Google Scholar, Malas F, Kara M, Kaymak B, Aknc A, zakar L (2014) Ultrasonographic evaluation in symptomatic knee osteoarthritis: clinical and radiological correlation. Meniscus The precise location of your knee pain can help you narrow down the potential cause. Knee Surg Relat Res. A threshold of 3mm, which was initially introduced, is most commonly used to define a significant ME [8]. taking pain medications. Am J Sports Med 42(10):23292337, Jauregui JJ, Wu ZD, Meredith S, Griffith C, Packer JD, Henn RF (2018) How should we secure our transplanted meniscus? Exercise programs start with an initial routine and then progress to intermediate and advanced routines. It can be hard to prevent an accidental injury. Improper positioning of the posterior horn causes a similar deviation to the anterior horn. Several other techniques of meniscal centralization with suture anchors as well as with transtibial tunnel, with or without prior meniscal release from its capsular attachments, have also been described in technical notes (Fig. Arthrosc Tech 10(1):e43e48, Okazaki Y, Furumatsu T, Miyazawa S, Kodama Y, Kamatsuki Y, Hino T et al (2019) Meniscal repair concurrent with anterior cruciate ligament reconstruction restores posterior shift of the medial meniscus in the knee-flexed position. Thats because you now have less shock absorption in your joint. The goal of the anatomic reconstruction of the ACL rupture is to replicate the normal knee anatomy. Some clinical studies on its effectiveness exist, but more research is needed. J Orthop Res Off Publ Orthop Res Soc 36(7):18941900, Kodama Y, Furumatsu T, Miyazawa S, Fujii M, Tanaka T, Inoue H et al (2017) Location of the tibial tunnel aperture affects extrusion of the lateral meniscus following reconstruction of the anterior cruciate ligament. Knee 24(6):14081413, Phua JKS, Razak HRBA, Mitra AK (2020) Arthroscopic procedures could delay the need for a subsequent knee arthroplasty in older patients with end-stage osteoarthritis. Another promising surgical approach for reducing the ME is the arthroscopic centralization of the extruded meniscus at the point where the capsule adjacent to the meniscus is repaired at the border of the tibial plateau [98, 101]. Partial meniscectomy involves trimming away the damaged meniscus. Your doctor will likely recommend physical therapy. J ISAKOS 6(1):3545, Beaufils P, Becker R, Kopf S, Englund M, Verdonk R, Ollivier M et al (2017) Surgical management of degenerative meniscus lesions: the 2016 ESSKA meniscus consensus. nonsteroidal anti-inflammatory drugs (NSAIDs), rimed.org/rimedicaljournal/2016/10/2016-10-27-sports-babu.pdf, ncbi.nlm.nih.gov/pmc/articles/PMC5489759/, ncbi.nlm.nih.gov/pmc/articles/PMC6483631/, ncbi.nlm.nih.gov/pmc/articles/PMC5994634/, orthoinfo.aaos.org/en/diseases--conditions/meniscus-tears/, ncbi.nlm.nih.gov/pmc/articles/PMC3418117/, physioworks.com.au/pain-injury/knee-pain/meniscus-tear/, sciencedirect.com/science/article/pii/S1063458418300827, ncbi.nlm.nih.gov/pmc/articles/PMC4095015/, racgp.org.au/afp/2012/april/meniscal-tear/, ncbi.nlm.nih.gov/pmc/articles/PMC5905745/, How to Ease Knee Pain and Sleep Tight Through the Night, The 6 Best Knee Compression Sleeves of 2023, What Your Knee Pain May Indicate Based on Its Location, Prepatellar Bursitis on the Kneecap: Treatment and Recovery from this Injury, ACL Knee Repair Sometimes Leads to Better Outcomes Than Reconstruction. Using the back of a chair for support, stand upright. Acta Med Okayama 70(6):441448, Narazaki S, Furumatsu T, Tanaka T, Fujii M, Miyazawa S, Inoue H et al (2015) Postoperative change in the length and extrusion of the medial meniscus after anterior cruciate ligament reconstruction. EFORT Open Rev 6(2):113117, Wang YX, Li ZL, Li J, Zhao ZD, Wang HR, Hou C et al (2019) Effect of medial meniscus extrusion on arthroscopic surgery outcome in the osteoarthritic knee associated with medial meniscus tear: a minimum 4-year follow-up. Unable to process the form. 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. Med Hypotheses 1(101):4851, Article 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. Degenerative lesions of the knee joint are more commonly present during concurrent ACLR with meniscectomy than with intact or repaired menisci. Straighten the opposite knee using the muscles on the front of the thigh. 1. If you have a The Relationship Between Meniscal Pathology and Osteoarthritis Depends on the Type of Meniscal Damage Visible on Magnetic Resonance Images: Data from the Osteoarthritis Initiative. You should call your healthcare provider if you: You may want to ask your healthcare provider: A torn meniscus is a very common knee injury. Ice. It is often used with chronic degenerative conditions although some authors also propose this term in the setting of a tear (macerated tear) 2.On imaging, it J Am Acad Orthop Surg 23(2):7176, Kwak YH, Lee S, Lee MC, Han HS (2018) Large meniscus extrusion ratio is a poor prognostic factor of conservative treatment for medial meniscus posterior root tear. Cookies policy. [74] retrospectively analyzed MRI series with isolated ME without concomitant serious knee pathologies, and found that isolated significant ME (>3mm) was associated with MTL abnormalities. Knee 27(5):15601566, Zheng T, Song G, Li Y, Zhang Z, Ni Q, Cao Y et al (2021) Clinical, radiographic, and arthroscopic outcomes of surgical repair for radial and avulsed lesions on the lateral meniscus posterior root during ACL reconstruction: a systematic review. Knee 26(6):12921298, Zhang ZZ, Zhou YF, Luo H, Zhang HZ, Chen Z, Jiang C et al (2020) A novel surgical technique for arthroscopic repair of type II posterior lateral meniscal root tear. Another successful strategy is osteophyte resection. Treatment with glucosamine, chondroitin sulfate and licofelone has https://doi.org/10.1177/2325967120913531, Bhatia S, LaPrade CM, Ellman MB, LaPrade RF (2014) Meniscal root tears: significance, diagnosis, and treatment. PubMed Central The concurrent ACLR with repair of the menisci has shown good clinical and functional results and less risk of reoperation during the follow-up periods [83, 87]. People who tear a meniscus often feel like something has popped in their knee at the time of the injury. Currently, MPRT repair constitutes the treatment of choice, since it restores the hoop tension and the joint kinematics [65], halts the progression of OA and lowers the rate of arthroplasty [66, 67]. (ACLR+LM tears left in situ) showed narrowing of 1.0mm at 10-year follow-up [96, 97]. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Moreover, it has been shown that allograft extrusion does not correlate with clinical outcomes and tends to be stable postoperatively during follow-up [62, 108, 113]. https://doi.org/10.1007/s00167-020-06363-0, Miller TT, Staron RB, Feldman F, epel E (1997) Meniscal position on routine MR imaging of the knee. Also consult a doctor if you continue to have pain after a course of conservative treatment. Knee Surg Sports Traumatol Arthrosc 20(1):4861, Kashihara N, Furumatsu T, Kodama Y, Tanaka T, Ozaki T (2016) Concurrent lateral meniscal repair with anterior cruciate ligament reconstruction induces the extrusion of the lateral meniscus: assessments of magnetic resonance images. Work up slowly to more intense exercise activity. Note that meniscectomy may cause osteoarthritis in the long term. Although there is a need for longer follow-up periods, the currently available data suggest a benefit of concomitant ACLR with the repair of longitudinal, radial, posterior horn and posterior root tears of the menisci, because the combination can even better reduce their shape and extrusion [92, 98,99,100]. In a recent meta-analysis, the percentages of medium-term and long-term survival after medial MAT were 85.8% and 52.6%, respectively, whereas after lateral MAT they were 89.2% and 56.6%, respectively [116]. Without surgery, recovery will take about 6 to 8 weeks, though this can vary. 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 Webinferior leaet of the meniscus tear. To the best of our knowledge, this is the first study to elaborate on these topics. It usually results from twisting your knee suddenly. Malays Orthop J 9(2):1720, Article National Institute of Arthritis and Musculoskeletal and Skin Diseases. Konstantinos G. Makiev. 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. This article outlines two types and their associated symptoms and causes. Most people will need to perform exercises following surgery. David Prado/Stocksy United. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. To perform this exercise, a person should do the following: An intermediate exercise routine may include straight leg raises. This thinner cartilage can tear more easily. Our website services, content, and products are for informational purposes only. Rehabilitation following meniscal repair: A systematic review. statement and {"url":"/signup-modal-props.json?lang=us"}, Weerakkody Y, Baba Y, Knipe H, Meniscal maceration. 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. A hip labral tear can be treated nonsurgically, or with surgery in severe cases. Therefore, with this article we aim to provide an up-to-date review of the literature with an emphasis on the clinical significance and new concepts in the treatment and reduction of ME in the different knee pathologies in which it is encountered. (C) After the suture has been passed through the meniscus with free limbs su-perior and inferior to the meniscus tear.