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Torn discoid lateral meniscus treated with arthroscopic meniscectomy:observations in 62 knees

Chinese Medical Journal 2007年第3期120卷 211-215页

作者： LU Ying LI Qiang HAO Jie Department of Orthopaedics Beijing Friendship Hospital CapitalMedical University Beijing 100050 China

Background Discoid lateral meniscus of the knee is common in Chinese population. There has been considerable debate about the best treatment for discoid lateral meniscus tears. The purpose of this study was to observe the effect of arthroscopic meniscectomy for the treatment of discoid lateral meniscus tears. Methods Between July 1999 and December 2004, arthroscopic meniscectomy was performed on 62 menisci of 57 patients with discoid lateral meniscus tears （52 unilateral, 5 bilateral）. 41 menisci were ＂complete discoid meniscus＂, 21 =incomplete＂. According to the extent of the meniscus tears, partial meniscectomy was performed on 52 knees, total meniscectomy on 7 knees, and partial meniscectomy combined with meniscus suture on 3 knees through an arthroscope After the operations, early rehabilitation training programs, including straight-leg-raising and range-of-motion exercises, were carried out. 51 patients were followed up for 1 year 2 months to 6 years 5 months （mean, 3 years 3 months）, 6 patients were lost. Lysholm-Ⅱ scoring system was used to assess the function of the knee joints before the operation and during the follow-up. Results The operations on all the 62 knees were successful without complications. The patients could walk normally after completing the 2-week postoperation rehabilitation program. After 3-4 weeks they could lead a normal life and participate in a moderate amount of sports or other physical activities. The mean Lysholm-Ⅱ score was 89 （60--100） during the follow-up, which was significantly higher than that before the operation （50, range 34-74; P〈0.01）. 88% of the patients achieved excellent or good clinical results. Conclusions Arthroscopic meniscectomy is an alternative for treatment of discoid lateral meniscus tears with minimal traumatic effects. It can achieve early mobilization and a low complication rate, as well as the preservation of the meniscus structure and functions to the largest extent. In combination with proper rehabil

关键词： knee joint discoid meniscus tear arthroscopy meniscectomy

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Controversial role of arthroscopic meniscectomy of the knee: A review

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World Journal of Orthopedics 2016年第5期7卷 287-292页

作者： Austin Y Ha Robert M Shalvoy Anne Voisinet Jennifer Racine Roy K Aaron Department of Orthopaedic Surgery Warren Alpert Medical School of Brown University

The role of arthroscopic partial meniscectomy(APM) in reducing pain and improving function in patients with meniscal tears remains controversial. Five recent highquality randomized controlled trials(RCTs) compared non-operative management of meniscal tears to APM, with four showing no difference and one demonstrating superiority of APM. In this review, we examined the strengths and weaknesses of each of these RCTs, with particular attention to the occurrence of inadvertent biases. We also completed a quantitative analysis that compares treatment successes in each treatment arm, considering crossovers as treatment failures. Our analysis revealed that each study was an excellent attempt to compare APM with non-surgical treatment but suffered from selection, performance, detection, and/or transfer biases that reduce confidence in its conclusions. While the RCT remains the methodological gold standard for establishing treatment efficacy, the use of an RCT design does not in itself ensure internal or external validity. Furthermore, under our alternative analysis of treatment successes, two studies had significantly more treatment successes in the APM arm than the non-operative arm although original intention-totreat analyses showed no difference between these two groups. Crossovers remain an important problem in surgical trials with no perfect analytical solution. With the studies available at present, no conclusion can be drawn concerning the optimal treatment modality for meniscal tears. Further work that minimizes significant biases and crossovers and incorporates sub-group and cost-benefit analyses may clarify therapeutic indications.

关键词： Arthroscopic partial meniscectomy Meniscal tear Knee osteoarthritis Physical therapy Randomized controlled trial Crossover Bias

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Impact of time between meniscal injury and isolated meniscus repair on post-operative outcomes:A systematic review

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World Journal of Clinical Cases 2025年第7期13卷 39-45页

作者： Kashif Javid Xavier Akins Nicole G Lemaster Amer Ahmad Austin V Stone Department of Orthopaedic Surgery and Sports Medicine University of KentuckyLexingtonKY 40504United States

BACKGROUND Meniscal tears are one of the most common knee *** the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical *** influence of time between injury and isolated meniscus repair on patient outcomes is not well *** this relationship is important as it may influence clinical decision-making and can add to the preoperative patient education *** hypothesized that increasing the time from injury to meniscus surgery would worsen postoperative *** To investigate the current literature for data on the relationship between time between meniscus injury and repair on patient *** PubMed,Academic Search Complete,MEDLINE,CINAHL,and SPORTDiscus were searched for studies published between January 1,1995 and July 13,2023 on isolated meniscus *** criteria included concomitant ligament surgery,incomplete outcomes or time to surgery data,and *** demographics,time to injury,and postoperative outcomes from each study were abstracted and *** Five studies met all inclusion and exclusion *** were 204(121 male,83 female)patients *** of five(60%)studies determined that time between injury and surgery was not statistically significant for postoperative Lysholm scores(P=0.62),Tegner scores(P=0.46),failure rate(P=0.45,P=0.86),and International Knee Documentation Committee scores(P=0.65).Two of five(40%)studies found a statistically significant increase in Lysholm scores with shorter time to surgery(P=0.03)and a statistically significant association between progression of medial meniscus extrusion ratio(P=0.01)and increasing time to *** Our results do not support the hypothesis that increased time from injury to isolated meniscus surgery worsens postoperative ***-making primarily based on injury interval is thus not recommended.

关键词： Meniscus Meniscal Meniscus repair meniscectomy Patient reported outcomes Postoperative outcomes Time to surgery Injury interval

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Biosynthetic scaffolds for partial meniscal loss:A systematic review from animal models to clinical practice

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Bioactive Materials 2021年第11期6卷 3782-3800页

作者： F.Veronesi B.Di Matteo N.D.Vitale G.Filardo A.Visani E.Kon M.Fini Complex Structure of Surgical Sciences and Technologies IRCCS Istituto Ortopedico RizzoliBolognaItaly Humanitas University Department of Biomedical SciencesVia Rita Levi Montalcini 420090Pieve EmanueleMilanItaly IRCCS Humanitas Research Hospital Via Manzoni 5620089RozzanoMilanItaly Applied and Translational Research Center IRCCS Istituto Ortopedico RizzoliBolognaItaly Orthopaedic and Traumatology Unit Ospedale Regionale di LuganoEOCLuganoSwitzerland Faculty of Biomedical Sciences Universit`a della Svizzera ItalianaLuganoSwitzerland First Moscow State Medical University-Sechenov University Bol’shaya Pirogovskaya Ulitsa19c1119146MoscowRussia

Acute or degenerative meniscus tears are the most common knee *** provides symptomatic relief and functional recovery only in the short-to mid-term follow-up but significantly increases the risk of *** this reason,preserving the meniscus is key,although it remains a *** transplants present many disadvantages,so during the last 20 years preclinical and clinical research focused on developing and investigating meniscal *** aim of this systematic review was to collect and evaluate all the available evidence on biosynthetic scaffolds for meniscus regeneration both in vivo and in clinical *** databases were searched:46 in vivo preclinical studies and 30 clinical ones were *** natural,15 synthetic,and 15 hybrid scaffolds were studied in *** them,only 2 were translated into clinic:the Collagen Meniscus Implant,used in 11 studies,and the polyurethane-based scaffold Actifit®,applied in 19 *** positive outcomes were described in the short-to mid-term,the number of concurrent procedures and the lack of randomized trials are the major limitations of the available clinical *** in vivo studies also combined the use of cells or growth factors,but these augmentation strategies have not been applied in the clinical practice *** solutions offer a significant but incomplete clinical improvement,and the regeneration potential is still *** upon the overall positive results of these“old”technologies to address partial meniscal loss,further innovation is urgently needed in this field to provide patients better joint sparing treatment options.

关键词： Meniscal scaffold meniscectomy Osteoarthritis Regenerative medicine Collagen Polyurethane

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Treatment of meniscal tears: An evidence based approach

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World Journal of Orthopedics 2014年第3期5卷 233-241页

作者： Simon C Mordecai Nawfal Al-Hadithy Howard E Ware Chinmay M Gupte Imperial College NHS Trust St Mary’s and Charing Cross HospitalsLondon W21NYUnited Kingdom The Wellington Hospital The Knee Surgery UnitLondon NW8 9LEUnited Kingdom

Treatment options for meniscal tears fall into three broad categories;non-operative,meniscectomy or meniscal *** the most appropriate treatment for a given patient involves both patient factors(e.g.,age,co-morbidities and compliance)and tear characteristics(e.g.,location of tear/age/reducibility of tear).There is evidence suggesting that degenerative tears in older patients without mechanical symptoms can be effectively treated non-operatively with a structured physical therapy programme as a first *** if these patients later require meniscectomy they will still achieve similar functional outcomes than if they had initially been treated *** meniscectomy is suitable for symptomatic tears not amenable to repair,and can still preserve meniscal function especially when the peripheral meniscal rim is *** repair shows 80%success at 2 years and is more suitable in younger patients with reducible tears that are peripheral(e.g.,nearer the capsular attachment)and horizontal or longitudinal in ***,careful patient selection and repair technique is required with good compliance to post-operative rehabilitation,which often consists of bracing and non-weight bearing for 4-6 wk.

关键词： Meniscus meniscectomy Meniscal tear Meniscal repair Arthroscopic surgery

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Lessons Learned from a Case with Valgus Deformity of the Knee Following Partial Removal of Lateral Discoid Meniscus

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Chinese Medical Journal 2015年第21期128卷 2967-2968页

作者： Ming Li Hua Liu Zhi-Yong He Zheng-Lin Di Jun-Hui Zhang Qun-Hua Jin Department of Joint Surgery Ningbo No. 6 Hospital Ningbo Zhejiang 315040 China Department of Orthopaedics Affiliated Hospital of Ningxia Medical University Yinchuan Ningxia 750000 China

Few studies have focused on the possible change in the axial alignment of the lower limb after lateral meniscectomy. Here, we present a patient with valgus deformity of the knee following the partial removal of lateral discoid meniscus. With the distal femur osteotomy and fixation, this complication was treated successfully. This case suggested that we should pay more attention to the axial alignment of the lower limb in patients with torn discoid lateral meniscus before meniscectomy, as a severe valgus inclination may develop in some of these patients.

关键词： Distal Femur Osteotomy Lateral Discoid Meniscus meniscectomy Valgus Deformity

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