Meniscus injuries under high-intensity training in cycling athletes / Lesões no menisco sob treinamento de alta intensidade em atletas de ciclismo / Lesiones de menisco bajo entrenamiento de alta intensidad en atletas de ciclismo

ABSTRACT Introduction: Due to the high intensity and speed of cycling, a high technical and tactical level, physical quality, and psychological quality are required of athletes. Meniscal injuries are common in cyclists. In particular, chronic meniscal injuries are usually caused by an accumulation of fatigue or untimely and incomplete treatment of acute sports injuries. Objective: Analyze the protective factors and methods for meniscal injuries in cyclists. Methods: Volunteer male cyclists were selected for a questionnaire that investigated the athletes' meniscal injuries. The data collected were statistically analyzed. Results: There were 6 cases of right knee meniscus injury in athletes; these data accounted for 75% of the injuries. Left meniscus injuries accounted for 2 cases. There was one case of medial injury in both knees. The corresponding preventive measures are presented according to the cause of the injury. Conclusion: Causes of meniscal injuries in cyclists include insufficient knee strength, inadequate training methods, physical fatigue, and long-term localized effort. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: Devido à alta intensidade e velocidade do ciclismo, é exigido um alto nível técnico e tático, qualidade física e qualidade psicológica dos atletas. Lesões meniscais são comuns em ciclistas. Em particular, as lesões meniscais crônicas são geralmente causadas por um acúmulo de fadiga ou tratamento inoportuno e incompleto de lesões esportivas agudas. Objetivo: Analisar os fatores e métodos de proteção para lesões meniscais em ciclistas. Métodos: Ciclistas do sexo masculino voluntários foram selecionados para um questionário que investigou as lesões meniscais dos atletas. Os dados coletados foram analisados estatisticamente. Resultados: Houve 6 casos de lesão meniscal do joelho direito em atleta, esses dados são responsáveis por 75% dos danos. Lesões no menisco esquerdo representaram 2 casos. Houve um caso de lesão medial em ambos os joelhos. As medidas preventivas correspondentes são apresentadas de acordo com a causa da lesão. Conclusão: As causas das lesões meniscais em ciclistas incluem força insuficiente no joelho, métodos de treinamento inadequados, fadiga física e esforço localizado a longo prazo. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: Debido a la alta intensidad y velocidad del ciclismo, se exige a los deportistas un alto nivel técnico y táctico, calidad física y calidad psicológica. Las lesiones de menisco son comunes en los ciclistas. En particular, las lesiones crónicas de menisco suelen ser causadas por una acumulación de fatiga o por un tratamiento inoportuno e incompleto de las lesiones deportivas agudas. Objetivo: Analizar los factores y métodos de protección de las lesiones meniscales en ciclistas. Métodos: Se seleccionaron ciclistas masculinos voluntarios para un cuestionario que investigaba las lesiones meniscales de los atletas. Los datos recogidos se analizaron estadísticamente. Resultados: Hubo 6 casos de lesiones de menisco de la rodilla derecha en atletas, estos datos representaron el 75% de las lesiones. Las lesiones del menisco izquierdo representaron 2 casos. Hubo un caso de lesión medial en ambas rodillas. Las medidas preventivas correspondientes se presentan según la causa de la lesión. Conclusión: Las causas de las lesiones de menisco en los ciclistas incluyen una fuerza insuficiente de la rodilla, métodos de entrenamiento inadecuados, fatiga física y esfuerzos localizados a largo plazo. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Sports rehabilitation in athletes with meniscal lesions based on electroacupuncture associated with sports therapy / Reabilitação esportiva de atletas com lesão meniscal baseada em eletroacupuntura combinada à terapia esportiva / Rehabilitación deportiva de atletas con lesión meniscal basada en electroacupuntura combinada con la terapia deportiva

ABSTRACT Introduction: Meniscal injury is a common condition that can lead to disability due to pain and proprioceptive failure, requiring immediate attention. Combination therapies involve advanced approaches aiming to accelerate rehabilitation in athletes, and electroacupuncture presents therapeutic benefits, although there is still no evidence of its combination with sports therapy. Objective: This paper analyzes the performance of sports rehabilitation in athletes with meniscal lesions using electroacupuncture combined with sports therapy. Methods: The intervention in the control group was based on a traditional range of motion work, muscle strength, proprioceptive training, and other exercise therapies, while the experimental group received a 30 min electro-acupuncture protocol three times a week for four consecutive weeks. The surrogate data (gender, age, disease course, location) are the same. Before treatment, joint activity, muscle strength, total joint scale score of the LYSHOLM questionnaire, and other observational indices were measured during the 6th and 12th week of treatment. The non-parametric statistical method and T-test were used to analyze the changes of each index before and after treatment. After 12 weeks of treatment, the difference between the experimental group and the combination before treatment was significant. Results: The treatment effect of the experimental group was significantly better than the control group. Conclusion: The effect of sports rehabilitation of athletes with meniscus injury based on electroacupuncture combined with sports therapy showed high resolutive application value, indicating an alternative for non-surgical treatment in knee meniscus injuries. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A lesão meniscal é um acometimento comum que pode gerar incapacitação por dor e falha proprioceptiva, exigindo atenção imediata. Terapias combinadas envolvem abordagens avançadas com o objetivo de acelerar a reabilitação nos atletas, e a eletroacupuntura apresenta benefícios terapêuticos, embora ainda não possua evidencias de sua combinação com a terapia esportiva. Objetivo: Analisar o desempenho da reabilitação esportiva em atletas com lesão meniscal utilizando eletroacupuntura combinada à terapia esportiva. Métodos: A intervenção no grupo controle baseou-se no trabalho tradicional de amplitude de movimento, força muscular, treinamento proprioceptivo e outros tipos de terapias de exercício enquanto que ao grupo experimental foi adicionado um protocolo de eletro-acupuntura de 30 minutos de duração, 3 vezes por semana durante 4 semanas consecutivas. Os dados de substituição (sexo, idade, curso de doença, localização) são basicamente os mesmos. Antes do tratamento, a atividade articular, a força muscular, o escore total da escala articular do questionário LYSHOLM e outros índices de observação foram medidos na 6ª e 12ª semana do tratamento. O método estatístico não paramétrico e teste-T foram utilizados para analisar as alterações de cada índice antes e depois do tratamento. Após 12 semanas de tratamento, a diferença entre o grupo experimental e a combinação antes do tratamento foi significativa. Resultados: O efeito de tratamento do grupo experimental foi significativamente melhor do que o grupo controle. Conclusão: O efeito de reabilitação esportiva de atletas com lesão meniscal baseada em eletroacupuntura combinada à terapia esportiva demonstrou alto valor de aplicação resolutiva, indicada como alternativa para o tratamento não cirúrgico em lesões no menisco do joelho. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

Resumen Introducción: La lesión meniscal es una lesión común que puede causar incapacidad por dolor y fallo propioceptivo, requiriendo atención inmediata. Las terapias combinadas implican enfoques avanzados con el objetivo de acelerar la rehabilitación en los deportistas, y la electroacupuntura presenta beneficios terapéuticos, aunque todavía no hay pruebas de su combinación con la terapia deportiva. Objetivo: Analizar el rendimiento de la rehabilitación deportiva en atletas con lesión meniscal utilizando electroacupuntura combinada con la terapia deportiva. Métodos: La intervención en el grupo de control se basó en el trabajo tradicional de amplitud de movimiento, fuerza muscular, entrenamiento propioceptivo y otros tipos de terapias de ejercicio, mientras que al grupo experimental se le añadió un protocolo de electroacupuntura de 30 minutos de duración, 3 veces a la semana durante 4 semanas consecutivas. Los datos sustitutivos (sexo, edad, evolución de la enfermedad, localización) son básicamente los mismos. Antes del tratamiento, se midieron la actividad articular, la fuerza muscular, la puntuación total de la escala articular del cuestionario LYSHOLM y otros índices de observación en la 6ª y 12ª semana de tratamiento. Se utilizó el método estadístico no paramétrico y la prueba T para analizar los cambios de cada índice antes y después del tratamiento. Tras 12 semanas de tratamiento, la diferencia entre el grupo experimental y la combinación antes del tratamiento era significativa. Resultados: El efecto del tratamiento del grupo experimental fue significativamente mejor que el del grupo de control. Conclusión: El efecto de la rehabilitación deportiva de atletas con lesión de menisco basada en la electroacupuntura combinada con la terapia deportiva mostró un alto valor de aplicación resolutiva, indicada como alternativa de tratamiento no quirúrgico en las lesiones de menisco de rodilla. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Functional exercise on patients after sports meniscus injury / Exercício funcional em pacientes após lesão esportiva de menisco / Ejercicio funcional en pacientes tras lesión deportiva de menisco

ABSTRACT Introduction Knee meniscus injury is a common sports injury, and minimally invasive surgery under knee arthroscopy has become an ideal method to treat meniscus injuries. This surgery rehabilitation has been improved, and several studies on the effects of functional exercise in the range of treatment are still inconclusive. Objective Study the functional exercise rehabilitation effects in patients after sports meniscus injury. Methods Twenty patients with meniscus-medial injury being operated on were selected, including eight men and 12 women. They were randomly divided into neuromuscular and strength training groups (11). Signs and symptoms were assessed before and eight weeks after treatment. JOA score indices and gait tests were compared. The impact of rehabilitation differences was evaluated in each group. Results Eight weeks after rehabilitation in both groups, the scores of the strength training group were higher than the neuromuscular group; the difference between the groups was statistically significant (P<0.05). Conclusion Functional exercise accelerates joint recovery, reflected in increased strength of adjacent muscles. The muscle and joint training effects on postoperative meniscus injury are worthy of recognition. The baropodometry revealed distinctions in walking patterns between different rehabilitation methods. From the perspective of this research, rehabilitation methods combined with proprioceptive exercises are complementary. Evidence Level II; Therapeutic Studies - Investigating the result.

RESUMO Introdução Lesão no menisco do joelho é uma lesão esportiva comum e a cirurgia minimamente invasiva sob artroscopia no joelho tornou-se um método ideal para tratar lesões no menisco. A reabilitação dessa cirurgia vem sendo aprimorada e vários estudos sobre os efeitos do exercício funcional no leque de tratamento ainda são inconclusivos. Objetivo Estudar os efeitos da reabilitação com exercício funcional em pacientes após a lesão esportiva do menisco. Métodos Foram selecionados 20 pacientes com lesão menisco-medial a serem operados, incluindo 8 homens e 12 mulheres. Divididos aleatoriamente em 2 grupos: grupo de treinamento neuromuscular e grupo de treinamento força (11). Sinais e sintomas foram avaliados antes do tratamento e 8 semanas após o tratamento, índices de score JOA e teste de marcha foram comparados, as diferenças do impacto da reabilitação em cada grupo foram avaliadas. Resultados Oito semanas após a reabilitação dos dois grupos, os escores do grupo de treinamento de força foram superiores aos do grupo neuromuscular, a diferença entre os grupos foi estatisticamente significante (P<0,05). Conclusão O exercício funcional acelera a recuperação das articulações, refletida no aumento da força dos músculos adjacentes. O efeito do treinamento muscular e articular na lesão do menisco pós-operatório é digno de reconhecimento. A baropodometria revelou distinções no padrão de marcha entre os diferentes métodos de reabilitação. Na perspectiva desta pesquisa, métodos de reabilitação combinados com exercícios proprioceptivos são complementares. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

RESUMEN Introducción La lesión de menisco de la rodilla es una lesión deportiva común y la cirugía mínimamente invasiva por artroscopia de rodilla se ha convertido en un método ideal para tratar las lesiones de menisco. La rehabilitación de esta cirugía ha sido mejorada y varios estudios sobre los efectos del ejercicio funcional en el rango de tratamiento aún no son concluyentes. Objetivo Estudiar los efectos de la rehabilitación con ejercicio funcional en pacientes tras una lesión de menisco deportiva. Métodos Se seleccionaron 20 pacientes con lesión de menisco-medial para ser operados, incluyendo 8 hombres y 12 mujeres. Se dividieron aleatoriamente en 2 grupos: grupo de entrenamiento neuromuscular y grupo de entrenamiento de fuerza (11). Se evaluaron los signos y síntomas antes del tratamiento y 8 semanas después del mismo, se compararon los índices de puntuación JOA y la prueba de marcha, y se evaluaron las diferencias del impacto de la rehabilitación en cada grupo. Resultados Ocho semanas después de la rehabilitación para ambos grupos, las puntuaciones del grupo de entrenamiento de fuerza fueron mayores que las del grupo neuromuscular, la diferencia entre los grupos fue estadísticamente significativa (P<0,05). Conclusión El ejercicio funcional acelera la recuperación de la articulación, lo que se refleja en el aumento de la fuerza de los músculos adyacentes. El efecto del entrenamiento muscular y articular en la lesión postoperatoria del menisco es digno de reconocimiento. La baropodometría reveló diferencias en el patrón de la marcha entre los diferentes métodos de rehabilitación. Desde la perspectiva de esta investigación, los métodos de rehabilitación combinados con los ejercicios propioceptivos son complementarios. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Microinvasive Meniscal Suture with Disposable Needle / Sutura meniscal microinvasiva com agulha descartável

Abstract The first meniscal suture was performed in 1885 and took about a century to become popular. Currently, all-inside meniscal repair devices are widely used. However, this technique presents the disadvantage of being a method dependent on specific devices, presenting a higher cost than other techniques. This high cost limits the use of such a technique in many locations. The objective of the present technical note is to describe a microinvasive meniscal suture technique as a modification of the all-inside technique, using a disposable 40 x 12 mm procedure needle. The authors believe that the proposed modification to the technique can make it more popular, enabling the use of the microinvasive technique in places with limited resources.

Resumo A primeira sutura meniscal foi realizada em 1885 e levou cerca de um século para tornar-se popular. Atualmente, os dispositivos de reparo meniscal all-inside são amplamente utilizados. Contudo, esta técnica apresenta a desvantagem de ser um método dependente de dispositivos específicos, apresentando um custo superior aos de outras técnicas. Este valor elevado limita o uso de tal técnica em muitos locais. O objetivo da presente nota técnica é descrever uma técnica de sutura meniscal microinvasiva, como uma modificação da técnica all-inside, utilizando uma agulha descartável de procedimento de 40 x 12 mm. Os autores acreditam que a modificação proposta para a técnica pode torná-la mais popular, possibilitando o uso da técnica microinvasiva em locais com recursos limitados.

Meniscus repair with simultaneous anterior cruciate ligament reconstruction: Clinical outcomes, failure rates and subsequent processing / 中华创伤杂志(英文版)

PURPOSE@#To retrospectively analyze the clinical outcomes of meniscus repair with simultaneous anterior cruciate ligament (ACL) reconstruction and explore the causes of failure of meniscus repair.@*METHODS@#From May 2013 to July 2018, the clinical data of 165 patients who were treated with meniscus surgery and simultaneous ACL reconstruction, including 69 cases of meniscus repair (repair group) and 96 cases of partial meniscectomy (partial meniscectomy group) were retrospectively analyzed. The exclusion criteria were as follows: (1) ACL rupture associated with fracture, collateral ligament injury, or complex ligament injury; (2) a history of knee surgery; or (3) a significant degree of osteoarthritis. The 69 patients in the repair group were divided into the non-failure group (62 cases) and the failure group (7 cases) depending on the repair effect. Postoperative outcomes of the repair group and the partial meniscectomy group were compared. General conditions and postoperative outcomes of the failure group and the non-failure group were compared. During the median follow-up period of 28 months (range, 4 - 65 months) after the second arthroscopy, postoperative outcomes of seven patients in the failure group were summarized. SPSS 25.0 statistical software was used for statistical analysis. A p value less than 0.05 was considered statistically significant.@*RESULTS@#Seven patients in the failure group who underwent the second arthroscopy were followed up for (30 ± 17.4) months and their postoperative outcomes were summarized. Compared with the partial meniscectomy group, the International Knee Documentation Committee scores of patients in the repair group improved significantly (p = 0.031). Compared with the non-failure group, more patients in the failure group were younger than 24 years (p = 0.030). The median follow-up period was 39.5 months. All patients recovered well after subsequent partial meniscectomy and relieved clinical symptoms. Visual analog scale scores decreased significantly (p = 0.026), and the International Knee Documentation Committee and Lysholm scores improved significantly (p = 0.046 for both).@*CONCLUSION@#The failure rate of meniscus repair in this study was 10.1% (7/69), all of which were medial meniscus tears. However, the surgical outcomes of ACL reconstruction were not affected, and there might be a role for graft protection. Therefore, meniscus retears can be successful treated by performing subsequent partial meniscectomy in patients with repair failure.

Diagnostic value of ultrasound in the discoid lateral meniscus of the knee / 中国骨伤

OBJECTIVE@#Based on the anatomical differences between discoid lateral meniscus(DLM) and normal lateral meniscus (NLM), this study aims to setting up the ultrasound examination parameters to distinguish DLM and NLM and explore the diagnostic value of these parameters on DLM.@*METHODS@#According to the inclusion, exclusion and matching criteria, 66 DLM patients(DLM group) and 132 NLM patients with other knee joint diseases(NLM group), hospitalized from October 2019 to June 2020, were included in this study. There were 18 males and 48 females in the DLM group, ranging in age from 3 to 60 years old, with a mean of (36.9±12.1) years old;36 males and 96 females in the NLM group, ranging in age from 3 to 60 years old, with a mean of (40.0±12.2) years old. Philips high frequency(3.0 to 12.0 MHz) linear array ultrasound probe was used to examine the lateral meniscus of all patients in two groups. Nine parameters including the thickness, width and the included angle of the anterior angle, body and posterior angle respectively in the lateral meniscus were measured. The included angke is formed by the chords of the upper and lower curved surfaces of the meniscus at the free edge. The independent t test was used to analyze the difference of the measured parameters between the DLM group and the NLM group. The receiver operating characteristic(ROC) curve was used to evaluate the cut-off value of each parameter for diagnosing DLM and the corresponding sensitivity, specificity, positive predictive value, negative predictive value, and area under the ROC curve(AUC).@*RESULTS@#The above 9 ultrasound measurement parameters between the DLM group and the NLM group had significant statistical differences(P<0.001). The ROC curve analysis method evaluated the cut-off value and diagnostic capabilities of these nine ultrasound parameters for DLM. The results showed that the cut-off value of the included angle of anterior part, body and posterior part were 25.85°, 24.85° and 29.15 °, respectively;and the sensitivity, specificity, negative predictive value, positive predictive value and AUC were significantly higher than other parameters, which were 88%, 91%, 79%, 95%, 0.94;89%, 94%, 82%, 97%, 0.96; 92%, 97%, 86%, 98%, 0.97, respectively.@*CONCLUSION@#Ultrasound diagnosis of DLM is feasible and reliable. The diagnostic ability of the included angle of the anterior part, body and posterior part in the lateral meniscus measured by ultrasound to diagnose DLM are significantly better than other ultrasound measurement parameters, and the sensitivity and specificity of those parameters are close to MRI. Therefore, ultrasound can be used as a reliable method for preliminary diagnosis of DLM.

Application of fracture liaison service-based intervention in elderly patients with meniscus injury / 中国实用护理杂志

Objective:To investigate the intervention effects of fracture liaison service (FLS)-based intervention in elderly patients with meniscus injury, to provide reference for clinical rehabilitation.Methods:A total of 86 elderly patients with meniscus injury from February 2018 to October 2019 in the Second Affiliated Hospital of Xi ′an Jiaotong University were divided into experimental group and control group according to random number table method. There were 43 cases in each group.The control group was given routine nursing, and the experimental group implemented FLS-based nursing intervention on the basis of the control group. The clinical effects were compared between the two groups by using knee function, knee joint mobility and degree of frailty. Results:Finally, 38 cases were included in the experimental group and 41 cases in the control group. There was no significant difference in knee function, knee joint mobility and degree of frailty between the two groups at discharge ( P>0.05). At 1, 3 months after discharge, the knee scores and knee joint mobility were (75.37 ± 4.68) points, (90.34 ± 3.02) points and (96.68 ± 8.11)°, (119.11 ± 7.92)° in the experimental group, higher than those in the control group (73.17 ± 3.92) points, (87.76 ± 2.93) points and (91.76 ± 7.75)°, (108.61 ± 7.72)°, the differences were statistically significant ( t values were 2.26-5.96, all P<0.05). The knee function scores and knee joint mobility of the two groups changed with time ( F=264.33, 279.54, both P<0.05). There were interaction effects between groups and time in the knee joint mobility of the two groups ( F=6.12, P<0.05). At 1, 3, 6 months after discharge, the physiological dimension scores and frailty total scores were 5.08 ± 1.34, 4.74 ± 1.10, 4.13 ± 0.88 and 8.32 ± 1.50, 7.82 ± 1.31, 6.82 ± 0.95 in the experimental group, lower than those in the control group 5.68 ± 1.15, 5.22 ± 0.85, 5.02 ± 0.76, 9.05 ± 1.28, 8.40 ± 0.89, 8.18 ± 0.90, the differences were statistically significant ( t values were 2.15-6.57, all P<0.05). At 6 months after discharge, the psychological and cognitive dimension scores were 0.98 ± 0.30 and 0.45 ± 0.24 in the experimental group, lower than those in the control group 1.32 ± 0.37 and 0.59 ± 0.22, the differences were statistically significant ( t=4.49, 2.82, both P<0.05). The physiological and cognitive dimension scores and total scores of the two groups changed with time ( F=30.61, 31.72, 38.50, all P<0.05). There were interaction effects between groups and time in the physiological demension scores and the frailty total scores of the two groups ( F=2.86, 4.03, both P<0.05). Conclusions:FLS-based intervention can promote the rehabilitation of knee joint function and alleviate the degree of frailty of elderly patients with meniscus injury.

Medial Knee Arthrosis: A Pathology with a Progressive Evolution / Artrose medial do joelho: Uma patologia de evolução progressiva

Abstract Medial arthrosis of the knee is an evolutionary pathology that occurs due to progressive muscle imbalance. The muscles of the knee region have a large imbalance caused by the difference of power and lever arm. With the progression of life, this imbalance manifests itself more importantly, especially due to the loss of muscle strength due to aging. Pathological postures begin to occur and determine areas of support and pressure harmful to the joint. Meniscal injury is typical in the evolution of this pathology, as well as cartilage injury. The recognition of this pathology enables good results with less aggressive treatments, such as correction of muscle imbalance and consequent reeducation of joint support. Economic and partial meniscectomy brings good results in the early stages of the degenerative process. Progressive evolution leads to knee degeneration and the consequent need for broader surgeries.

Resumo A artrose medial do joelho é uma patologia evolutiva que ocorre em decorrência de desequilíbrio muscular progressivo. Os músculos da região do joelho têm um grande desequilíbrio, provocado pela diferença de potência e braço de alavanca. Com a progressão da vida, este desequilíbrio se manifesta de forma mais importante, especialmente em decorrência da perda de força muscular em função do envelhecimento. Posturas patológicas passam a ocorrer e determinar zonas de apoio e pressão lesivas para a articulação. A lesão meniscal é típica na evolução desta patologia, assim como a lesão da cartilagem. O reconhecimento desta patologia possibilita resultados bons com tratamentos menos agressivos, como a correção do desequilíbrio muscular e consequente reeducação do apoio da articulação. A meniscectomia econômica e parcial traz bons resultados nas fases iniciais do processo degenerativo. A evolução progressiva leva à degeneração do joelho e à consequente necessidade de cirurgias mais amplas.

Arthroscopic classification and management for the popliteal hiatus of the lateral meniscus tears / 北京大学学报(医学版)

OBJECTIVE@#To bring forward an arthroscopic classification of the popliteal hiatus of the lateral meniscus (PHLM) tears and to assess the effects of arthroscopic all-inside repair with suture hook in management of such injuries.@*METHODS@#This study involved 146 patients who underwent arthroscopic operation because of PHLM tears from April 2014 to October 2017, eliminating the patients who had discoid lateral meniscus. There were 81 males and 65 females, with 54 left knees and 92 right knees. The average ages were (34.7±3.7) years. Among the selected participants, there were 107 patients with anterior cruciate ligament (ACL) injuries, 39 patients with medial collateral ligament (MCL) injuries, and 48 patients with medial meniscus tears. The average preoperative Lysholm and International Knee Documentation Committee (IKDC) scores were 57.7±9.2 and 54.1±8.9, respectively. The arthroscopic classification was based on the extent and degree of PHLM tears and using the arthroscopic all-inside repair with suture hook for such injuries. For the patients associated with ACL injuries, the ipsilateral autograft hamstring tendons use as the reconstruction graft for single bundle ACL reconstructions. The suture anchors were used for treatment of MCL Ⅲ injuries, and the arthroscopic all-inside repair for medial meniscus tears.@*RESULTS@#A total of 146 PHLM tears in 146 patients were divided into type Ⅰ (tears not involved in popliteus tendon incisura; n=86, 58.9%), type Ⅱ (tears involved in popliteomeniscal fascicles; n=36, 24.7%), and type Ⅲ (tears involved in popliteus tendon incisura; n=24, 16.4%). For type Ⅰ, there were three subtypes, including type Ⅰa: longitudinal tear (n=53, 61.6%), type Ⅰb: horizontal tear (n=27, 31.4%), and type Ⅰc: radial tear (n=6, 7.0%). For type Ⅱ, there were also three subtypes, including type Ⅱa: anterosuperior popliteomeniscal fascicle tear (n=5, 13.9%), type Ⅱb: posterosuperior popliteomeniscal fascicle tear (n=20, 55.6%), and type Ⅱc: both tears (n=11, 30.6%). For type Ⅲ, there were two subtypes, including type Ⅲa: horizontal tear (n=9, 37.5%), type Ⅲb: radial tear (n=15, 62.5%). In the follow-up for an average of 15.3±2.6 months, all the patients had done well with significantly improved Lysholm (84.6±14.3) and IKDC (83.2±12.8) scores at the end of the last follow-up relative to preoperative scores (P > 0.01).@*CONCLUSION@#We propose that it is possible to classify lateral meniscus tears at the popliteal hiatus region for three types, which can summarize the injury characteristics of this area. The arthroscopic all-inside repair with suture hook for the PHLM tears can avoid stitching to popliteal tendon or narrowing popliteal hiatus and have satisfactory clinical results.

Experimental study on the diagnosis of dry eye tear film grading by Keratograph 5M ocular surface analyzer and conventional ocular surface examination / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the diagnostic value of Keratograph 5M for the diagnosis of dry eye(dry eye)tear film grading. <p>METHODS: Totally 100 eyes diagnosed with dry eye by conventional means and 40 non-dry eye eyes with suspected dry eye at the same time were enrolled through OPC. The immediate ocular surface parameters of the above cases were collected by the K5M ocular surface analyzer, including the first tear film rupture time(NIBUTf), the average tear film rupture time(NIBUTav), and the tear river height(TMH)which were utilized to evaluated the diagnostic efficacy of K5M compared to routine ocular surface examination on the index of dry eye tear film. <p>RESULTS: The comparison of NIBUTf, NIBUTav and TMH between dry eye group and non-dry eye group by K5M eye surface comprehensive analyzer showed statistically significant differences(all <i>P</i><0.05). The coincidence rate between the NIBUTf of K5M ocular surface analyzer and the BUT of routine diagnosis was 78.6%, and the area under the ROC curve as well as the standard error were 0.042 and 0.795(<i>P</i><0.01)with 95% confidence interval(0.712, 0.878); The coincidence rate between NIBUTav of K5M and BUT of routine examination diagnosis was 73.6%, and the area under the ROC curve as well as the standard error were 0.853 and 0.033(<i>P</i><0.01), with 95% confidence interval(0.788, 0.917).The coincidence rate between TMH of K5M and the SⅠt of conventional diagnosis was 87.9%, and the area under the ROC curve as well as the standard error were 0.795 and 0.044(<i>P</i><0.01), with the 95% confidence interval(0.709, 0.880). The sensitivity, specificity, correctness index, positive likelihood ratio, negative likelihood ratio, and odds ratio of the exploratory diagnosis of dry eye by NIBUTf combined with TMH were 98, 40, 38, 1.63, 0.05, and 32.6%, respectively. The sensitivity, specificity, correctness index, positive likelihood ratio, negative likelihood ratio, and odds ratio of the exploratory diagnosis of dry eye by NIBUTav combined with TMH were 86, 75, 61, 3.44, 0.187, 18.39%, respectively.<p>CONCLUSION: K5M ocular surface analyzer can provide accurate and reliable diagnostic value for single tear film index grading diagnosis of dry eye; compared with TMH combined with NIBUTav, TMH combined with NIBUTf was more sensitive but less specific in diagnosing dry eye.

Ultrastructural changes of the white zone cells of the meniscus in a rat model of early osteoarthritis / 中国组织工程研究

BACKGROUND: The research focuses of knee osteoarthritis are on mainly articular cartilage, subchondral bone and synovium. There are few studies on the ultrastructure of the meniscus in animal models. OBJECTIVE: On the basis of observing the ultrastructure and types of chondrocytes in the white zone of the meniscus, to observe the ultrastructural changes of the white zone cells of the meniscus in an animal model of early osteoarthritis, in order to explore the relationship between the microstructural changes and the physiological functional changes in the meniscus. METHODS: Sprague-Dawley rats were randomly divided into a control group and a model group. Rats in the model group were made into the model of early knee osteoarthritis by intraarticular injection of papain. After 5 weeks, the meniscuses of three rat models in each group were taken, located and observed for the ultrastructure of the white zone cells through a transmission electron microscope. An ethics approval was obtained from the Animal Ethics Committee of Fujian University of Traditional Chinese Medicine. RESULTS AND CONCLUSION: In the control group, most of cells were fusiform in the superficial layer of meniscus and were triangular-like in the deeper layer. They were rich in rough endoplasmic reticulum and mitochondria, with presence of Golgi and other organelles. Extracellular collagen fibrils were mainly type II collagen fibrils. The cells in the white zone of meniscus were chondrocytes. In the model group, the meniscal surface became rough, the cells were swollen, cytoplasmic organelles were reduced and swollen, glycogen was accumulated, and most of nuclei were abnormal with heterochromatin agglutination. Extracellular collagen fibrils became disordered and sparse. These findings indicate that the mild degeneration of chondrocytes and matrix in the meniscus can reduce the ability of cells to synthesize and secrete matrix components, which may lead to the physiological hypofunction.

Risk factors for the postoperative effect of symptomatic discoid lateral meniscus after arthroscopy / 中国骨伤

OBJECTIVE@#To explore the influencing factors of the postoperative effect of arthroscopic treatment of symptomatic discoid lateral meniscus (DLM).@*METHODS@#From September 2008 to September 2015, patients with symptomatic DLM treated by arthroscopic surgery were retrospectively analyzed. The knee function was evaluated by Lysholm scoring system. According to the scoring results, it was divided into excellent (≥90 points), good (80 to 89 points), fair (70 to 79 points) and poor (<70 points). Sixteen research factors were collected, namely gender, operation age, body mass index, work intensity, symptom duration, history of knee injury, involved knee side, DLM classification, DLM injury type, DLM injury site, medial meniscus injury, knee cartilage injury site and degree, Kellgren-Lawrence (K-L) classification, operation method, and latest follow-up time. According to the data type, Kruskall-Wallis rank sum test or @*RESULTS@#According to the inclusion and exclusion criteria, 502 patients were included. Lysholm functional grade at the latest follow-up was higher than that before operation (@*CONCLUSION@#Arthroscopy is a safe and effective method for the treatment of symptomatic DLM. The gender, body mass index, work intensity, age of operation, duration of symptoms and degree of knee cartilage injury are independent influencing factors for the postoperative efficacy of symptomatic DLM.

Arthroscopic surgery combined with platelet-rich plasma for meniscus injury:a Meta analysis / 中国骨伤

OBJECTIVE@#To evaluate clinical efficacy of arthroscopic with platelet-rich plasma (PRP) in treating meniscus injury.@*METHODS@#From January 2015 to December 2019, clinical control study on repair meniscus injury by arthroscopic with PRP between arthroscopic were searched by PubMed, Science Direct, Cochrane library, Chinese Journal Full-text Database, Wanfang and VIP database. Literature screening, data extraction and quality evaluation according to inclusion and exclusion criteria. Visual analogue scale(VAS) of knee joint and Lysholm score at 1, 6 and 12 months after opertaion between two groups were compared, and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) at 3, 6 and 12 months after opertaion between twogroups were also compared.@*RESULTS@#Totally 9 literatures and 329 patients with meniscal injuries were screened, include 146 patients treated by arthroscopic with PRP and 183 patients treated by arthroscopic. There were no statistical differences in VAS between two groups at 1, 6 and 12 months after opertaion. There were differences in Lysholm score at 1 and 6 months after operation between two groups [@*CONCLUSION@#Arthroscopic with PRP for repair meniscus injury has short term efficacy of knee function and delay arthritis, while has similar effect in long term clinical efficacy and relieve pain.

Clinical oberservation on rotator cuff suture threader and strapping suture in meniscus tear under arthroscopy / 中国骨伤

OBJECTIVE@#To explore clinical effect of arthroscopic meniscus tear strapping suture by rotator cuff suture threader.@*METHODS@#Forty patients with meniscus tear injury admitted from July 2015 to May 2019, including 27 males and 13 females, aged from 20 to 55 years old with an average of (36.0±1.4) years old. Menisci laceration was sutured with rotator cuff suture thread under arthroscopy. Postoperative complication was observed, Lysholm knee joint score before and after operation at 12 months were used to evaluate clinical effects, visual analogue scale (VAS) and range of knee flexion and extension were applied to evaluate recovery of pain and function.@*RESULTS@#All patients were followed up from 12 to 15 months with an average of (12.6±0.7) months.No complication such as joint effusion, suture failure occurred. Two patients occurred mild pain after activity without clinical physical abnormality, and 1 patient manifested moderate pain with joint space tenderness, the other rest without abnormal. Lysholm knee joint score was increased from (49.55±1.21) preoperatively to (98.95±0.42) at 12 months after operation, VAS score decreased from (5.18±0.78)preoperatively to (1.03±0.77) at 12 months after operation, and range of knee joint flexion and extension activity increased from (50.63±9.20)°preoperatively to (130.38±4.99)°after operation, and there were statistical differences in Lysholm knee joint score, VAS and range of knee joint flexion and extension activity (@*CONCLUSION@#Arthroscopic strapping suture by rotator cuff suture threading device applies to most meniscus injuries, including medial meniscus posterior horn tears, lateral meniscus body tears and lateral meniscus posterior horn tears. This technique meets the need of full-internal meniscus suture without specialmeniscus suture, and has advantages of convenient operation, less complications and good postoperative function.

Application of pie-crusting technique of deep medial collateral ligament under arthroscopy in repairing posterior horn of medial meniscus tears / 中国骨伤

OBJECTIVE@#To explore effectiveness and safety of an inside-out, arthroscopic deep medial collateral ligament pie-crusting release in treating posterior horn of medial meniscus (PHMM) tear in tight medial tibiofemoral compartment of knee joint.@*METHODS@#From January 2016 to December 2017, 61 patients (61 knees) were underwent arthroscopic partial meniscectomies for PHMM tear in tight medial tibiofemoral compartment of knee joint, who were divided into valgus group and pie-crusting group according to exposure of PHMM region . There were 28 patients in valgus group, including 12 males and 16 females aged from 27 to 60 years old with an average age of (35.75±7.57) years old;who were performed conventional valgused knee to exporsure PHMM region. There were 33 patients in pie-crusting group, including 15 males and 18 females aged from 26 to 58 years old with an average age of (36.06±7.93) years old;who were treated with inside-out, arthroscopic deep MCL pie crusting release technique with MM-Ⅱ meniscus suture package (Smith & Nephew). Operation time, preoperative and postopertaive Lysholm score of knee joint, injury of MCL between two groups were recorded and compared.@*RESULTS@#All patients were followed up from 12 to 18 months with an average of (15.19±2.22) months. The incisions were healed at stageⅠ. There were no statistical difference in anatomical classification of PHMM between two groups(@*CONCLUSION@#The inside-out, arthroscopic deep MCL pie-crusting release for the treatment of posterior horn of medial meniscus tear in tight medial tibiofemoral could expand working apace, shorten operation time, reduce injury to MCL and obtain good clinical efficacy.

Biomechanical study on different high-strength sutures and suture site for repairing posterior root tear of the medial meniscus / 中国骨伤

OBJECTIVE@#To compare biomechanical characteristic of different high-strength sutures and suture sites for repairing posterior root tear of the medial meniscus with modified Mason-Allen technique.@*METHODS@#Forty-eight specimen of medial meniscus of knee joint from fresh porcine (female, aged from 5 to 9 months with an average of 7 months) were chosen and established experimental model. The samples were divided into red zone fixation group and red-white zone fixation group according to suture sites, 24 in each group; and then were randomly divided into 3 subgroups which 8 in each group, and fixed with Ethibond suture, Ultrabraid suture and FiberWire suture, respectively. Biomechanical tests were performedon universal electromagnetic and mechanical testing machine. Each specimen was underwent 1 000 cyclic tests on the first time, then pull out test until failure. The maximum failure load, yield load, stiffness and displacement were analyzed.@*RESULTS@#All specimen were successfully completed biomechanical tests. The failure mode of Ethibond group was caused by suture fracture; 6 cases of Ultrabraid suture group was caused by suture fracture which belong to red zone fixation group, 10 cases were caused by suture pull out, which 2 cases belong to red zone fixation group, 8 cases belong to red-white zone fixation group;8 cases of FiberWire group was caused by suture pull-out. Biomechanical test showed that:(1)In terms of suture strength, comparison of the maximum failure load, yield load and stiffness showed that Ethibond suture group

Modified single-needle arthroscopic repair technique for the treatment of longitudinal meniscal tear / 中国骨伤

OBJECTIVE@#To compare therapeutic efficacy of modified single-needle arthroscopic repair technique and Fast-Fix technique in repairing longitudinal meniscus injuries.@*METHODS@#From July 2016 to July 2017, patients with longitudinal meniscus injuries who underwent meniscal repair surgery were retrospectively analyzed. Ninety-one patients treated with modified single-needle technique and 77 patients were treated with Fast-Fix technique, the average age were (26.7±7.6) and (27.9±6.1) years old respectively, the average lengths of follow-up were (32.5±9.2) and (33.2±11.9) months, respectively. Operation cost, suture time, intraoperative failure rate and postoperative failure rate were used as clinical outcomes, MRI of knee joint was used as main diagnosis and evaluation basis; 2000 IKDC subjective score, Lysholm score and Tegner activity scale were compared between two groups preoperatively, 12 months after operation and at the latest follow-up. Intraoperative and postopertaive complications were observed.@*RESULTS@#Compared with Fast-Fix group, patients in modified single-needle technique group had lower operation costs [(645.7±133.1 vs.(12 184.8±4 709.8), @*CONCLUSION@#Modified single-needle arthrscopicrepair technique could achieve the similar therapeutic efficacy as Fast-Fix technique, and it has advantageds of simple opertion and more economical. This study recommends clinical application of modified single-needle arthrscopic repair technique in treating meniscus injuries.

Changes in Composition of ADAMTS-5 and CD-68 in the Knee Joint Synovial Fluid Cells of Meniscal Tears Patients an Immunohistochemical Study / Cambios en la Composición de ADAMTS-5 y CD-68 en las Células del Líquido Sinovial de la Articulación de la Rodilla en Pacientes con Desgarro de Menisco. Un Estudio Inmunohistoquímico

SUMMARY: Meniscus tear is an important injury affecting the quality of life. This work is aimed to investigate the activity of CD68 and ADAMTS-5 in cells in synovial fluid in male and female patients with meniscal tear. In this study ,18 male and 22 female patients with meniscal tears were included. Local pain sensation during patients' physical examination, swelling, performing daily activities and difficulty in running-walking complaints were determined. 5 cc synovial fluids were aspirated from the lateral suprapatellar pouch part of the knees with meniscal pain. After routine histological follow-up of the samples, they were embedded in paraffin and sectioned with microtome and 5 micrometer thickness. CD68 and ADAMTS-5 primary antibodies were used for immunohistochemical analysis. Sections were taken and evaluated with a stylish microscope. The distribution of blood cells after meniscus tear was higher in female patients than in male patients. CD68 distribution in female patients appeared higher than in male patients. CD68 expression was high in macrophage cell cytoplasm. ADAMTS-5 expression was higher in female patients in degenerative cells and apoptotic cells. ADAMTS-5 is an important metallo-protein involved in the development of apoptotic signal and extracellular matrix synthesis in patients with ADAMTS-5 meniscus tear, and it may be an important criterion for the treatment developed after injury. CD68 and ADAMTS-5 activity was thought to be one of the important signal pathways that can be identified in the treatment of meniscus tear.

RESUMEN: La rotura del menisco es una lesión importante que afecta la calidad de vida. El objetivo fue investigar la actividad de CD68 y ADAMTS-5 en células del líquido sinovial en pacientes masculinos y femeninos con desgarro meniscal. Se incluyeron 18 pacientes masculinos y 22 femeninos con desgarros meniscales. Se determinó la sensación de dolor local durante el examen físico de los pacientes, la hinchazón, la realización de actividades diarias y la dificultad al correr y caminar. Se aspiraron 5 cc de líquido sinoviale de la parte de la bolsa suprapatelar lateral de las rodillas de los pacientes con dolor meniscal. Después del seguimiento histológico de rutina, las muestras se incluyeron en parafina y se seccionaron con un micrótomo de grosor de 5 micrómetros. Para el análisis inmunohistoquímico se usaron los anticuerpos primarios CD68 y ADAMTS-5. La distribución de las células sanguíneas después del desgarro del menisco fue mayor en pacientes femeninos que en pacientes masculinos. La distribución de CD68 en pacientes femeninos fue más alta que en pacientes masculinos. Además la expresión de CD68 fue alta en el citoplasma de los macrófagos. La expresión de ADAMTS-5 fue mayor en pacientes femeninos en las células degenerativas y células apoptóticas. ADAMTS-5 es una metaloproteína importante en el desarrollo de la señal apoptótica y la síntesis de matriz extracelular en pacientes con rotura de menisco ADAMTS-5, y puede ser un criterio importante para el tratamiento después de la lesión. La actividad de CD68 y ADAMTS-5 era una de las vías de señal importantes que se pueden identificar en el tratamiento de la rotura del menisco.

Return to play after anterior cruciate ligament reconstruction / Retorno ao esporte após a reconstrução do ligamento cruzado anterior / Retorno al deporte después de reconstrucción del ligamento cruzado anterior

ABSTRACT The anterior cruciate ligament (ACL) tear represents more than half of all knee injuries in sports that involve body rotations and sudden changes of direction. Discharging the athlete for return to play (RTP) post-ACL reconstruction (ACLR) is a difficult task with multidisciplinary responsibility. For many years, a six-month period post-ACLR was adopted as the only criterion for RTP. However, it is now suggested that RTP should not be exclusively time-based, but to clinical data and systematic assessments. Despite the importance of post-ACLR factors for RTP, pre- and peri-ACLR factors must also be considered. Historically, ACLR is performed with the hamstring or autologous patellar tendons, although the choice of graft is still an open and constantly evolving theme. Anterolateral ligament reconstruction and repair of meniscal ramp tear associated with ACLR have recently been suggested as strategies for improving knee joint stability. Subjective questionnaires are easy to apply, and help identify physical or psychological factors that can hamper RTP. Functional tests, such as hop tests and strength assessment by means of isokinetic dynamometers, are fundamental tools for decision making when associated with clinical evaluation and magnetic resonance imaging. Recently, the capacity to generate force explosively has been incorporated into the muscle strength assessment. This is quantified through the rate of torque development (RTD). Due to characteristics inherent to the practice of sport, there is an extremely short time available for produce strength. Thus, RTD seems to better represent athletic demands than the maximum strength assessment alone. This review investigates the pre-, peri- and post-ACLR factors established in the literature, and shares our clinical practice, which we consider to be best practice for RTP. Level of evidence V; Specialist opinion.

RESUMO A ruptura do ligamento cruzado anterior (LCA) representa mais da metade das lesões do joelho em esportes que envolvem rotações e mudanças repentinas de direção. A liberação do atleta para o retorno ao esporte (RAE) depois da reconstrução do LCA (RLCA) é uma tarefa difícil, de responsabilidade multidisciplinar. Por muitos anos, o período de seis meses pós-RLCA foi utilizado como único critério para RAE. Contudo, atualmente, sugere-se que o RAE não deve estar atrelado exclusivamente ao tempo, mas a dados clínicos e avaliações sistemáticas. Apesar da importância dos fatores pós-RLCA para o RAE, os fatores pré- e peri-RLCA também devem ser contemplados. Historicamente, a RLCA é realizada com tendões isquiotibiais ou patelares autólogos, apesar da escolha do enxerto ainda ser um tema em aberto e em constante evolução. Recentemente, a reconstrução do ligamento anterolateral e o reparo da lesão na rampa meniscal associadas à RLCA têm sido sugeridas como estratégias para melhorar a estabilidade articular do joelho. Questionários subjetivos são de fácil aplicação e ajudam a identificar fatores físicos ou psicológicos que possam dificultar o RAE. Testes funcionais como os hop tests e a avaliação de força com dinamômetros isocinéticos são ferramentas fundamentais na decisão quando aliadas à avaliação clínica e de ressonância magnética. Recentemente, tem-se incorporado ao escopo de avaliação da força muscular a capacidade de gerar força de maneira explosiva, mensurada através da taxa de desenvolvimento de torque (TDT). Devido a características inerentes a prática esportiva os tempos disponíveis para produção de força são demasiadamente pequenos e, sendo assim, a TDT parece representar melhor as demandas esportivas do que a avaliação isolada de força máxima. Nesta revisão, foram reunidos fatores pré, peri e pós-RLCA estabelecidos na literatura, assim como foi compartilhada nossa prática clínica, que consideramos ser a melhor para o RAE. Nível de evidência V; Opinião do especialista.

RESUMEN La ruptura del ligamento cruzado anterior (LCA) representa más de la mitad de las lesiones de rodilla en deportes que involucran rotaciones y cambios repentinos de dirección. La liberación del atleta para el retorno al deporte (RAD) después de la reconstrucción del LCA (RLCA) es una tarea difícil, de responsabilidad multidisciplinaria. Durante muchos años, el período de seis meses post-RLCA fue usado como único criterio para RAD. Sin embargo, actualmente, se sugiere que el RAD no debe estar vinculado exclusivamente al tiempo, sino a datos clínicos y evaluaciones sistemáticas. A pesar de la importancia de los factores post-RLCA para el RAD, también deben ser contemplados los factores pre y peri-RLCA. Históricamente, la RLCA es realizada con tendones isquiotibiales o patelares autólogos, a pesar de que la elección del injerto aún sea un tema abierto y en constante evolución. Recientemente, la reconstrucción del ligamento anterolateral y la reparación de la lesión en la rampa meniscal asociadas a la RLCA han sido sugeridas como estrategias para mejorar la estabilidad articular de la rodilla. Los cuestionarios subjetivos son de fácil aplicación y ayudan a identificar los factores físicos o psicológicos que pueden dificultar el RAD. Los tests funcionales como los hop tests y la evaluación de fuerza con dinamómetros isocinéticos son herramientas fundamentales en la decisión cuando se combinan a la evaluación clínica y de resonancia magnética. Recientemente, se ha incorporado al alcance de evaluación de la fuerza muscular, la capacidad de generar fuerza de manera explosiva, medida a través de la tasa de desarrollo de torque (TDT). Debido a características inherentes a la práctica deportiva, los tiempos disponibles para producción de fuerza son demasiado pequeños y, siendo así, la TDT parece representar mejor las demandas deportivas que la evaluación aislada de fuerza máxima. En esta revisión fueron reunidos factores pre, peri y post-RLCA establecidos en la literatura, así como fue compartida nuestra práctica clínica, que consideramos la mejor para el RAD. Nivel de evidencia V; Opinión del especialista.

Evaluation of Histological Properties of Human Meniscal Grafts Stored in a Tissue Bank / Avaliação das propriedades histológicas de enxertos meniscais humanos armazenados em banco de tecido

Abstract Objectives The present paper aims to evaluate and compare the histological features of fresh and frozen menisci stored in a tissue bank for 1 month and for 5 years. Methods The meniscal grafts were subjected to a histological study. A total of 10 menisci were evaluated; 2 were frozen for 5 years, 4 were frozen for 1 month, and 4 were fresh, recently harvested specimens. Histological properties were evaluated in sections stained with hematoxylin and eosin and Masson trichrome methods. Results The menisci frozen for 1 month showed partially preserved collagen fiber structure and no significant hydropic tissue degeneration. The menisci frozen for 5 years presented an evident dissociation of collagen fibers and multiple foci of hydropic degeneration. Discussion Degeneration was much more significant in menisci stored for 5 years, indicating that a long freezing period results in substantial progression of tissue deterioration. This may suggest that the 5-year period, considered the maximum time for graft storage before transplant, is too long. Conclusion Grafts stored for 1 month showed a slight degenerative change in collagen fibers, whereas menisci frozen for 5 years presented significant tissue degeneration.

Resumo Objetivos Avaliar e comparar as características histológicas de meniscos frescos e meniscos congelados armazenados em banco de tecidos por 1 mês e por 5 anos. Métodos Foi feito um estudo histológico com enxertos meniscais. Avaliamos 10 meniscos, sendo 2 que ficaram armazenados sob congelamento por 5 anos, 4 armazenados congelados por 1 mês, e 4 frescos, recém captados. Foram feitos cortes histológicos corados com hematoxilina e eosina e Tricrômico de Masson, para avaliação das propriedades histológicas. Resultados Os meniscos congelados por 1 mês apresentaram preservação parcial da estrutura das fibras colágenas, sem degeneração hidrópica significativa do tecido. Nos meniscos congelados por 5 anos, observamos dissociação evidente das fibras colágenas, com presença de múltiplos focos de degeneração hidrópica. Discussão Encontramos degeneração bem mais significativa nos meniscos armazenados por 5 anos, o que indica que o longo período de congelamento leva à progressão significativa da degeneração do tecido. Isto pode sugerir que o período de 5 anos, considerado período máximo que o enxerto pode permanecer armazenado antes de ser transplantado, é um período muito longo. Conclusão Nos enxertos armazenados por 1 mês, existiu apenas discreta alteração degenerativa das fibras colágenas, enquanto que nos meniscos com 5 anos de congelamento foi observada degeneração significativa do tecido. Tibiais