Does the location of placement of meniscal sutures have a clinical effect in the all-inside repair of meniscocapsular tears?

Tiftikçi, Uğur; Serbest, Sancar

doi:10.1186/s13018-017-0591-2

Cited by 20 publications

(19 citation statements)

References 26 publications

(37 reference statements)

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“…Placing the patient's knee into the figure-of-4 position resulted in varus stress, reducing this inward displacement. Our patient presentation was consistent with that previously reported in the literature for isolated MCS: teenage female athlete with joint line tenderness limited to the area of separation, with or without McMurray or mechanical symptoms, and pain that typically only occurs with sporting activities but not with activities of daily living (Table 1) [5][6][7].…”

Section: Discussionsupporting

confidence: 88%

Dynamic Sonographic Visualization of an Occult Posterior Lateral Meniscocapsular Separation: A Case Report

Schroeder

Musahl

Urbanek

et al. 2018

PM&R

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Meniscocapsular separation describes detachment of the meniscus from the knee joint capsule. Diagnosis is challenging with conventional examination and imaging methods. We report a case of an 18-year-old female softball catcher with unrevealing magnetic resonance imaging despite continued left knee locking and discomfort with deep squatting. Meniscocapsular separation was revealed only on dynamic sonographic examination, where knee flexion revealed a 3.1-mm gap that developed between the capsule and peripheral meniscus. Arthroscopy confirmed the sonographic findings, and repair resulted in complete resolution of symptoms. This case highlights the utility of dynamic diagnostic sonography in a rare case of posterior lateral meniscocapsular separation. LEVEL OF EVIDENCE: V.

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Section: Discussionsupporting

confidence: 88%

Dynamic Sonographic Visualization of an Occult Posterior Lateral Meniscocapsular Separation: A Case Report

Schroeder

Musahl

Urbanek

et al. 2018

PM&R

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“…Second, we did not investigate the consequences of suture shape in meniscus repair after surgery because the outcomes in this study were measured at time zero after surgery. Third, we conducted our biomechanical analysis only on the middle segment of the medial meniscus, and a recent study indicated that the location of sutures in the meniscus may affect their biomechanical features (Tiftikci and Serbest 2017 ). Finally, we did not investigate all-inside devices or sutures made of ultra-high-molecular-weight polyethylene (UHMWPE).…”

Section: Discussionmentioning

confidence: 99%

Novel flat and wide meniscal repair material improves the ultimate load of knot breakage in a porcine trans-capsular meniscal repair model

et al. 2017

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Background: In the meniscal repair procedures, a high ultimate load capacity and low cyclic creep at the repair site are favorable and lead to good biological incorporation of the tear site after surgery. Previous biomechanical tensile tests of the meniscal sutures have identified the suture knot as the weakest point. We hypothesized that the strength of a suture knot depends on the suture shape, and therefore, we compared three differently shaped suture materials composed of the same material and quantity per length. The purpose of this study was to determine whether a novel flat and wide repair material (FWRM), which consists of braided multi-threads that are cross-sectionally flat and wide, improves the ultimate load of knot breakage in a biomechanical experiment using a porcine trans-capsular meniscal repair model. Methods: Eighteen fresh-frozen porcine knees (n = 6 in each group) were used. A longitudinal tear in the middle segment of the medial meniscus was created and repaired with a trans-capsular inside-out method using the following suture materials: No. 2-0 braided polyester conventional suture, hollow suture, and FWRM. After the separation of the inner segment of the meniscus with leaving, the suture stability of the repaired menisci was biomechanically analyzed with a video camera system for widening after a cyclic load between 5 and 20 N was applied 300 times. Ultimate failure load and stiffness at 5 mm/ min were also analyzed.

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“…Quadriceps strength and ROM were evaluated and incorporated as part of the rehabilitation guidelines for a few of the included studies that implemented them into their return-to-play criteria. 14 , 15 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 The use of arthroscopic findings to help determine to what level an athlete could return-to-play was not used in the included studies. However, Willinger et al.…”

Section: Discussionmentioning

confidence: 99%

Return-to-Play and Rehabilitation Protocols Following Isolated Meniscal Repair—A Systematic Review

Fried¹,

Manjunath²,

Hurley³

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To systematically review the literature and assess the reported rehabilitation protocols, return-to-play guidelines, and reported rates of return-to-play after meniscal repair. Methods MEDLINE, EMBASE, and the Cochrane Library were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify studies on meniscal repair. Studies were included if return-to-play data and/or rehabilitation protocols were reported. The rate and timing of return-to-play was assessed. The rehabilitation protocols were documented, in addition to when to start range of motion (ROM), full ROM, partial weight-bearing (WB), and full WB. Results Overall, 88 studies met our inclusion criteria. Thirteen studies, including 507 patients, cited a range of 71.2% to 100% of return-to-play, with 53.9% to 92.6% returning to the same/greater level, ranging between 3.3 and 10 months. There was considerable variability in the reported rehabilitation protocols, but the most frequently reported time to begin ROM exercises was within the first week (78.9%) and full ROM at 6 weeks (33.3%). Partial WB was typically begun during the first week (61.0%), and full WB between the fourth and sixth week (65.6%) postoperatively. Following surgery, time elapsed was the most commonly cited criteria for return-to-play (97.0%), with 6 months being the most common time point applied (46.9%). No study advised against returning to competitive or contact sports after meniscal repair. Conclusions In conclusion, there was a high rate of return-to-play following meniscal repair, with 60% of patients returning to the same level of play. However, there was considerable diversity in the reported rehabilitation protocols and insufficient reporting on return-to-play criteria in the literature. This demonstrates the need for further research and formulation of an evidence-based consensus statement for this patient population. Level of Evidence Level IV, systematic review of Level I to IV studies.

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Does the location of placement of meniscal sutures have a clinical effect in the all-inside repair of meniscocapsular tears?

Cited by 20 publications

References 26 publications

Dynamic Sonographic Visualization of an Occult Posterior Lateral Meniscocapsular Separation: A Case Report

Dynamic Sonographic Visualization of an Occult Posterior Lateral Meniscocapsular Separation: A Case Report

Novel flat and wide meniscal repair material improves the ultimate load of knot breakage in a porcine trans-capsular meniscal repair model

Return-to-Play and Rehabilitation Protocols Following Isolated Meniscal Repair—A Systematic Review

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