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Outcome of meniscal repairs in paediatric population:A tertiary centre experience

World Journal of Orthopedics 2024年第6期15卷 547-553页

作者： Ayman Gabr Samson Williams Sophie Dodd Nick Barton-Hanson Department of Trauma&Orthopaedics West Suffolk HospitalSuffolk IP332QZUnited Kingdom Department of Trauma and Orthopaedics Alder Hey Children's HospitalLiverpool L145ABUnited Kingdom

BACKGROUND Meniscal sparing surgery is a widely utilised treatment option for unstable meniscal tears with the aim of minimising the risk of progression towards osteoarthritis.However,there is limited data in the literature on meniscal repair outcomes in skeletally immature patients.AIM To evaluate the re-operation rate and functional outcomes of meniscal repairs in children and adolescents.METHODS We performed a retrospective review of all patients who underwent arthroscopic meniscal repair surgery between January 2007 and January 2018.All patients were under the age of 18 at the time of surgery.Procedures were all performed by a single surgeon.Information was gathered from our hospital Electronic Patient Records system.The primary outcome measure was re-operation rate(need for further surgery on the same meniscus).Secondary outcome measures were surgical complications and patient reported outcome measures that were International Knee Documentation Committee(IKDC),Tegner and Lysholm scores.RESULTS We identified 59 patients who underwent 66 All-inside meniscal repairs(32 medial meniscus and 34 Lateral meniscus).Meniscal repairs were performed utilizing FasT-Fix(Smith and Nephew)implants.There were 37 males and 22 females with an average age of 14 years(range 6-16).The average follow-up time was 53 months(range 26-140).Six patients had concomitant anterior cruciate ligament reconstruction surgery along with the meniscal repair.There were no requiring further meniscal repairs and 9 patients underwent partial meniscectomies.The mean postoperative IKDC score was 88(44-100),Tegner score was 7(2-10)and Lysholm score was 94(57-100).CONCLUSION Our results showed that arthroscopic repair of meniscal tears in the paediatric population is an effective treatment option that has a low failure rate and good postoperative clinical with the advantage of preserving meniscal tissues.

关键词： meniscus Meniscal repair Outcome Meniscal preservation

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meniscus repair with simultaneous anterior cruciate ligament reconstruction: Clinical outcomes, failure rates and subsequent processing

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Chinese Journal of Traumatology 2022年第1期25卷 37-44页

作者： Yu-Ping Yang Xiao Ma Hua An Xiao-Peng Liu Ning An Ying-Fang Ao Department of Sports Medicine Peking University Third Hospital-ChongliZhangjiakou076350Hebei provinceChina Department of Sports Medicine Peking University Third HospitalInstitute of Sports Medicine of Peking UniversityBeijing Key Laboratory of Sports InjuriesBeijing100191China

Purpose::To retrospectively analyze the clinical outcomes of meniscus repair with simultaneous anterior cruciate ligament(ACL)reconstruction and explore the causes of failure of meniscus repair.Methods::From May 2013 to July 2018,the clinical data of 165 patients who were treated with meniscus surgery and simultaneous ACL reconstruction,including 69 cases of meniscus repair(repair group)and 96 cases of partial meniscectomy(partial meniscectomy group)were retrospectively analyzed.The exclusion criteria were as follows:(1)ACL rupture associated with fracture,collateral ligament injury,or complex ligament injury;(2)a history of knee surgery;or(3)a significant degree of osteoarthritis.The 69 patients in the repair group were divided into the non-failure group(62 cases)and the failure group(7 cases)depending on the repair effect.Postoperative outcomes of the repair group and the partial meniscectomy group were compared.General conditions and postoperative outcomes of the failure group and the non-failure group were compared.During the median follow-up period of 28 months(range,4-65 months)after the second arthroscopy,postoperative outcomes of seven patients in the failure group were summarized.SPSS 25.0 statistical software was used for statistical analysis.A p value less than 0.05 was considered statistically significant.Results::Seven patients in the failure group who underwent the second arthroscopy were followed up for(30±17.4)months and their postoperative outcomes were summarized.Compared with the partial meniscectomy group,the International Knee Documentation Committee scores of patients in the repair group improved significantly(p=0.031).Compared with the non-failure group,more patients in the failure group were younger than 24 years(p=0.030).The median follow-up period was 39.5 months.All patients recovered well after subsequent partial meniscectomy and relieved clinical symptoms.Visual analog scale scores decreased significantly(p=0.026),and the International Knee Documentation Committee and Lysholm scores i

关键词： meniscus Failure of repair Anterior cruciate ligament reconstruction Arthroscopy

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meniscus tears treatment:The good,the bad and the ugly-patterns classification and practical guide

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World Journal of Orthopedics 2023年第4期14卷 171-185页

作者： Roberto Simonetta Arcangelo Russo Michelangelo Palco Giuseppe Gianluca Costa Pier Paolo Mariani Department of Orthopaedic and Traumatology Villa del Sole ClinicCatanzaro 88100Italy Orthopaedic and Traumatology Unit Umberto I HospitalEnna 94100Italy Department of Orthopaedic and Traumatology Villa Stuart Sport Clinic-FIFA Medical Centre of ExcellenceRoma 00135Italy

Over the years,several studies demonstrated the crucial role of knee menisci in joint biomechanics.As a result,save the meniscus has become the new imperative nowadays,and more and more studies addressed this topic.The huge amount of data on this topic may create confusion in those who want to approach this surgery.The aim of this review is to provide a practical guide for treatment of meniscus tears,including an overview of technical aspects,outcomes in the literature and personal tips.Taking inspiration from a famous movie directed by Sergio Leone in 1966,the authors classified meniscus tears in three categories:The good,the bad and the ugly lesions.The inclusion in each group was determined by the lesion pattern,its biomechanical effects on knee joint,the technical challenge,and prognosis.This classification is not intended to substitute the currently proposed classifications on meniscus tears but aims at offering a readerfriendly narrative review of an otherwise difficult topic.Furthermore,the authors provide a concise premise to deal with some aspects of menisci phylogeny,anatomy and biomechanics.

关键词： meniscus meniscus anatomy meniscus tear meniscus repair Root lesion Ramp lesion

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Immunity-and-matrix-regulatory cells enhance cartilage regeneration for meniscus injuries: a phase I dose-escalation trial

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Signal Transduction and Targeted Therapy 2023年第12期8卷 5873-5886页

作者： Liangjiang Huang Song Zhang Jun Wu Baojie Guo Tingting Gao Sayed Zulfiqar Ali Shah Bo Huang Yajie Li Bo Zhu Jiaqi Fan Liu Wang Yani Xiao Wenjing Liu Yao Tian Zhengyu Fang Yingying Lv Lingfeng Xie Sheng Yao Gaotan Ke Xiaolin Huang Ying Huang Yujuan Li Yi Jia Zhongwen Li Guihai Feng Yan Huo Wei Li Qi Zhou Jie Hao Baoyang Hu Hong Chen Department of Rehabilitation Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina National Stem Cell Resource Center State Key Laboratory of Stem Cell and Reproductive BiologyInstitute of ZoologyInstitute for Stem Cell and RegenerationChinese Academy of SciencesBeijingChina Beijing Institute for Stem Cell and Regenerative Medicine BeijingChina Department of Radiology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Stem Cell Research Center Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Department of Orthopedics Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina University of Chinese Academy of Sciences BeijingChina Beijing Key Lab for Pre-clinical Safety Evaluation of Drugs National Center for Safety Evaluation of DrugsNational Institutes for Food and Drug ControlBeijingChina Beijing Zephyrm Biotechnologies Co. Ltd.BeijingChina

Immunity-and-matrix-regulatory cells(IMRCs)derived from human embryonic stem cells have unique abilities in modulating immunity and regulating the extracellular matrix,which could be mass-produced with stable biological properties.Despite resemblance to mesenchymal stem cells(MSCs)in terms of self-renew and tri-lineage differentiation,the ability of IMRCs to repair the meniscus and the underlying mechanism remains undetermined.Here,we showed that IMRCs demonstrated stronger immunomodulatory and pro-regenerative potential than umbilical cord MSCs when stimulated by synovial fluid from patients with meniscus injury.Following injection into the knees of rabbits with meniscal injury,IMRCs enhanced endogenous fibrocartilage regeneration.In the dose-escalating phase I clinical trial(NCT03839238)with eighteen patients recruited,we found that intra-articular IMRCs injection in patients was safe over 12 months post-grafting.Furthermore,the effective results of magnetic resonance imaging(MRI)of meniscus repair and knee functional scores suggested that 5×107 cells are optimal for meniscus injury treatment.In summary,we present the first report of a phase I clinical trial using IMRCs to treat meniscus injury.Our results demonstrated that intra-articular injection of IMRCs is a safe and effective therapy by providing a permissive niche for cartilage regeneration.

关键词： meniscus injuries cartilage

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Effect of medial meniscus extrusion on arthroscopic surgery outcome in the osteoarthritic knee associated with medial meniscus tear:a minimum 4-year follow-up

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Chinese Medical Journal 2019年第21期132卷 2550-2558页

作者： Yu-Xing Wang Zhong-Li Li Ji Li Zhi-Dong Zhao Hao-Ran Wang Cheng Hou Wei Li Chun-Hui Liu Department of Orthopedics Chinese PLA General HospitalBeijing 100853China Department of Hematology Chinese PLA General HospitalBeijing 100853China

Background:The potential benefit of arthroscopic surgery for osteoarthritic knee associated with medial meniscus tear is controversial.This study was conducted to determine the effect of pre-operative medial meniscus extrusion(MME)on arthroscopic surgery outcomes in the osteoarthritic knee associated with medial meniscus tear during a minimum 4-year follow-up.Methods:This was a retrospective review of a total of 131 patients diagnosed with osteoarthritic knee associated with medial symptomatic degenerative meniscus tear who underwent arthroscopic surgery from January 2012 to December 2014 and were observed for more than 4 years.Patients were classified into two groups:MME≥3mm(major MME group,n=54)and MME<3mm(non-major MME group,n=77).Clinical assessments,including the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score,and radiographic assessments,including the Kellgren-Lawrence(K-L)grade and medial joint space width(JSW),were evaluated pre-operatively and at final follow-up.The longitudinal changes of clinical and radiographic parameters(WOMAC and the medial JSW change,K-L grade progression)were compared between groups unadjusted and adjusted for age,sex,and body mass index.Four-year survival rates(without progression to knee replacement[KR])were also evaluated using a log-rank test and Cox proportional hazard regression model.Results:Major MME was present in 41%of patients.After a minimum 4-year follow-up,the mean WOMAC total and pain scores improved significantly in both groups.However,the medial JSW and K-L grade worsened significantly.Patients with pre-operative majorMMEworsened more inWOMACtotal(adjusted mean difference[MD]3.800,95%confidence interval[CI]:0.900,11.400;P=0.037)and function(adjusted MD 3.100,95%CI:0.700,6.300;P=0.038)scores than patients with pre-operative non-major MME,and no significant difference was observed inWOMACpain and stiffness score between groups.The group with majorMME had significantly higher joint space narrowing(adjusted MD 0.630,95%CI: 1.250, 0.100;P=0.

关键词： Osteoarthritis Knee meniscus Arthroscopy Prognosis Treatment Outcome

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An Elastic-plastic Adhesion Model for Contacting Fractal Rough Surface and Perfectly Wetted Plane with meniscus

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Chinese Journal of Mechanical Engineering 2009年第1期22卷 9-14页

作者： PENG Yunfeng GUO Yinbiao Department of Mechanical and Electrical Engineering Xiamen University Xiamen 361005 China

The strong stiction of adjacent surfaces with meniscus is a major design concern in the devices with a micro-sized interface. Today, more and more research works are devoted to understand the adhesion mechanism. This paper concerns the elastic-plastic adhesion of a fractal rough surface contacting with a perfectly wetted rigid plane. The topography of rough surface is modeled with a two-variable Weierstrass-Mandelbrot fractal function. The Laplace pressure is dealt with the Dugdale approximation. Then the adhesion model of the plastically deformed asperities with meniscus can be established with the fractal microcontact model. According to the plastic flow criterion, the elastic-plastic adhesion model of the contacting rough surfaces with meniscus can be solved by combining the Maugis-Dugdale （MD） model and its extension with the Morrow method. The necessity for considering the asperities＇ plastic deformation has been validated by comparing the simulation result of the presented model with that of the elastic adhesion model. The stiction mechanism of rough surfaces with meniscus is also discussed.

关键词： adhesion meniscus Laplace pressure rough surface ffactal function

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Indirect printing of hierarchical patient-specific scaffolds for meniscus tissue engineering

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Bio-Design and Manufacturing 2019年第4期2卷 225-241页

作者： Joao BCosta Joana Silva-Correia Sandra Pina Alain da Silva Morais Sílvia Vieira Hélder Pereira Joao Espregueira-Mendes Rui LReis Joaquim M.Oliveira B′s Research Group I3Bs-Research Institute on BiomaterialsBiodegradables and BiomimeticsUniversity of MinhoHeadquarters of the European Institute of Excellence on Tissue Engineering and Regenerative MedicineAveParkZona Industrial da Gandra4805-017 Barco GmrPortugal ICVS/3B’s-PT Government Associate Laboratory Braga/GuimaraesPortugal The Discoveries Centre for Regenerative and Precision Medicine Headquarters at University of MinhoAvepark4805-017 BarcoGuimar'sPortugal Ripoll y De Prado Sports Clinic:Murcia-Madrid FIFA Medical Centre of Excellence MurciaSpain Orthopedic Department Centro Hospitalar Póvoa de Varzim Vila do CondePortugal Clínica do Dragao Espregueira-Mendes Sports CentreFIFA Medical Centre of ExcellencePortoPortugal Dom Henrique Research Centre PortoPortugal Orthopedic Department University of MinhoBragaPortugal

The complex meniscus tissue plays a critical role in the knee. The high susceptibility to injury has led to an intense pursuit for better tissue engineering regenerative strategies, where scaffolds play a major role. In this study, indirect printed hierarchical multilayered sca ffolds composed by a silk fibroin (SF) upper layer and an 80/20 (w/w) ratio of SF/ionic-doped β-tricalcium phosphate (TCP) bottom layer were developed. Furthermore, a comparative analysis between two types of sca ffolds pro- duced using di fferent SF concentrations, i.e., 8% (w/v) (Hi8) and 16% (w/v) (Hi16) was performed. In terms of architecture and morphology, the produced sca ffolds presented homogeneous porosity in both layers and no di fferences were observed when comparing both sca ffolds. A decrease in terms of mechanical performance of the sca ffolds was observed when SF concentration decreased from 16 to 8% (w/v). Hi16 revealed a static compressive modulus of 0.66 ± 0.05 MPa and dynamical mechanical properties ranging from 2.17 ± 0.25 to 3.19 ± 0.38 MPa. By its turn, Hi8 presented a compressive modulus of 0.27 ± 0.08 MPa and dynamical mechanical properties ranging from 1.03 ± 0.08 MPa to 1.56 ± 0.13 MPa. In vitro bioactivity studies showed formation of apatite crystals onto the surface of Hi8 and Hi16 bottom layers. Human meniscus cells (hMCs) and human primary osteoblasts were cultured separately onto the top layer (SF8 and SF16) and bottom layer (SF8/TCP and SF16/TCP) of the hierarchical sca ffolds Hi8 and Hi16, respectively. Both cell types showed good adhesion and proliferation as denoted by the live/dead staining, Alamar Blue assay and DNA quanti fication analysis. Subcutaneous implantation in mice revealed weak in flammation and sca ffold’s integrity. The hierarchical indirect printed SF sca ffolds can be promising candidate for meniscus TE sca ffolding applications due their suitable mechanical properties, good biological performance and possibility of being applied in a patient-speci fic approach.

关键词： Patient-specific Indirect printing Hierarchical Silk fibroin Enzymatic-cross-linking meniscus

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Degenerative meniscus: Pathogenesis, diagnosis, and treatment options

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World Journal of Orthopedics 2014年第5期5卷 597-602页

作者： Richard Howell Neil S Kumar Nimit Patel James Tom Department of Orthopedic Surgery Drexel University College of Medicine Hahnemann University Hospital

The symptomatic degenerative meniscus continues to be a source of discomfort for a significant number of patients. With vascular penetration of less than onethird of the adult meniscus, healing potential in the setting of chronic degeneration remains low. Continued hoop and shear stresses upon the degenerative meniscus results in gross failure, often in the form of complex tears in the posterior horn and midbody. Patient history and physical examination are critical to determine the true source of pain, particularly with the significant incidence of simultaneous articular pathology. Joint line tenderness, a positive Mc Murray test, and mechanical catching or locking can be highly suggestive of a meniscal source of knee pain and dysfunction. Radiographs and magnetic resonance imaging are frequently utilized to examine for osteoarthritis and to verify the presence of meniscal tears, in addition to ruling out other sources of pain. Non-operative therapy focused on nonsteroidal anti-inflammatory drugs and physical therapy may be able to provide pain relief as well as improve mechanical function of the knee joint. For patients re-fractory to conservative therapy, arthroscopic partial meniscectomy can provide short-term gains regarding pain relief, especially when combined with an effective, regular physiotherapy program. Patients with clear mechanical symptoms and meniscal pathology may benefit from arthroscopic partial meniscectomy, but surgery is not a guaranteed success, especially with concomitant articular pathology. Ultimately, the long-term outcomes of either treatment arm provide similar results for most patients. Further study is needed regarding the short and long-term outcomes regarding conservative and surgical therapy, with a particular focus on the economic impact of treatment as well.

关键词： meniscus Degenerative joint disease Meniscal tear Osteoarthritis Arthroscopy

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SOME CHARACTERISTICS OF LIQUID METAL meniscus IN ELECTROMAGNETIC FIELD

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中国有色金属学会会刊：英文版 1995年第4期5卷 64-68页

作者： Shen, J Li, JS Li, JG Fu, HZ Zeng, FC Cui, ZS NORTHWESTERN POLYTECH UNIV STATE KEY LAB SOLIDIFICAT PROCXIAN 710072PEOPLES R CHINA AVIAT IND CHINA DEPT SCI & TECHNOLBEIJING 100712PEOPLES R CHINA

ＳＯＭＥＣＨＡＲＡＣＴＥＲＩＳＴＩＣＳＯＦＬＩＱＵＩＤＭＥＴＡＬＭＥＮＩＳＣＵＳＩＮＥＬＥＣＴＲＯＭＡＧＮＥＴＩＣＦＩＥＬＤＳｈｅｎＪｕｎ；ＬｉＪｉｎｓｈａｎ；ＬｉＪｉａｎｇｕｏ；ＦｕＨｅｎｇｚｈｉ（ＳｔａｔｅＫｅｙ... 详细信息

ＳＯＭＥＣＨＡＲＡＣＴＥＲＩＳＴＩＣＳＯＦＬＩＱＵＩＤＭＥＴＡＬＭＥＮＩＳＣＵＳＩＮＥＬＥＣＴＲＯＭＡＧＮＥＴＩＣＦＩＥＬＤＳｈｅｎＪｕｎ；ＬｉＪｉｎｓｈａｎ；ＬｉＪｉａｎｇｕｏ；ＦｕＨｅｎｇｚｈｉ（ＳｔａｔｅＫｅｙＬａｂｏｒａｔｏｒｙｏｆＳｏｌｉｄ...

关键词： liquid metal meniscus electromagnetic cast unidirectional solidification

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Study on the Anisotropy of meniscus in the Growing Sapphire

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Chinese Journal of Aeronautics 2006年第B12期19卷 78-81页

作者： YAO Tai ZUO Hong-bo HANJie-cai MENG Song-he ZHANG Ming-fu LI Chang-qing Grigoryan Benik Center for Composite Materials Harbin Institute of Technology Harbin 150006 China

This study is aimed at predicting the relationship between the meniscus and the quality of the sapphire crystals produced by the micro-pulling and shoulder at cooled center （SAPMIC） technique. As with different orientations, the shapes of the meniscus vary, so an investigation into the anisotropy of the meniscus shapes is very important for the final quality of the sapphire crystal. An effective model to describe meniscus shapes and their formation process has been presented. The model has been applied to a sapphire crystal of 200 mm diameter in order to check its reliability. The results show that the model proves to be useful for forecasting the final shapes of the sapphire crystal made by the SAPMIC technique.

关键词： anisotropy meniscus simulation sapphire

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