-
Sports Medicine and Arthroscopy Review Sep 2021A basic understanding of meniscal anatomy and biomechanics is important for physicians evaluating knee injuries and surgeons treating meniscal injuries. This chapter... (Review)
Review
A basic understanding of meniscal anatomy and biomechanics is important for physicians evaluating knee injuries and surgeons treating meniscal injuries. This chapter provides a concise review of meniscal anatomy and biomechanics relevant for the evaluation and treatment of meniscus injuries. Anatomic landmarks relevant for meniscal root repair and transplant are discussed, along with the gross, microscopic, vascular, and neuroanatomy of the menisci.
Topics: Anatomic Landmarks; Biomechanical Phenomena; Humans; Medical Illustration; Menisci, Tibial; Organ Motion; Organ Size; Tibial Meniscus Injuries
PubMed: 34398117
DOI: 10.1097/JSA.0000000000000327 -
Clinics in Sports Medicine Oct 2021The menisci of the knee are accurately evaluated by MRI. Knowledge of normal anatomy, imaging parameters, imaging appearance of the normal and torn meniscus, and common... (Review)
Review
The menisci of the knee are accurately evaluated by MRI. Knowledge of normal anatomy, imaging parameters, imaging appearance of the normal and torn meniscus, and common anatomic variants and pitfalls are essential in obtaining the correct imaging diagnosis. There are multiple imaging signs of meniscal tear, including linear signal intensity extending to an articular surface on at least 2 images, altered meniscal shape, displaced meniscal flap, ghost meniscus, meniscal extrusion, and parameniscal cyst. After surgery, granulation tissue may mimic tear. Diagnosis is improved by comparison to preoperative images, operative note, and intra-articular contrast administration.
Topics: Humans; Magnetic Resonance Imaging; Menisci, Tibial; Retrospective Studies; Tibial Meniscus Injuries
PubMed: 34509203
DOI: 10.1016/j.csm.2021.05.004 -
Clinics in Sports Medicine Oct 2022Discoid meniscus is the most common congenital variant of the meniscus. Its variability in pathology leads to a spectrum of clinical presentations in patients. Treatment... (Review)
Review
Discoid meniscus is the most common congenital variant of the meniscus. Its variability in pathology leads to a spectrum of clinical presentations in patients. Treatment must be tailored to the specific pathology of the discoid meniscus. Imaging studies such as radiographs and magnetic resonance imaging can be useful in confirming the diagnosis, but may be the most accurate in determining specific pathology. Thorough intraoperative evaluation of the discoid is critical to appropriate surgical management. Rim preservation and repair is preferred to prevent degenerative changes in the knee.
Topics: Arthroscopy; Humans; Joint Diseases; Knee Joint; Magnetic Resonance Imaging; Menisci, Tibial; Meniscus; Tibial Meniscus Injuries
PubMed: 36210168
DOI: 10.1016/j.csm.2022.05.009 -
Biomaterials Oct 2011Extensive scientific investigations in recent decades have established the anatomical, biomechanical, and functional importance that the meniscus holds within the knee... (Review)
Review
Extensive scientific investigations in recent decades have established the anatomical, biomechanical, and functional importance that the meniscus holds within the knee joint. As a vital part of the joint, it acts to prevent the deterioration and degeneration of articular cartilage, and the onset and development of osteoarthritis. For this reason, research into meniscus repair has been the recipient of particular interest from the orthopedic and bioengineering communities. Current repair techniques are only effective in treating lesions located in the peripheral vascularized region of the meniscus. Healing lesions found in the inner avascular region, which functions under a highly demanding mechanical environment, is considered to be a significant challenge. An adequate treatment approach has yet to be established, though many attempts have been undertaken. The current primary method for treatment is partial meniscectomy, which commonly results in the progressive development of osteoarthritis. This drawback has shifted research interest toward the fields of biomaterials and bioengineering, where it is hoped that meniscal deterioration can be tackled with the help of tissue engineering. So far, different approaches and strategies have contributed to the in vitro generation of meniscus constructs, which are capable of restoring meniscal lesions to some extent, both functionally as well as anatomically. The selection of the appropriate cell source (autologous, allogeneic, or xenogeneic cells, or stem cells) is undoubtedly regarded as key to successful meniscal tissue engineering. Furthermore, a large variation of scaffolds for tissue engineering have been proposed and produced in experimental and clinical studies, although a few problems with these (e.g., byproducts of degradation, stress shielding) have shifted research interest toward new strategies (e.g., scaffoldless approaches, self-assembly). A large number of different chemical (e.g., TGF-β1, C-ABC) and mechanical stimuli (e.g., direct compression, hydrostatic pressure) have also been investigated, both in terms of encouraging functional tissue formation, as well as in differentiating stem cells. Even though the problems accompanying meniscus tissue engineering research are considerable, we are undoubtedly in the dawn of a new era, whereby recent advances in biology, engineering, and medicine are leading to the successful treatment of meniscal lesions.
Topics: Animals; Biomechanical Phenomena; Humans; Menisci, Tibial; Regeneration; Tissue Engineering; Tissue Scaffolds
PubMed: 21764438
DOI: 10.1016/j.biomaterials.2011.06.037 -
Clinical Anatomy (New York, N.Y.) Mar 2015Meniscal injuries are recognized as a cause of significant musculoskeletal morbidity. The menisci are vital for the normal function and long-term health of the knee... (Review)
Review
Meniscal injuries are recognized as a cause of significant musculoskeletal morbidity. The menisci are vital for the normal function and long-term health of the knee joint. The purpose of this review is to provide current knowledge regarding the anatomy and biomechanical functions of the menisci, incidence, injury patterns and the advancements in treatment options of meniscal injury. A literature search was performed by a review of PubMed, Google Scholar, MEDLINE, and OVID for all relevant articles published between 1897 and 2014. This study highlights the anatomical and biomechanical characteristics of the menisci, which may be relevant to injury patterns and treatment options. An understanding of the normal anatomy and biomechanical functions of the knee menisci is a necessary prerequisite to understanding pathologies associated with the knee.
Topics: Biomechanical Phenomena; Humans; Knee Injuries; Menisci, Tibial; Tibial Meniscus Injuries
PubMed: 25125315
DOI: 10.1002/ca.22456 -
Archives of Orthopaedic and Trauma... May 2022Aim of this systematic review was to analyze long-term results after meniscus refixation. (Review)
Review
PURPOSE
Aim of this systematic review was to analyze long-term results after meniscus refixation.
METHODS
A systematic literature search was carried out in various databases on studies on long-term results after meniscus refixation with a minimum follow-up of 7 years. Primary outcome criterion was the failure rate. Secondary outcome criteria were radiological signs of osteoarthritis (OA) and clinical scores.
RESULTS
A total of 12 retrospective case series (level 4 evidence) were identified that reported about failure rates of more than 7 years follow-up. There was no statistical difference in the failure rates between open repair, arthroscopic inside-out with posterior incisions and arthroscopic all-inside repair with flexible non-resorbable implants. In long-term studies that examined meniscal repair in children and adolescents, failure rates were significantly higher than in studies that examined adults. Six studies have shown minor radiological degenerative changes that differ little from the opposite side. The reported clinical scores at follow-up were good to very good.
CONCLUSION
This systematic review demonstrates that good long-term outcomes can be obtained in patients after isolated meniscal repair and in combination with ACL reconstruction. With regard to the chondroprotective effect of meniscus repair, the long-term failure rate is acceptable.
LEVEL OF EVIDENCE
IV.
Topics: Adolescent; Adult; Anterior Cruciate Ligament Injuries; Arthroscopy; Child; Humans; Menisci, Tibial; Meniscus; Retrospective Studies; Tibial Meniscus Injuries
PubMed: 33913009
DOI: 10.1007/s00402-021-03906-z -
Clinics in Sports Medicine Oct 2022Meniscus tears are common in the pediatric population, typically occur after noncontact injuries, and can be diagnosed clinically with MRI confirmation. Surgery should... (Review)
Review
Meniscus tears are common in the pediatric population, typically occur after noncontact injuries, and can be diagnosed clinically with MRI confirmation. Surgery should be offered to patients with loss of range of motion, persistent symptoms, or displaced/complex tears. Given poor long-term outcomes reported after meniscectomy, repair should be attempted when possible as pediatric menisci are well vascularized and have better outcomes after repair than their adult counterparts. The location of the tear is an important determining factor when deciding on the type of repair to use. Pediatric meniscus repair techniques will be discussed noting differences between pediatric and adult procedures. Further studies are needed to explore the role of biologics and define postoperative protocols.
Topics: Adult; Arthroscopy; Athletes; Biological Products; Child; Humans; Menisci, Tibial; Meniscus; Tibial Meniscus Injuries
PubMed: 36210169
DOI: 10.1016/j.csm.2022.05.010 -
Journal of Cellular Physiology Feb 2022Meniscus fibrochondrocytes (MFCs) are an important cell population responsible for regulating the biomechanical properties of the knee meniscus. Despite their... (Review)
Review
Meniscus fibrochondrocytes (MFCs) are an important cell population responsible for regulating the biomechanical properties of the knee meniscus. Despite their significance, not much is known about them, including how they sense and respond to mechanical stimuli. Due to the mechanical nature of the knee joint, it is therefore paramount to our understanding of the meniscus that its mechanotransductive mechanism be elucidated. In this review, we will summarize the current knowledge on mechanotransduction in MFCs and highlight the relevance of caveolae in lieu of a recent discovery. Additionally, we will discuss the importance of future studies in this area to help advance the field of meniscus research.
Topics: Biomechanical Phenomena; Caveolae; Knee Joint; Mechanotransduction, Cellular; Menisci, Tibial; Meniscus
PubMed: 34676536
DOI: 10.1002/jcp.30616 -
Magnetic Resonance Imaging Clinics of... May 2022Meniscal tears are one of the most common knee injuries. Partial meniscectomy and meniscal repair are the most common treatment options in the setting of an unstable... (Review)
Review
Meniscal tears are one of the most common knee injuries. Partial meniscectomy and meniscal repair are the most common treatment options in the setting of an unstable meniscal tear. Standard MR diagnostic criteria of a meniscal tear may be normal findings postoperatively. The diagnosis of a recurrent or residual meniscal tear after prior meniscal surgery is primarily based on the visualization of surfacing high meniscal T2-weighted signal. After meniscectomy of greater than 25%, or meniscal repair, MR arthrography may be of benefit in the accurate evaluation of a possible residual or recurrent meniscal tear.
Topics: Arthroscopy; Humans; Knee Injuries; Magnetic Resonance Imaging; Menisci, Tibial; Meniscus; Tibial Meniscus Injuries
PubMed: 35512895
DOI: 10.1016/j.mric.2021.11.012 -
Magnetic Resonance Imaging Clinics of... Nov 2022Surgery to treat a torn meniscus is a common orthopedic procedure, and radiologists are frequently asked to image patients with new or recurrent knee pain after meniscus... (Review)
Review
Surgery to treat a torn meniscus is a common orthopedic procedure, and radiologists are frequently asked to image patients with new or recurrent knee pain after meniscus surgery. However, surgery alters the MR imaging appearance of the meniscus, making the diagnosis of recurrent tear a diagnostic challenge. This article reviews relevant anatomy of the meniscus, surgical techniques used to treat meniscus tear, the roles of conventional MR imaging and MR arthrography to assess the postoperative meniscus, and the key MR imaging findings to distinguish the intact postoperative meniscus from recurrent tear.
Topics: Humans; Knee Injuries; Magnetic Resonance Imaging; Menisci, Tibial; Meniscus; Tibial Meniscus Injuries
PubMed: 36243514
DOI: 10.1016/j.mric.2022.02.005