WebAnatomy Two bones meet to form your knee joint: the femur and the tibia. Arthrosc. The aim of this study was to investigate the biomechanical effects of horizontal meniscal tears and different resection strategies on a rabbit knee joint by finite element analysis and to provide reference for animal Biotechnol. Faun P, Nielsen AB. Suzanne werner, lars weidenhielm. J. Orthop. In the lateral compartment, the contact areas of the LFC-LM and LTC-LM were 3.9 mm2 and 6.4mm2 after the STM, which decreased by 4.8% and 2.3% compared with the IMM, respectively. All image data were from Peking University Third Hospital. Sometimes the meniscus damage occurs more gradually as part of degeneration. Despite this most patients still showed clinical improvement suggesting that the favourable results seen after meniscal repair do not necessarily correlate with the appearance of a normal looking meniscus. Nepple JJ, Dunn WR, Wright RW. Horizontal Tear A horizontal tear runs along the curved fibers of the meniscus. doi:10.1016/j.arthro.2011.08.294, Ogawa, H., Matsumoto, K., Sengoku, M., Yoshioka, H., and Akiyama, H. (2020). Lee et al. Methods Surgery versus physical therapy for a meniscal tear and osteoarthritis. There may also be a feeling of weakness in the leg and a The intact knee joint was flexed to the degree consistent with Tans model, and the axial load was 80N. The results showed that the maximum von Mises stress on the femoral cartilage was 5.7 MPa, which was basically consistent with Tans research (7.9 2.5MPa). This may enhance our understanding of the influence of biomechanics on the development of osteoarthritis. University of Veterinary Medicine Vienna, Austria, Rizzoli Orthopedic Institute (IRCCS), Italy. Arthrosc. A recent high-quality study found that exercise therapy not only provided the same improvement in symptoms as surgery, but also increased thigh muscle strength. In vivo kinematics of the rabbit knee in unstable models of osteoarthrosis. The surgical team cleans the skin on your knee and covers the rest of your leg with a surgical drape. Selecting the correct treatment can be challenging and involves multiple factors. Even if these patients later require meniscectomy they will still achieve similar functional outcomes than if they had initially been treated surgically. doi:10.1177/0363546515623782, Chevrier, A., Nelea, M., Hurtig, M. B., Hoemann, C. D., and Buschmann, M. D. (2009). Long-term follow-up of meniscectomy in athletes. Rehabilitation Eng. (2020). Authors recommend a trial of supervised exercise alone as first line treatment. Therefore, additional simulations were performed, one of which followed the study of Tan et al. As a library, NLM provides access to scientific literature. Meniscal tears are the most common pathology of the knee with a mean annual incidence of 66 per 100000[1]. Experimentally induced degenerative joint lesions following partial meniscectomy in the rabbit. Side knee pain is commonly caused by osteoarthritis ("wear-and-tear arthritis"), injuries to the There was little difference in the magnitude of the maximum von Mises stress on the medial femoral cartilage (MFC), lateral femoral cartilage (LFC), medial tibial cartilage (MTC), lateral tibial cartilage (LTC) and lateral menisci (LM). The reason might be that the HTMM did not break the hoop stress of the meniscus, so it did not affect the maintenance of the meniscal basic biomechanical function and performed the same functions as the IMM (Kedgley et al., 2019). The structure of these fibres are important clinically when deciding which meniscal tears are stable or which are unstable and warrant resection or repair. 6 Types of Meniscus Tears and Treatments - Verywell Health Surg. Magee T, Shapiro M, Williams D. Comparison of high-field-strength versus low-field-strength MRI of the shoulder. doi:10.1007/978-3-642-02450-4_15, Shanmugaraj, A., Tejpal, T., Ekhtiari, S., Gohal, C., Bhandari, M., Hanson, B., et al. 28 (11), 34743480. ACL Tear Treatment and Reconstruction IMM, HTMM, and different resections on the tibial plateau of (A) Von Mises stress distribution, (B) Contact pressure distribution, and (C) Radial displacement of the medial meniscus. For the motion of the tibia and femur is relative, the axial and internal/external rotation degrees of the femur were released, and the other degrees of the femur and tibia were constrained. Repair of isolated horizontal meniscal tears with all-inside suture materials using the overlock method: outcome study with a minimum 2-year follow-up - PMC Back to Top Skip to main content An official website of the United States government Here's how you know The .gov means its official. At just four months, 94% showed sufficient healing to protect the underlying articular cartilage. Significant improvements in all outcomes were found at follow-up. Bioeng. Seo HS, Lee SC, Jung KA. A randomised double blinded placebo controlled study published in The New England Journal of Medicine[42] looked at 180 patients who were randomly assigned to receive arthroscopic debridement, arthroscopic lavage or placebo surgery. Deteriorating outcomes after meniscal repair using the Meniscus Arrow in knees undergoing concurrent anterior cruciate ligament reconstruction: increased failure rate with long-term follow-up. Getgood A, Robertson A. Meniscal tears, repairs and replacement a current concepts review. At long term follow-up (8.8 years) no osteoarthritic progression was detectable in 80.8% after repair compared with 40.0% after meniscectomy. Also potential benefits of meniscal repair must be weighed up against significant differences in post-operative rehabilitation. Furthermore randomising patients to receive either repair or resection would not be ethical as different tear patterns require different interventions. (2013). Patients were divided into two groups based on degree of articular degeneration. The absence of blood vessels in the remaining meniscus prevents widespread use of meniscal repair and patients are subjected to meniscectomy. doi:10.2106/JBJS.RVW.17.00125, Lee, S. W., Chun, Y. M., Choi, C. H., Kim, S. J., Jung, M., Han, J. W., et al. J. Orthop. Considering the need for future research, it is necessary to further compare the biomechanical similarities and differences in meniscal tears and surgical strategies between different species to provide a better animal model for relevant research on menisci. Written informed consent was obtained from the owners for the participation of their animals in this study. FIGURE 2. Arthroscopic meniscal repair with fibrin clot of complete radial tears of the lateral meniscus in the avascular zone. also found that root tears caused a greater degree of spontaneous osteonecrosis of the knee (Sung et al., 2013). Finite element analysis of cartilage stress of rabbits in the knee joints and establishment of a model for cartilage defects in different weight-bearing sites. tear Finally, by resecting the medial meniscal body in ABAQUS, different rabbit knee joint models of posterior root horizontal tears and different meniscectomies were established, including a horizontal tear of the medial meniscus (HTMM, Figure 1D), a superior leaf partial meniscectomy (SLPM, Figure 1E), an inferior leaf partial meniscectomy (ILPM, Figure 1F), a double-leaf partial meniscectomy (DLPM, Figure 1G), a subtotal meniscectomy (STM, Figure 1H), and a total meniscectomy (TTM). A prospective longitudinal study. It was also noted that acute repairs within 8 wk of injury did better than the more chronic repairs. Side knee pain is commonly caused by osteoarthritis ("wear-and-tear arthritis"), injuries to the collateral ligaments, tears to the meniscus, or sprains. It's a tear in the crescent-shaped wedge of tough, rubbery cartilage in your knee called your meniscus. IEEE Trans. The site is secure. doi:10.1016/j.arthro.2012.11.016, Sweigart, M. A., and Athanasiou, K. A. J. Arthrosc. Meniscal repair: Biomechanics, in The meniscus. Request an appointment using our secure online form. All patients were recruited from the Houston Veterans Affairs Medical Centre of which 97% were male. Exogenous fibrin clots have been used to stimulate a reparative response in an avascular zone[48]. This should be considered for all repairable tears provided the patient can comply with the post-operative rehabilitation. Cabaud HE, Rodkey WG, Fitzwater JE. 8600 Rockville Pike It was noted that modern all-inside repair devices were not included in the review and long term results are still awaited before firm conclusion on the best repair technique and device can be made. Z., Zhao, F., Wang, S. J., Qi, Y. S., Zhao, L. H., et al. Such tears account for 12-35% of all tear patterns and can be treated by partial meniscectomy or arthroscopic repair. After the SLPM, ILPM, and DLPM, the maximum contact pressure of the medial menisci was 12.2 MPa, 11.1 MPa, and 18.5 MPa, which increased by 100.8%, 82.2%, and 202.7%, respectively, compared with the IMM (6.1MPa), respectively (Figure 2C). Curr. Rabbit knee joint biomechanics: Motion analysis and modeling of forces during hopping. After the SLPM, ILPM, and DLPM, the maximum von Mises stress on the medial menisci was 8.3 MPa, 13.1 MPa, and 8.4 MPa, respectively. There is no similar reported finite element study to simulate the resting state (45) of the rabbit knee joint. Roos et al[29] report on a long term clinical study with follow-up of 21 years of patients after total meniscectomy compared to matched controls. It also provides protection of healthy cartilage in the knee. Treatment for a lateral meniscus tear is usually Treatment PubMed. Maffulli N, Longo UG, Campi S, Denaro V. Meniscal tears. These results demonstrated the reliability of the model used in this study. Relat. Patients were followed up multiple times over a 2 year period. Posterior root tears of the lateral meniscus. Studies comparing meniscal repair with meniscectomy are limited. Eng. MRI scans are only 80%-90% accurate at diagnosing meniscal tears initially and even less accurate post-operatively. Factors influencing the risk of developing arthritis following meniscectomy. doi:10.1097/JSA.0000000000000224, Kurzweil, P. R., Lynch, N. M., Coleman, S., and Kearney, B. There was little effect on the axial load distribution of the medial and lateral compartments of the rabbit knee joint among the IMM, HTMM, and different resections. It is well-established that The analysis used the Standard solver. Arthroscopic, open partial, and total meniscectomy. doi:10.1007/s00167-012-1960-3, Jiang, D., Luo, X., Ao, Y., Gong, X., Wang, Y. J., Wang, H. J., et al. Bethesda, MD 20894, Web Policies WebStart New Search ABOUT CAUSES DIAGNOSIS TREATMENT NEXT STEPS What is a meniscus tear? A locking or catching sensation may also be felt in the knee, and it will often become inflamed (swollen). Sports Med. The present study found that more axial load is transmitted to the lateral compartment of the rabbit knee joint, where the load ratio between the medial and lateral compartments is 0.97, and the ratio of the axial load on the menisci in the intact compartment is approximately 40.6%. Aspiration and injection for meniscal cysts. A comparative study. HHS Vulnerability Disclosure, Help An in vitro experimental study. Rockborn P, Gillquist J. Sports Traumatol. Northmore-Ball et al[35] compared arthroscopic partial meniscectomy with open partial and total meniscectomy in 219 knees. Biodegradable gelatin hydrogels incorporating fibroblast growth factor 2 promote healing of horizontal tears in rabbit meniscus. Ice. RICE Treatment usually starts with the RICE method: Rest. Bernstein and Quach[43] in a critique of this paper believe the inclusion criteria were too broad and arthroscopy based these indications should be invalidated.Finally the authors state that the billions of dollars spent on arthroscopies annually might be put to better use. doi:10.1007/s00167-019-05557-5, Sung, J. H., Ha, J. K., Lee, D. W., Seo, W. Y., and Kim, J. G. (2013). Open meniscal repair through an incision posterior to the collateral ligaments is now rarely performed due to associated neurovascular injury. 27 (10), 33903395. Meniscus root tears are associated with chondral injury, early degenerative change, and a high conversion rate to total knee arthroplasty. Pitfalls associated with FasT-Fix meniscal repair. Rep. 8 (1), 9041. doi:10.1038/s41598-018-27016-w, Kani, K. K., Porrino, J. Barber FA, Herbert MA. J. Orthop. Evidence shows that non-operative treatment can be successful especially in the short term and in the presence of osteoarthritis. Mangione KK, McCully K, Gloviak A, Lefebvre I, Hofmann M, Craik R. The effects of high-intensity and low-intensity cycle ergometry in older adults with knee osteoarthritis. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Comparison of inside-out and all-inside techniques for the repair of isolated meniscal tears: a systematic review. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. The contact pressure was also mainly located in the remaining edge of the medial meniscus, which contacted the articular cartilage. 20, 4755. Natural history of new horizontal meniscal tears in individuals at risk for and with mild to moderate osteoarthritis: Data from osteoarthritis initiative. In the medial compartment, the distribution of contact pressure was more on the MTC than on the MM. They identified that although partial meniscectomy generally had favourable outcomes, extent of cartilage damage as well as workers compensation case pending and low preoperative physical function were predictors of poor outcome.