WebArthroscopic meniscus repairs typically takes about 40 minutes. However, it remains unknown whether it is capable of delaying or modifying OA progression, and further research is warranted [32, 48, 49]. Reference article, Radiopaedia.org (Accessed on 01 May 2023) https://doi.org/10.53347/rID-70702. Google Scholar, Magnusson K, Turkiewicz A, Kumm J, Zhang F, Englund M (2020) The relationship between MRI features and knee pain over 6 years in knees without radiographic osteoarthritis at baseline. Correspondence to Terms and Conditions, Most of the meniscus pathologies have recently been correlated with meniscal extrusion [3, 6]. In another study where they examined MRI series both before and after medial MPRT, they showed that MTL disruption and ME predated the MPRT, thus emphasizing the potential role that MTL could play as a causal factor of ME, and even suggesting that disruption of MTL should be addressed alongside MPRT repair in order to reduce ME [75]. Treatment with glucosamine, chondroitin sulfate and licofelone has been found beneficial in patients with knee OA and ME, as it may lead to alleviation of symptoms and reduce cartilage volume loss over time. Meniscus Also taking into consideration that residual ME after MPRT repair correlates with worse outcomes regarding both clinical parameters and OA progression [72, 73], a better understanding of the causality of ME is needed in order to appropriately address it. Slowly lower the body, keeping the foot flat. Clinical significance and management of meniscal extrusion in different knee pathologies: a comprehensive review of the literature and treatment algorithm, https://doi.org/10.1186/s43019-022-00163-1, Anterior cruciate ligament reconstruction (ACLR), https://doi.org/10.1007/s00167-020-06363-0, https://link.springer.com/article/10.1007%2Fs00402-020-03683-1, https://doi.org/10.1186/s43019-019-0019-x, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. It is a very common injury, especially among people who play sports. For an athlete, playing through knee pain can cause greater problems later. This can result from disruption of collagen fibers within the meniscus that provide hoop strength 8.. (2012). Arthroscopy 35(6):16581666, Jiang D, Ao YF, Gong X, Wang YJ, Zheng ZZ, Yu JK (2014) Comparative study on immediate versus delayed meniscus allograft transplantation: 4- to 6-year follow-up. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Getting hit or tackled can make you twist your knee, tearing the cartilage. This will reduce the stress on your knee. Get useful, helpful and relevant health + wellness information, 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.merckmanuals.com/home/injuries-and-poisoning/sprains-and-other-soft-tissue-injuries/knee-sprains-and-related-injuries), (https://www.niams.nih.gov/health-topics/knee-problems#tab-overview), (https://orthoinfo.aaos.org/en/treatment/knee-arthroscopy/), (https://orthoinfo.aaos.org/en/diseases--conditions/meniscus-tears/), (https://www.physio-pedia.com/Meniscal_Repair). https://doi.org/10.1055/s-0040-1715109, Strauss EJ, Day MS, Ryan M, Jazrawi L (2016) Evaluation, treatment, and outcomes of meniscal root tears: a critical analysis review. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 28(4):11771194, Swamy N, Wadhwa V, Bajaj G, Chhabra A, Pandey T (2018) Medial meniscal extrusion: detection, evaluation and clinical implications. The tear frequently occurs while playing sports. Torn or Frayed Meniscus: When Surgery May Be WebItll help increase your range of motion and help your knee get stronger. PubMed Central Orthop J Sports Med 8(7):2325967120936672, Koga H, Muneta T, Watanabe T, Mochizuki T, Horie M, Nakamura T et al (2016) Two-year outcomes after arthroscopic lateral meniscus centralization. Nonanatomical placement of the meniscal allograft>5mm relative to the endogenous meniscus adversely affects the mechanical contacts of the knee, which may affect the allograft's ability to prevent articular cartilage degeneration [16, 124]. This puts tension on a torn meniscus. Where possible, doctors will recommend nonsurgical forms of treatment. Meniscal maceration is a finding sometimes used on MRI imaging to describe the wasting away of the meniscus or cause it to become soft or separated into constituent elements. Therefore, proper placement of the posterior horn is critical to the anatomical repair of the meniscus [125,126,127]. Moreover, extrusion of the LM does not improve after ACLR unless the meniscal tear is repaired [87, 92]. Treatment usually starts with the RICE method: Rest. View Yuranga Weerakkody's current disclosures, see full revision history and disclosures, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity. J Orthop Res 35(8):16251633, Shefelbine SJ, Ma CB, Lee KY, Schrumpf MA, Patel P, Safran MR et al (2006) MRI analysis of in vivo meniscal and tibiofemoral kinematics in ACL-deficient and normal knees. Knee Surg Relat Res. Medial and Lateral Meniscus Tears | Cedars-Sinai Often, athletes and people who play sports for fun suffer meniscus tears. J Orthop Res Off Publ Orthop Res Soc 24(6):12081217, Wenger A, Englund M, Wirth W, Hudelmaier M, Kwoh K, Eckstein F et al (2012) Relationship of 3D meniscal morphology and position with knee pain in subjects with knee osteoarthritis: a pilot study. It is often used with chronic degenerative conditions although some authors also propose this term in the setting of a tear (macerated tear)2. Cant fully bend or straighten your leg without knee pain. This condition may lead to increased cartilage degeneration, progressive OA and allograft failure, as mentioned in several biomechanical studies [17, 111]. Eur Radiol 29(5):26162623, Debieux P, Jimenez AE, Novaretti JV, Kaleka CC, Kriscenski DE, Astur DC et al (2020) Medial meniscal extrusion greater than 4 mm reduces medial tibiofemoral compartment contact area: a biomechanical analysis of tibiofemoral contact area and pressures with varying amounts of meniscal extrusion. PubMed Central Older people are likely to have meniscus damage related to degeneration from wear-and-tear. (2016). If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Semin Arthritis Rheum 46(5):552561, LaPrade RF, LaPrade CM, James EW (2015) Recent advances in posterior meniscal root repair techniques. According to this technique, a more posterolateral position of the tibial tunnel aperture within the ACL footprint reduces the RTD (reference point to tibial tunnel distance) and increases the extrusion of the LM following ACLR [93]. Arthroscopy 31(12):2380-2391.e2, Ren S, Zhang X, You T, Jiang X, Jin D, Zhang W (2018) Clinical and radiologic outcomes after a modified bone plug technique with anatomical meniscal root reinsertion for meniscal allograft transplantation and a minimum 18-month follow-up. Severe Meniscus Tear: Treatment Options This pattern completely disrupts the continuity of the circumferential fibers, leading to the loss of the hoop tension and substantial ME, thus promoting rapid progression of knee OA [1, 57]. A persons initial exercise routine may include an exercise called hamstring contractions. We avoid using tertiary references. Google Scholar, Hart HF, Crossley KM, Felson D, Jarraya M, Guermazi A, Roemer F et al (2018) Relation of meniscus pathology to prevalence and worsening of patellofemoral joint osteoarthritis: the multicenter osteoarthritis study. 2023 BioMed Central Ltd unless otherwise stated. Recovery time is 6 to 8 weeks with conservative treatment. Furthermore, they performed an open MTL repair in 15 patients with meniscal tear and medial ME through a mini-incision with three interconnecting suture anchors (Fig. California Privacy Statement, The recovery time is longer than in the case of a meniscectomy. Modern treatment of meniscal tears. Heres what it involves: Treatment usually starts with the RICE method: If recommended by your doctor, use nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen to reduce pain and swelling for 8 to 12 weeks. Fig 3. Several studies also argue that the presence of ME is predictive of knee OA progression [32,33,34]. It will also help stabilize your balance and help prevent another knee injury. People who play sports (like tennis, soccer, basketball or football) that involve sudden twisting movements are most likely to tear a meniscus. Here, find nine gentle exercises that may help strengthen and heal a torn meniscus. Policy. It permits immediate weight bearing following surgery and provides a full range of motion soon afterward. Therefore, they suggested that this type of OA patient, with MME and varus malalignment with a low MPTA, could benefit primarily from an early intervention with high tibial osteotomy (HTO), thus delaying the progression of knee OA. MNT is the registered trade mark of Healthline Media. https://doi.org/10.1177/2325967120961368, Paletta GA, Crane DM, Konicek J, Piepenbrink M, Higgins LD, Milner JD et al (2020) Surgical treatment of meniscal extrusion: a biomechanical study on the role of the medial meniscotibial ligaments with early clinical validation. Hart et al. Our website services, content, and products are for informational purposes only. Knee Surg Sports Traumatol Arthrosc 24(5):14551468, Feucht MJ, Khle J, Bode G, Mehl J, Schmal H, Sdkamp NP et al (2015) Arthroscopic transtibial pullout repair for posterior medial meniscus root tears: a systematic review of clinical, radiographic, and second-look arthroscopic results. Over time, the joint can break down. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359983/, https://orthoinfo.aaos.org/en/recovery/knee-arthroscopy-exercise-guide/, https://orthoinfo.aaos.org/en/diseases--conditions/meniscus-tears/, https://www.ncbi.nlm.nih.gov/books/NBK431067/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5444079/, New clues to slow aging? Kneecap pain. In addition, when there is ACL rupture and the preoperative extrusion of the LM is 1.1mm, the surgeon should consider the possibility of a complete posterior root tear (PRT) of the LM. Meniscus Tear Repair Surgery: What To Expect Its best to see a doctor for diagnosis of knee pain and a treatment plan. Most often, the meniscus tears during a sudden motion in which your knee twists while your foot stays planted on the ground. ME, in the coronary plane, is defined as the maximum distance of the most distal end of the meniscus from the border of the tibial plateau, where the tibial eminences are the most prominent, without taking into account the osteophytes. A small 2018 randomized controlled study comparing conventional to Ayurvedic treatment in 151 people found that Ayurvedic treatments were beneficial in reducing osteoarthritis knee symptoms at 3, 6, and 12 months. These tests include: However, these may not have the best accuracy. Meniscal extrusion (ME) is a radiological finding, especially in magnetic resonance imaging (MRI) scans, for which there has been growing interest in recent years. Clin Anat N Y N 28(6):792799, Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA et al (2019) OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. defined significant ME as when more than 25% of the meniscal body width extends beyond the tibial limit [14,15,16,17]. Medial Compartment Osteoarthritis A physical therapist can provide a daily routine of exercises and stretches to improve your muscle strength, flexibility, range of motion, and stability. https://doi.org/10.1186/s43019-022-00163-1, DOI: https://doi.org/10.1186/s43019-022-00163-1. Without surgery, recovery will take about 6 to 8 weeks, though this can vary. Furthermore, supplementary centralization of the meniscus appears to be able to adequately reduce the ME, as it also addresses potential MTL lesions. Eur J Radiol 1(102):115124, Karpinski K, Diermeier T, Willinger L, Imhoff AB, Achtnich A, Petersen W (2019) No dynamic extrusion of the medial meniscus in ultrasound examination in patients with confirmed root tear lesion. Note that meniscectomy may cause osteoarthritis in the long term. Debieux et al. The menisci can be torn or strained by any rotation or twisting motion that puts stress on the knee. Proposed treatment algorithm for meniscal extrusion (ME) in different knee pathologies (OA osteoarthritis, ME meniscal extrusion, HTO high tibial osteotomy, MPRTs meniscal posterior root tears, ACL anterior cruciate ligament reconstruction, LM lateral meniscus, PRT posterior root tear, MAT meniscal allograft transplantation), Krych AJ, Bernard CD, Kennedy NI, Tagliero AJ, Camp CL, Levy BA et al (2020) Medial versus lateral meniscus root tears: is there a difference in injury presentation, treatment decisions, and surgical repair outcomes? Meniscal extrusion or subluxation refers to the peripheral meniscal margin extending beyond the external aspect of the tibiofemoral compartment of the knee.. MPRT are defined as an avulsion fracture or a radial lesion occurring within 1cm of the bony tibial attachment [56]. PubMedGoogle Scholar. J Knee Surg. The term meniscal extrusion (ME) is used to describe the radial meniscal body displacement beyond the peripheral tibial plateau margin [7, 8]. Am J Sports Med 47(12):28882894, Delinc P, Ghafil D (2012) Anterior cruciate ligament tears: conservative or surgical treatment? The early results of MAT are encouraging, as pain relief and improved knee function are reported [15,16,17, 62, 104,105,106,107,108,109]. See this post to learn more about how a meniscus functions, As mentioned in my recent post, the majority of posterior horn tears are determined to be degenerative. Skeletal Radiol 26(7):424427, Article During the meniscus surgery, a small instrument called an arthroscope, which has a camera at its tip, is inserted into your knee. Meniscal tears: Current understanding, diagnosis, and management. How can you tell whether you have a meniscus tear? Am J Sports Med 45(8):18641871, Novaretti JV, Astur DC, Cavalcante ELB, Kaleka CC, Amaro JT, Cohen M (2020) Preoperative meniscal extrusion predicts unsatisfactory clinical outcomes and progression of osteoarthritis after isolated partial medial meniscectomy: a 5-year follow-up study. Beaufils P, et al. 2017;25(1):76-84. Knee Surg Sports Traumatol Arthrosc 27(10):33113317, Costa CR, Morrison WB, Carrino JA (2004) Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear? Knee Surgery & Related Research Meniscus tears are the most frequently treated knee injuries. [77] performed arthroscopic centralization of nine extruded lateral menisci with the use of suture anchors, and ME was significantly reduced in 2years of follow-up. Semin Arthritis Rheum 45(3):257267, Liu Y, Joseph GB, Foreman SC, Li X, Lane NE, Nevitt MC et al (2020) Determining a threshold of medial meniscal extrusion for prediction of knee pain and cartilage damage progression over 4 years: data from the osteoarthritis initiative. The menisci are crescent-shaped, fibrocartilaginous structures that play a crucial role in the load transition and distribution of the contact forces along the tibiofemoral articulation. MAT is not a simple surgical procedure, has a high learning curve, and if it is not performed under certain indications (Table 1) it fails, leaving both the surgeon and the patient dissatisfied [106, 109]. Therefore, ultrasound (U/S) was recently introduced as a reliable alternative to MRI for the evaluation of ME, which also offers the possibility for dynamically assessing ME in various positions, as well as in a weight-bearing state, in an inexpensive and feasible manner [20,21,22]. PubMed Knee Surg Relat Res. Home treatment, If you've been sidelined by a common sports injury like an ACL tear, you're likely wondering how long it will take to heal. 2a), and found that postoperative ME was significantly reduced. Osteoarthritis Cartilage 26(7):912919, Roubille C, Martel-Pelletier J, Abram F, Dorais M, Delorme P, Raynauld JP et al (2015) Impact of disease treatments on the progression of knee osteoarthritis structural changes related to meniscal extrusion: data from the OAI progression cohort. Therefore, ACL rupture alone cannot cause the posterior extrusion of the MM, and the ACLR alone does not directly cause distinct damage to the MM. If these measures do not alleviate a persons symptoms, doctors may recommend surgical options, such as a partial meniscectomy or a meniscus repair. Am J Sports Med 38(8):15421548, Yanagisawa S, Kimura M, Hagiwara K, Ogoshi A (2020) Association between postoperative meniscal extrusion and clinical outcomes of the pullout fixation technique for medial meniscus posterior root tear. WebThere are two general forms of treatment for meniscus tears: conservative, or nonsurgical, and surgical. Cite this article. https://doi.org/10.1155/2015/210972, Kijima H, Miyakoshi N, Kasukawa Y, Ishikawa Y, Kinoshita H, Ohuchi K et al (2017) Cut-off value of medial meniscal extrusion for knee pain. Knee Surg Sports Traumatol Arthrosc 29(4):11971205, Song JH, Bin SI, Kim JM, Lee BS (2020) Postoperative subchondral bone marrow lesion is associated with graft extrusion after lateral meniscal allograft transplantation. https://doi.org/10.1002/acr.24394, Wu PT, Shao CJ, Wu KC, Wu TT, Chern TC, Kuo LC et al (2012) Pain in patients with equal radiographic grades of osteoarthritis in both knees: the value of gray scale ultrasound. 2021. https://link.springer.com/article/10.1007%2Fs00402-020-03683-1. Comparative studies between normal knees and knees with ACL rupture demonstrated that the posterior extrusion of the MM during knee flexion is almost the same [83, 94]. During this procedure, the surgeon inserts a tiny camera (called an arthroscope) through a small incision into your knee. Am J Sports Med 45(1):4249, Krych AJ, Bernard CD, Leland DP, Camp CL, Johnson AC, Finnoff JT et al (2020) Isolated meniscus extrusion associated with meniscotibial ligament abnormality. ME is found in several knee pathologies and is well correlated with rapid knee OA progression as well as increased morbidity. To address the problems of patients with meniscectomy, efforts are constantly being made to develop techniques that aim at meniscal regeneration or development of meniscal scaffolds. Have swelling that doesnt go away with a few days of RICE and taking NSAIDs. [39,40,41]. Meniscus Tears Why Surgery Isnt Always Necessary, Batters Shoulder : Posterior Labral Tears, Runners require strength too: What to do and when to do it, Lactate, the lactate shuttle, and lactate threshold workouts in polarized training, Zone 2 Heart Rate Training For Longevity and Performance, Pain In The Front Of The Knee: 6 Common Causes, Sometimes our joints just hurt, and its ok not to know why. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. The time of recovery varies depending on: The meniscus is a C-shaped band of cartilage that goes around the knee joint and cushions the junction of your thighbone (femur) and shinbone (tibia).
Paul Kendrick Studio Email,
3 Color Paracord Bracelet Without Buckle,
Articles M
