Editorial Commentary: Meniscal Root Avulsion Repair Outcomes Are at the Level of a Salvage Procedure

Lubowitz, James H.

doi:10.1016/j.arthro.2015.06.046

Cited by 4 publications

(4 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Perfect results with complete healing and the reduction in meniscal extrusion were observed in about 60 % of patients [7]. This is undoubtedly lower than what can be expected after meniscal repair in younger patients, but, given the age of the patients and the limited options for biological treatment alternatives, these results may be superior to what can be expected as a result of salvage procedures [14]. In addition to this, two recent studies found an association between medial meniscus root tears and spontaneous aseptic osteonecrosis of the medial femoral condyle [22, 28].…”

Section: Figmentioning

confidence: 99%

Time for a paradigm change in meniscal repair: save the meniscus!

Seil

Becker

2016

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

impact on that risk, and it became obvious that the differentiation of tear types and repair techniques has resulted in significant progress over the last few years.In 2016, numerous advanced techniques for meniscal repair are being performed, regardless of the site of the tear [4,26]. There is no place in the knee that cannot be reached by the arthroscope. However, some of the repair techniques are in the early stages of development and require further improvement to reach global acceptance [24]. They appear very promising, as many surgeons have adopted them in a short period of time.Meniscus repair is gaining in popularity among an increasing number of surgeons. A better understanding, more sophisticated devices for meniscus repair and the increasing success rate might be some of the explanations. The increasing popularity of meniscus repair also includes meniscus lesions, which are associated with anterior cruciate ligament (ACL) injuries. At several European centres, meniscal repair procedures are now being performed in up to 40-60 % of all ACL reconstructions. In addition, these repairs are being extended increasingly to an athletic population and even professional athletes and football players. The medial meniscus in particular is becoming the focus of attention. As the main secondary stabiliser in anteroposterior laxity after an ACL injury, it is well known that this structure plays an important role in the long-term development of osteoarthritis and, as shown recently by Robb et al.[21], its absence negatively affects the fate of ACL graft survival. These are the reasons why efforts have recently been made to increase our understanding of medial meniscus tears [27], to rediscover certain types of injury like the meniscosynovial or ramp lesions [1,5,8,19,23,25] and to improve long-existing repair techniques [15,20].Another new development in meniscal repair relates to root tears, which have moved into focus over the last One of the most important clinical achievements highlighted at the third international meeting "The Meniscus: Preserve the future", held in Porto in early February this year [9], was the improvement made in the field of meniscal repair. The loss of the meniscus can be regarded as a pre-arthritic condition for the knee due to the loss of protective function [2,3]. However, the tear pattern has a crucial

show abstract

Section: Figmentioning

confidence: 99%

Time for a paradigm change in meniscal repair: save the meniscus!

Seil

Becker

2016

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

“…Unfortunately, both approaches increase contact pressures in the knee, which can accelerate the degeneration of the cartilage. 1,18,24 In addition, clinical studies showed that patients receiving either a meniscectomy or nonoperative therapy have a very high clinical failure rate and subsequent conversion to total knee replacement. 8,14,15…”

mentioning

confidence: 99%

“…8,13 There is still uncertainty and controversy regarding the effectiveness of treatment strategies in clinical practice for medial meniscus root tears, their associated risks for subsequent procedures, and the associated costs over an extended period. 24 In consideration of one surgical procedure to prevent another condition or knee operation, long-term projections of clinical outcomes and costs may be helpful to make informed decisions or provide accurate recommendations. Therefore, the purpose of the present study was to evaluate the long-term clinical effectiveness and cost-effectiveness of 3 strategies in the management of medial meniscus posterior root tears among those without osteoarthritis: arthroscopic meniscus root repair, arthroscopic meniscectomy, and initial nonoperative management.…”

mentioning

confidence: 99%

Meniscus Root Repair vs Meniscectomy or Nonoperative Management to Prevent Knee Osteoarthritis After Medial Meniscus Root Tears: Clinical and Economic Effectiveness

et al. 2018

View full text Add to dashboard Cite

Repair of medial meniscus root tears, as compared with total meniscectomy and nonsurgical treatment, leads to less osteoarthritis and is a cost-saving intervention. While small confirmatory randomized clinical head-to-head trials are warranted, the presented evidence seems to point relatively clearly toward adopting meniscus repair as the preferred initial intervention for medial meniscus root tears.

show abstract

“…12 Some authors have even suggested meniscal root repair outcomes are at the level of a salvage procedure. 13 Furthermore, several biomechanical studies have shown that early rehabilitative loading of medial meniscus root repair causes substantial displacement and loosening of the posterior medial root. [14][15][16] These findings suggest the need to consider slower incorporation of weight-bearing protocols in the setting of medial meniscus root repair.…”

mentioning

confidence: 99%

Editorial Commentary: Failure With Continuity: Redefining Healing With Meniscal Root Repair

Athiviraham¹

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

The importance of the medial meniscus posterior root for preserving knee joint kinematics, joint contact pressures, and articular cartilage integrity is well recognized. Medial meniscus root repair generally is associated with favorable clinical outcomes and radiographic changes compared with conservative treatment or subtotal meniscectomy; however, second-look arthroscopy often reveals some laxity at the repair site. Even in this latter situation of "failure with continuity" of the meniscus root repair, there may be benefit in delaying progression of radiographic degeneration changes. Given that the displacement of the repair often occurs with premature rehabilitative loading, it is important to delay the progression of weight-bearing until adequate healing has occurred. See related article on page 3079 "The road to success and the road to failure are almost exactly the same."

show abstract

Editorial Commentary: Meniscal Root Avulsion Repair Outcomes Are at the Level of a Salvage Procedure

Cited by 4 publications

References 30 publications

Time for a paradigm change in meniscal repair: save the meniscus!

Time for a paradigm change in meniscal repair: save the meniscus!

Meniscus Root Repair vs Meniscectomy or Nonoperative Management to Prevent Knee Osteoarthritis After Medial Meniscus Root Tears: Clinical and Economic Effectiveness

Editorial Commentary: Failure With Continuity: Redefining Healing With Meniscal Root Repair

Contact Info

Product

Resources

About