The meniscus tear. State of the art of rehabilitation protocols related to surgical procedures (original) (raw)
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Journal of Orthopaedic Science and Research, 2021
Meniscus tears are the most frequent knee injuries. Menisci provide joint stability and local pressure distribution. A meniscus injury contributes to the early development of osteoarthritis. The aim of our study is to analyze the results of partial meniscectomy at 4 years follow-up, comparing time of sport recovery between lateral and medial partial meniscectomy. At our institute 94 young athletes with meniscal tear were surgically treated with partial meniscectomy. 75 (80%) were males and 19 (20%) females. Medial meniscus was interested in 74 cases (79%), lateral meniscus in 20 (21 %). Mean age at treatment was 26 ± 4, 98 (range 18-35) years. 15 (16%) patients with medial meniscus tear had associated an ACL tear, which was repaired with an arthroscopic reconstruction by hamstring. Return to sport happened significantly earlier in the medial meniscus tears group than in the lateral meniscus tears group (average time 40±4, 14 days versus 59±7, 24 days). Student's Ttest showed statistical significance (p-value = 0.0147).
Knee Surgery, Sports Traumatology, Arthroscopy
Purpose This study aimed to evaluate and compare the time required to return to sports (RTS) after surgery, the rate of revision surgery and the time required for RTS after revision surgery in elite athletes undergoing meniscal repair or partial meniscectomy, particularly analysing the difference between medial and lateral menisci. It was hypothesised that both procedures would entail similar, high rates of RTS, with the lateral meniscus exhibiting higher potential healing postprocedure compared to the medial meniscus. Methods A systematic review was conducted based on the PRISMA guidelines. Quality assessment of the systematic review was performed using the AMSTAR-2 checklist. The following search terms were browsed in the title, abstract and keyword fields: ‘meniscus’ or ‘meniscal’ AND ‘tear,’ ‘injury’ or ‘lesion’ AND ‘professional,’ ‘elite’ or ‘high-level’ AND ‘athletes,’ ‘sports,’ ‘sportsman,’ ‘soccer,’ ‘basketball,’ ‘football’ or ‘handball’. The resulting measures extracted fro...
Meniscus Tears and Review of the Literature
Meniscus of the Knee - Function, Pathology and Management, 2018
The knee joint is the largest and most complicated joint in the human body. Bone structures, capsules, menisci, and ligaments provide static stability in the knee joint and are responsible for dynamic stabilization of the muscles and tendons. Menisci are fibrocartilage structures that cover two-thirds of the tibial plateau joint surface. The main functions of the meniscus are load sharing and loading of the tibiofemoral joint, shock absorption, helping to feed the cartilage by facilitating dissociation of the joint fluid, and contributing to the joint fit by increasing joint stability and joint contact surface area. Menisci are frequently injured structures. The incidence of acute meniscal tears is 60 per 100,000. It is more common in males. Trauma-related tears are common in patients under 30 years of age, whereas degenerative complex tears increase in patients over 30 years of age. There may not be a significant trauma story, especially in degenerative meniscus tears. They are sports traumas that come to the fore in the etiology of meniscus tears. It is the football that has the greatest risk of creating a meniscus lesion, followed by athletics, American football, and skiing. There is an indication for repair in peripheral ruptures where blood flow is excessive. In the central rupture where blood is not present, the treatment is meniscectomy. In this review, we compiled the diagnosis, etiology, and treatment methods of the meniscal tears.
Meniscal fixation is a successful treatment for hypermobile lateral meniscus in soccer players
Knee Surgery, Sports Traumatology, Arthroscopy, 2018
Purpose To report the outcomes (subjective function, return to play, complications and reoperations) of arthroscopic allinside meniscal fixation in a large sample of soccer players with hypermobile lateral meniscus. Methods Between 2010 and 2015, 55 patients undergoing surgical treatment for hypermobile lateral meniscus at Mutualidad Catalana de Futbolistas (Barcelona, Spain) were identified. Patients with open physes, associated injuries, discoid meniscus, or clinical follow-up less than 6 months were excluded. Once identified, all patients were contacted over the phone to collect cross-sectional data on International Knee Documentation Committee (IKDC) score, postoperative Tegner score, and postoperative visual analogue scale (VAS) for pain. In addition, complications and reoperations were retrospectively collected. Results Forty-six cases (in 45 patients) with a mean (SD) age of 26.3 (9.5) years and mean (SD; range) follow-up of 43 (19.5; 8-73) months were included. The pre-and post-operative median (range) Tegner score was 9 (6-9) and 8 (0-9), respectively. Compared to the preoperative period, the postoperative Tegner score was equal in 27/46 (59%) cases and lower in 16/46 (35%) cases (3 missing values). Return to play was possible in 38/46 (82%) cases, from which 27/46 (59%) corresponded to the same pre-injury activity level. Postoperatively, the median (range) VAS for pain was 1 (0-9), and the mean (SD) subjective IKDC was 86.2 (16.7). Three of the 46 cases (6.5%) required a reoperation because of pain in one patient (meniscal suture failure) and meniscal tear in two patients. Conclusions All-inside meniscal fixation is a successful treatment for hypermobile lateral meniscus, which allows acceptable return to play and good function in soccer players at a low reoperation rate. However, according to the present cross-sectional case series, players should be advised that return to the same pre-injury activity level is achieved in only 27 of 46 (59%) of the cases. Surgeons facing with the difficult problem of hypermobile lateral meniscus in soccer players shouldconsider meniscus fixation as an easy and successful option. Level of evidence Level IV-Therapeutic Case Series.
2014
The aim of the study was to assess the variability of parameters characterising the gait of patients after Tibio-talo-calaneal arthrodesis. The locomotion study evaluated values of angular changes in the hip, knee and ankle joints in three planes of motion, as well as spatio-temporal parameters. The locomotion examination was carried on 4 patients aged between 45 and 60 years (55±7,6), using Vicon 250, with diagnosed secondary degenerative changes of the left ankle and subtalar joints who had undergone the Tibio-talo-calaneal arthrodesis by retrograde intramedullary nail. The control group comprised 30 healthy subjects aged 50- 70 years. Ankle and subtalar arthrodesis have changed the gait stereotype causing a reduction in the economy of patients’ locomotion, the influence of the surgery on the function of the neighbouring joints is also distinctly marked.
Anterior Horn Tears of the Lateral Meniscus in Soccer Players
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2006
The purpose of this retrospective study was to define the clinical and arthroscopic characteristics of anterior horn tears of the lateral meniscus. Type of Study: Case series. Methods: Fourteen patients with mean age of 20.2 years were enrolled in this institutional review boardapproved study. All patients were soccer players with tears of the anterior horn of the lateral meniscus. All patients underwent physical examinations, magnetic resonance imaging (MRI), and arthroscopic treatment. Results: Common symptoms were a catching sensation in 10 patients (71.4%), pain at squatting in 9 patients (64.3%), and sense of giving way and effusion, each in 7 patients (50%). Five patients (35.7%) had lateral joint-line tenderness. McMurray's test was positive in 6 (42.9%) and tears were diagnosed by MRI in 13 (92.8%) patients. Arthroscopic examination showed multiple longitudinal tears in the avascular white zone of the meniscus in 7 patients (50%). Conclusions: These data show that the McMurray test and joint-line tenderness had a low diagnostic value in diagnosing anterior horn tears of the lateral meniscus. MRI, however, had a high diagnostic value. Common arthroscopic findings included multiple longitudinal tears within the white zone of the anterior horn. Level of Evidence: Level IV.
Mechanism of Meniscal Injury and its Impact on Performance in Athletes
The Healer Journal of Physiotherapy and Rehabilitation Sciences
Background: In today’s life style, the gap between athletic activities and daily life activities is becoming wider. The daily life routine is becoming sedentary due to technology and sports activities and thus require high level of physical performance. Knee joint is the most vulnerable to rapid forces and injuries, in which meniscal injury is quite noticeable. Objective: To determine the mechanism of meniscal injury and its impact on performance in athletes after knee meniscal injury. Methods: After taking approval from ethical committee, consent was taken from the athletes prior to filling out the forms. The study was conducted on 145 male athletes in Lahore, aged between 17 to 40 years. Data was collected through international knee documentation committee subjective knee form which consisted of demographical data and questions which were divided into three sections; symptoms, sports activities and knee functions. Results: The main results regarding the mechanism of meniscal injur...
The knee meniscus: management of traumatic tears and degenerative lesions
EFORT Open Reviews
Meniscectomy is one of the most popular orthopaedic procedures, but long-term results are not entirely satisfactory and the concept of meniscal preservation has therefore progressed over the years. However, the meniscectomy rate remains too high even though robust scientific publications indicate the value of meniscal repair or non-removal in traumatic tears and non-operative treatment rather than meniscectomy in degenerative meniscal lesions In traumatic tears, the first-line choice is repair or non-removal. Longitudinal vertical tears are a proper indication for repair, especially in the red-white or red-red zones. Success rate is high and cartilage preservation has been proven. Non-removal can be discussed for stable asymptomatic lateral meniscal tears in conjunction with anterior cruciate ligament (ACL) reconstruction. Extended indications are now recommended for some specific conditions: horizontal cleavage tears in young athletes, hidden posterior capsulo-meniscal tears in ACL...