outer side of the shin), and, Torn meniscus is perhaps the most common type of knee injury in which a ligament in the knee becomes lacerated, affecting stability and causing pain, Locked knee refers to an inability to either bend or straighten the knee. These are the knee compression sleeves we recommend for stability during exercise. National Institute of Arthritis and Musculoskeletal and Skin Diseases. This study was exempted from the requirement for local institutional review board approval as it is a narrative review of the literature. Arthroscopy 27(7):914922, Kim JH, Lee S, Ha DH, Lee SM, Jung K, Choi W (2018) The effects of graft shrinkage and extrusion on early clinical outcomes after meniscal allograft transplantation. This is probably why capsulodesis is so effective in minimizing extrusion. Associations. Google Scholar, Ozeki N, Seil R, Krych AJ, Koga H (2021) Surgical treatment of complex meniscus tear and disease: state of the art. Your doctor may also recommend conservative measures as a first step if the tear is caused by injury to the knee. https://doi.org/10.1055/s-0040-1715109, Strauss EJ, Day MS, Ryan M, Jazrawi L (2016) Evaluation, treatment, and outcomes of meniscal root tears: a critical analysis review. Knee 27(5):15601566, Zheng T, Song G, Li Y, Zhang Z, Ni Q, Cao Y et al (2021) Clinical, radiographic, and arthroscopic outcomes of surgical repair for radial and avulsed lesions on the lateral meniscus posterior root during ACL reconstruction: a systematic review. The term meniscal extrusion (ME) is used to describe the radial meniscal body displacement beyond the peripheral tibial plateau margin [7, 8]. David Prado/Stocksy United. EFORT Open Rev 4(4):115120, Gonzlez-Lucena G, Gelber PE, Pelfort X, Tey M, Monllau JC (2010) Meniscal allograft transplantation without bone blocks: a 5- to 8-year follow-up of 33 patients. More serious meniscus tears may not heal on their own. Most people will need to perform exercises following surgery. Arthrosc Tech 9(10):e1511e1517, Tsujii A, Yonetani Y, Kinugasa K, Matsuo T, Yoneda K, Ohori T et al (2019) Outcomes more than 2 years after meniscal repair for radial/flap tears of the posterior lateral meniscus combined with anterior cruciate ligament reconstruction. (ACLR+LM tear repair) demonstrated that the narrowing was only 0.04mm at 3.4years postoperatively, whereas another study showed widening of 0.1mm at 3.5years postoperatively [85, 90]. However, over a long-term period, the degenerative changes in the articular cartilage worsened, especially in the lateral tibial plateau, regardless of the healing status of the meniscus [85, 87, 90]. Radiographics. Check for errors and try again. medial meniscal extrusion is associated with More importantly, it leads to rapid progression of the degenerative process of the knee as well as substantial morbidity and pain [25,26,27,28]. Knee Surg Sports Traumatol Arthrosc 28(11):35993605, Krych AJ, LaPrade MD, Hevesi M, Rhodes NG, Johnson AC, Camp CL et al (2020) Investigating the chronology of meniscus root tears: do medial meniscus posterior root tears cause extrusion or the other way around? The incidence of meniscal tears associated with ACL injury is as high as 79%, with the LM being affected more often than the MM in acute situations [89]. Knee arthroscopy versus conservative management in patients with degenerative knee disease: A systematic review. Bend the unaffected leg, touching the toe to the floor as necessary for balance. Following proper treatment and rehabilitation, people can typically resume their pre-injury activities. Meniscus tears can occur at any age. Rehabilitation following meniscal repair: A systematic review. Knee Surg Sports Traumatol Arthrosc 28(11):34163425, Stein T, Mehling AP, Welsch F, von Eisenhart-Rothe R, Jger A (2010) Long-term outcome after arthroscopic meniscal repair versus arthroscopic partial meniscectomy for traumatic meniscal tears. A physical therapist can provide a daily routine of exercises and stretches to improve your muscle strength, flexibility, range of motion, and stability. The knee meniscus: Management of traumatic tears and degenerative lesions. Meniscal injury decreases their functional properties, resulting in degeneration of the knee joint [2]. The survival of the graft depends substantially on the condition of the articular cartilage [117,118,119]. At the time the article was created Yuranga Weerakkody had no recorded disclosures. They will test your range of motion. Orthop J Sports Med 8(7):2325967120936672, Koga H, Muneta T, Watanabe T, Mochizuki T, Horie M, Nakamura T et al (2016) Two-year outcomes after arthroscopic lateral meniscus centralization. Moreover, instead of a single value, Miller et al. Osteoarthritis Cartilage 25(7):10761083, Naredo E, Cabero F, Palop MJ, Collado P, Cruz A, Crespo M (2005) Ultrasonographic findings in knee osteoarthritis: a comparative study with clinical and radiographic assessment. On the contrary, traumatic tears usually involve the lateral meniscus after an acute traumatic episode with concomitant ligamentous injury, especially anterior cruciate ligament tear, in younger patients [5]. Whilst APM is one of the most commonly performed orthopaedic procedures [], meniscal repair is the treatment of choice for the young athlete with an acute meniscal tear [].Meniscal repair is most commonly performed in younger populations aged under 35 years [10, 2127] and aims to preserve the entire meniscus, without excision.The These tests include: However, these may not have the best accuracy. Conservative treatment is also advised for smaller tears, and stable longitudinal meniscus tears that occur in the outer third of the meniscus, the red zone. This is the area of your meniscus that has some blood supply, which aids healing. Another successful strategy is osteophyte resection. [76] showed that induction of MTL lesions in cadaveric knees resulted in ME after only a few cycles of loading and that repair of the lesion led to a significant reduction of ME. This procedure involves inserting a miniature camera and tiny surgical instruments through two or three small incisions in the knee to repair or trim a meniscus tear. A tear that gives you a lot of pain or impairs use of your knee may require surgery to remove or repair the torn part of the meniscus. Arthroscopy 32(7):13371345, Kim NK, Bin SI, Kim JM, Lee CR, Kim JH (2017) Meniscal extrusion does not progress during the midterm follow-up period after lateral meniscal transplantation. Meniscal extrusion (ME) is a radiological finding, especially in magnetic resonance imaging (MRI) scans, for which there has been growing interest in recent years. What is the usual treatment for a meniscal tear? Symptomatic meniscal tears are usually treated surgically. If the tear is in an area of the meniscus that has good blood supply, then it will generally be repaired with sutures. See additional information. The rubbery wedges of cartilage act like shock absorbers for your knee, providing cushioning for your bones and knee joint. https://doi.org/10.1007/s00167-020-06363-0, Miller TT, Staron RB, Feldman F, epel E (1997) Meniscal position on routine MR imaging of the knee. Osteophyte removal>2mm at the edge of the lateral tibial plateau can reduce extrusion after lateral MAT [109, 121, 122]. Playing contact sports also increases your risk of a meniscus tear. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. This post goes into considerable detail about managing a knee with arthritis and a complex or degenerative meniscus tear. Treatment for knee meniscus tears may involve: using the rest, ice, compression, and elevation (RICE) method. Theres an inner (medial) meniscus and an outer (lateral) meniscus. Scientists use genetic rewiring to increase lifespan of cells, Beyond amyloid and tau: New targets in developing dementia treatments, Napping longer than 30 minutes linked to higher risk of obesity and high blood pressure, Activity 'snacks' could lower blood sugar, complication risk in type 1 diabetes, In Conversation: Investigating the power of music for dementia, Daniel Bubnis, M.S., NASM-CPT, NASE Level II-CSS, stability through preventing the knee from bending and straightening at extreme angles, having an occupation that requires frequent squatting or bending, inability to fully bend and straighten the knee. if you have sudden pain from a knee injury. Google Scholar, uczkiewicz P, Daszkiewicz K, Chrcielewski J, Witkowski W, Kuik L (2017) High meniscal slope angle as a risk factor for meniscal allograft extrusion. Getting hit or tackled can make you twist your knee, tearing the cartilage. Knee Surg Sports Traumatol Arthrosc 23(1):290302, Gelber PE, Torres-Claramunt R, Poggioli F, Prez-Prieto D, Monllau JC (2020) Polyurethane Meniscal Scaffold: Does Preoperative Remnant Meniscal Extrusion Have an Influence on Postoperative Extrusion and Knee Function? (2017). [54] showed that varus alignment factors, and specifically medial proximal tibial angle (MPTA), were significantly related to the extent of MME, especially as the knee OA grade progressed. Arthroscopy 31(4):699706, Lee SM, Bin SI, Kim JM, Lee BS, Park JG (2020) Absolute meniscal extrusion after lateral meniscal allograft transplantation does not progress during long-term follow-up: average of 10.3 years follow-up longitudinal magnetic resonance imaging study. Meniscal tears: Current understanding, diagnosis, and management. It has been suggested that a 510% reduction of implant size from the estimated one reduces postoperative extrusion [2, 105, 123]. Healthline Media does not provide medical advice, diagnosis, or treatment. This article outlines two types and their associated symptoms and causes. Am J Sports Med 47(4):815821, Son DW, Bin SI, Kim JM, Lee BS, Lee CR, Park JG et al (2021) Extrusions do not affect degenerative morphologic changes in lateral meniscus allografts during midterm follow-ups.
