Inferior Healing Rate in Isolated Meniscal Repair than that in Meniscal Repair with Concomitant ACL Reconstruction Evaluated with MRI

@#Introduction: Isolated meniscal repair has been suggested as one of the contributing factors in unhealed meniscal repair. The purpose of this study was to compare the healing rate between isolated meniscal repair and meniscal repair with concomitant anterior cruciate ligament reconstruction (ACLR) using a standardised assessment method after propensity score matching. Materials and methods: Accuracy of the Crues' grading system for meniscal healing was validated using second-look arthroscopy as the reference standard in 17 patients. Propensity score matching (one-to-one) was performed between 26 patients who underwent isolated meniscal repair and 98 patients who underwent meniscal repair with concomitant ACLR. Patients were matched for sex, age, side and zone of the meniscal repair, and number of sutures. Healing rates at one year which were evaluated with magnetic resonance imaging (MRI) were compared between the two groups. Results: The sensitivity and specificity of the Crues' grading system on multiple plane MRI for meniscal healing were 100% and 83.3%, respectively. Both the isolated meniscal repair group and the meniscal repair with concomitant ACLR group included 21 patients after propensity score matching. Baseline characteristics did not differ significantly between the two groups. The healing rate was significantly lower in the isolated meniscal repairs group (14.3%) than in the meniscal repair concomitant with ACLR group (47.6%, P=0.04). Conclusion: The healing rate for isolated meniscal repair using a standardised MRI assessment method was inferior to that of meniscal repair with concomitant ACLR after propensity score matching.

Concerns of Technical Evaluation on Registration of All-inside Meniscus Suture System / 中国医疗器械杂志

OBJECTIVE@#To summarize the product registration declaration ideas and registration technical review of the all-inside meniscal suture system, and to systematically think about of the technical review concerns of the all-inside meniscal suture system products to provide technical guidance for improving the quality of registration and application and regulatory efficiency.@*METHODS@#Consult the public information of such products at home and abroad, and summarize the experience of registration review of such products.@*RESULTS@#The technical review of the all-inside meniscus suture system registration mainly focuses on product basic information, pre-clinical research, clinical evaluation and product technical requirements.@*CONCLUSIONS@#The difficulty of product registration and declaration of the all-inside meniscus suture system lies in the provision of pre-clinical research data of the product, and the applicant needs to strengthen the basic research ability, formulate scientific technical indicators and test methods to ensure the safety and effectiveness of the product, and also provide sufficient supporting data for the registration declaration.

Safety and antibacterial properties of gentamicin-loaded silk fibroin in meniscus repair / 中国组织工程研究

BACKGROUND: Silk fibroin material has good biocompatibility, excellent mechanical properties, biodegradation and other advantages. However, it has not been used as a kind of suture fixation material in the repair of meniscus tear. OBJECTIVE: To prepare gentamicin loaded silk fibroin material and analyze its biocompatibility and antibacterial properties. METHODS: After dissolving the degummed natural silkworm cocoon with ternary solution, the silk fibroin material was prepared by dialysis, freeze-drying, redissolution and molding, and gentamicin was dissolved in silk fibroin solution to prepare gentamicin loaded silk fibroin material. Silk fibroin material and gentamicin loaded silk fibroin material were co-cultured with mouse pre chondroblasts respectively. After 1, 3, and 5 days, cell proliferation was detected by MTT assay. After 24 hours of co-culture, the cytotoxic effect of the material was detected by calcein staining. The early apoptosis of cells was detected by flow cytometry. The adhesion of cells on the surface of the material was observed by scanning electron microscope. Silk fibroin material and gentamicin loaded silk fibroin material were mixed with anticoagulant separately. The hemolysis rate of the material was detected by hemolysis experiment. The silk fibroin material and gentamicin loaded silk fibroin material were co-cultured with S.aureus and E.coli respectively. The bacterial count, scanning electron microscope observation and bacteriostatic circle experiment were carried out. RESULTS AND CONCLUSION: (1) The two materials had no significant effect on cell proliferation and early apoptosis. (2) There was no obvious cytotoxicity between the two materials, and the cells adhered on the surfaces of the two materials grew well, arranged tightly, and the morphology of the cells expanded. (3) The two materials had good blood compatibility and did not cause hemolytic reaction. (4) Gentamicin loaded silk fibroin material had obvious inhibition on S.aureus and E.coli, and the inhibition on S.aureus was more obvious. (5) The results showed that the gentamicin loaded silk fibroin material has good biocompatibility and antibacterial property.

Advances in stem cells research concerning tissue-engineered meniscus / 中国组织工程研究

BACKGROUND: Meniscus cartilage injury is a most common injury of knee joint. In the past decade, stem cell based therapies have been widely applied, and the related studies have been increased rapidly. Pluripotent stem cells have been shown to exist in the meniscus, which may play a key role in the healing of meniscus.OBJECTIVE: To determine the source and culture conditions of stem cells related to tissue-engineered meniscus, and to understand the current development status of tissue-engineered meniscus. METHODS: PubMed, Embase, EBSCO, Cochrane library, and Clinical library databases were retrieved for relevant articles published between 2009 and 2019. The articles concerning tissue-engineered meniscus and selection of seed cells were selected, and finally 64 eligible articles were included for analysis. RESULTS AND CONCLUSION: Stem cells have been extensively used as seed cells in tissue-engineered meniscus due to its high proliferation ability and multipotent property. These cells can effectively repair the meniscus in animals, but the clinical outcomes still remain unclear. Therefore, there is a certain distance from basic research to clinical application.

National Trends of Meniscectomy and Meniscus Repair in Korea

BACKGROUND: Meniscus surgeries are frequently performed in orthopaedics. However, their current status is not well known in many countries, including Korea. This study aimed to investigate the national trends of meniscus surgery in Korea. METHODS: Information from the national database was acquired through the Korean Health Insurance Review and Assessment Service from 2010 to 2017. All cases coded as meniscectomy or meniscus repair were included. The total number and incidence of cases of meniscus surgery per 100,000 persons were determined, and the results were stratified by age and gender. The meniscus repair ratio for the total number of meniscus surgeries was evaluated. RESULTS: The total number and incidence of meniscectomy cases were 65,752 and 137, respectively, in 2010, which increased to 74,088 and 154, respectively, in 2017. The number of meniscectomies increased by 12.67% in 8 years. The total number and incidence of meniscus repair cases were 9,055 and 18, respectively, in 2010, which increased to 14,947 and 31 in 2017. The number of meniscus repairs increased by 65.04%. The meniscus repair ratio was 12.1% in 2010, which increased to 16.8% in 2017. The highest peak was noted for patients who underwent meniscus surgeries in their 50s and 60s. Meniscectomy was performed more frequently in women (57%) than in men (43%), whereas repair was performed more frequently in men (54%) than in women (46%) over the study period. CONCLUSION: The total number and incidence of meniscus surgeries increased from 2010 to 2017; the number and incidence of meniscus repair procedures increased more rapidly than those of meniscectomy, with the peak treatment age for both surgeries being in the 50s and 60s. The current study will contribute to understanding the epidemiology of meniscus surgery, its prevention, and cost-saving measures in Korea.

Fibrin Clot Delivery System for Meniscal Repair

As meniscal preservation particularly in younger active individuals with a symptomatic meniscal tear remains the preferred treatment option, various methods have been suggested to increase healing and success rates after meniscal repair. The recent increase in clinical use of platelet rich plasma has contributed to the increased use of fibrin clot, which virtually has the same healing property. However, despite the relative ease of acquisition and preparation of fibrin clots, delivering it to the desired target area arthroscopically is challenging. Therefore, we report with a pertinent literature review a novel method of planting a fibrin clot to the desired area of meniscal tear arthroscopically using our delivery system to enhance healing.

Meniscus Repair with Fibrin Clot in Complete Radial Tear of Lateral Meniscus / 대한정형외과학회잡지

Meniscus tear is one of the most common knee injuries. The increasing recognition of the importance of the meniscal function has led to a range of new treatments for meniscal tears. A complete radial tear disrupts the circumferential hoop tension of the meniscus. Therefore, restoring its natural architecture is of utmost importance. However, it is difficult to achieve meniscal healing of a complete radial tear due to its structural characteristics. We report five cases of a complete radial tear of the lateral meniscus treated successfully using a fibrin clot that showed good meniscal healing and excellent clinical outcomes.

Clinical Results of the Accelerated Rehabilitation Program after Meniscal Repair using the RapidLoc Device / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the clinical results of the accelerated rehabilitation program after performing meniscal repair using the RapidLoc device, and we wanted to investigate the incidence of complications related to using the RapidLoc device together with the accelerated rehabilitation program. MATERIALS AND METHODS: We performed a retrospective review of a consecutive series of meniscal repairs that were done by single surgeon with using the RapidLoc meniscal repair device. An accelerated postoperative rehabilitation program followed, and this was independent of whether anterior cruciate ligament (ACL) surgery was also performed. The Lysholm and IKDC (International Knee Documentation Committee) activity scores, the clinical examination findings and the adverse events were recorded for all the patients. In addition, using Barrett's criteria, a repaired meniscus was considered healed if there was no joint line tenderness, effusion or a negative McMurray's test at the latest follow-up. RESULTS: At follow-up, the mean IKDC activity score was 3.38 (1.75 preoperatively), the Lysholm score was 91.8 (48.7 preoperatively). Clinical success occurred for 30 repairs (93.7%) at the time of the last follow-up. Two patient had tenderness on joint line palpation and intermittent effusion, so theses repair were considered failure according to our criteria. There was no specific complication related to the RapidLoc device. CONCLUSION: Our results show that accelerated rehabilitation program after arthroscopic meniscal repair with using the RapidLoc device provided a high rate of clinical meniscus healing and this appeared to be safe and effective.

Two Posteromedial Portal Technique of All-Inside Meniscus Repair for Posterior Horn Tear of Medial Meniscus

No abstract available.

Meniscus Repair using Meniscus Arrow: Preliminary Report

No abstract available.

A Comparative Clinical analysis of Arthroscopic Meniscectomy and Arthroscopic Meniscus Repair / 대한정형외과학회잡지

There have been controversies on the rationale, surgicl indication, technique and results of meniscus repair.. Authors comparatively studied 100 cases of meniscus injury in 88 patients (arthroscopic total menisectomy: 16 cases, arthroscopic partial menisectomy: 68 cases, arthroscopic meniscus suturing: 16 cases) from February 1985 to March 1992. The results were as follows: 1. Male (61.4%) was much more affected than female. 2. The third decade group was most commonly affected and the most common causes was sports injury (43.2%) 3. The lateral meniscus was more injured (71%), than the medial (29%) 4. In arthroscopic finding, longitudinal tear (37%) was the most common. 5. According to the Tapper and Hoover's criteria, satisfactory result was 56.3% in arthroscopic meniscus repair group.

Open Men iscal Repair of the Knee Joint / 대한정형외과학회잡지

The meniscus has improtant functions of shock absorption, load transmission, lubrication and significant contribution to stability of the knee. Accordingly, repair rather than excision can be expectd to be satisfactory and functional teatment for knee joint. We had Repaired 56 cases of meniscal tears from March, 1987 to September of 1992, among which 42 cases were followed up for at least 12 months to 60 months at most(in average 36 months). The results were as follows; 1) In medial meniscal tears, 26 cases were acute, while five were chronic. As for the lateral meniscus, acute and chronic teats were observed in nine and two cases, respectively. 2) Eleven of the 35 acute tears were associated with anterior cruciate ligament tears, while three of seven chronic tears were associated with anterior cruciate ligament tears. 3) Second-look arthroscopic examinations were performed on nine repaired cases. Retears occurred in two cases and seven cases revealed healing at repair sites. 4) Two cases(5%) out of 42 repaired menisci were return during follow-up. One was a case of isolated meniscal tear and the other was associated with rupture of anterior cruciate ligament. 5) Two return cases were repaired in the chronic stage of more than one year after trauma. 6) The standing radiographs which were taken in full extension and 45 flexion on eight out of 13 patients, who had been followed up for more than 4 years showed intact joint space without narrowing.

Arthroscopic All-inside Suture Technique for Repairing Medial Meniscus Posterior Horn Tear / 中国运动医学杂志

Objective To present the special arthroscopic all-inside suture technique for repairing medial meniscus posterior horn tears and clinical follow-up results including arthroscopy and MRI outcome. Methods Eighty nine cases of posterior horn tears of medial meniscus combining with anterior cruciate ligament injuries were enrolled in this setting.Arthroscopic all-inside suturing medial meniscus through 2 posteromedial portals and 1 transcondylar portal was performed, with simultaneous ACL reconstruction using hamstring or B-PT-B autograft or allograft. Results Seventy five cases(84.3%)were followed-up for an average of 20.2 months, in which 25 cases underwent arthroscopic evaluation and 21 MRI evaluation.All 25 cases undergoing second-look arthroscopies were completely healed.Of the 21 cases receiving MRI evaluation, 18 were completely healed and 3 were partialy healed. Conclusions Arthroscopic all-inside suture technique is a good alternative for repairing medial meniscus posterior horn tear and a higher healing rate can be obtained using such a technique.