Isolated meniscus injuries in skeletally immature children and adolescents: state of the art

Vinagre, Gustavo; Cruz, Flavio Carvalho; Alkhelaifi, Khalid; D’Hooghe, Pieter

doi:10.1136/jisakos-2020-000496

Cited by 18 publications

(34 citation statements)

References 75 publications

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“…However, DLM is unique in anatomy, morphology, and histopathology. 47 Between complete DLM and incomplete DLM, the histological structure is similar, and the differences are mainly reflected in the coverage of the lateral tibial plateau and the thickness of their central region and free rim. 15,48 The Wrisberg meniscus is similar to NLM in morphology and histology, with an incidence of only 0.2%.…”

Section: Agree 36/36 100%mentioning

confidence: 98%

Chinese Experts Consensus and Practice Guideline on Discoid Lateral Meniscus

Yang

Zhang

et al. 2023

Orthopaedic Surgery

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Discoid lateral meniscus (DLM) is the most common congenital variant of the lateral meniscus, which is prone to degeneration and lesions, and often leads to knee osteoarthritis. At present, there is no consensus on the clinical practice of DLM, and this expert consensus and practice guidelines on DLM was developed and approved by Chinese Society of Sports Medicine according to the Delphi method. Among 32 statements drafted, 14 statements were excluded for redundant information, and 18 statements achieved consensus. This expert consensus focused on the definition, epidemiology, etiology, classification, clinical manifestations, diagnosis, treatment, prognosis, and rehabilitation of DLM. Restoring the normal shape, retaining appropriate width and thickness, and ensuring the stability of the remnant meniscus is critical to sustaining the physiological function of the meniscus and preserving the knee. The partial meniscectomy with or without repair should be the first-line treatment when possible, given that the clinical and radiological long-term outcomes of total or subtotal meniscectomy are worse.

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Section: Agree 36/36 100%mentioning

confidence: 98%

Chinese Experts Consensus and Practice Guideline on Discoid Lateral Meniscus

Yang

Zhang

et al. 2023

Orthopaedic Surgery

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“… 21 , 22 Partial meniscectomy, when required, should be performed gently, because of the risk of later osteoarthritis. 23 …”

Section: Clinical Decision-making Of Meniscos Tear By Mri-based Injur...mentioning

confidence: 99%

“…21,22 Partial meniscectomy, when required, should be performed gently, because of the risk of later osteoarthritis. 23 After making a primary diagnosis of meniscal tear, arthroscopy is recommended surgical approach for both repair and debridement. 24 Meniscal repair can be made through all-inside, inside-out, or outside-in techniques.…”

Section: Clinical Decision-making Of Meniscos Tear By Mri-based Injur...mentioning

confidence: 99%

Clinical considerations of anatomy and magnetic resonance imaging in pediatric meniscus tear, with imaging-based treatment options

Cabral

Sinikumpu

2023

Journal of Children's Orthopaedics

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Background: The incidence of meniscal tears in children has been increasing. Early sport specialization, more intense training activity, and increasing participation in competitive sports may have affected to that increasing trend. Diagnosing acute menisci tear in children is based on suggestive clinical and magnetic resonance imaging findings. There are special particulars in immature menisci, due to relatively good vascular supply. Furthermore, growing skeleton makes differences in injury pattern, and a clinician needs to recognize not only meniscus but also potential injuries in growth plates and ligaments, which are usual in connection with pediatric meniscus leasion. Clinical and imaging investigation prior to treatment is crucial, because non-operative care is considerable, to achieve spontaneous healing, especially in peripherial tears of younger children. Second, repair is preferred always as possible, in spite of resection due to high rate of long-term sequelae after partial meniscectomy. High standard preoperative imaging aid in preparing to the meniscus sparing arthroscopic intervention. Methods: In this current concept article, the clinical considerations of imaging the injured pediatric knee with a suspected meniscus tear and the treatment options by the imaging findings are reviewed. Level of evidence: level III.

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“…However, being in a high stress environment often leads to repair failure, and if the tissue has to be surgically removed, it can lead to an increased risk for OA as reviewed in [ 51 ]. Of relevance to this discussion is the fact that some injuries to menisci of the knee in young individuals do heal with some interventions [ 52 ], likely via the more anabolic environment operative during active growth and maturation.…”

Section: Interactions Between Inflammation and Injured Connective Tis...mentioning

confidence: 99%

Creating an Optimal In Vivo Environment to Enhance Outcomes Using Cell Therapy to Repair/Regenerate Injured Tissues of the Musculoskeletal System

Hart

Nakamura

2022

Biomedicines

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Following most injuries to a musculoskeletal tissue which function in unique mechanical environments, an inflammatory response occurs to facilitate endogenous repair. This is a process that usually yields functionally inferior scar tissue. In the case of such injuries occurring in adults, the injury environment no longer expresses the anabolic processes that contributed to growth and maturation. An injury can also contribute to the development of a degenerative process, such as osteoarthritis. Over the past several years, researchers have attempted to use cellular therapies to enhance the repair and regeneration of injured tissues, including Platelet-rich Plasma and mesenchymal stem/medicinal signaling cells (MSC) from a variety of tissue sources, either as free MSC or incorporated into tissue engineered constructs, to facilitate regeneration of such damaged tissues. The use of free MSC can sometimes affect pain symptoms associated with conditions such as OA, but regeneration of damaged tissues has been challenging, particularly as some of these tissues have very complex structures. Therefore, implanting MSC or engineered constructs into an inflammatory environment in an adult may compromise the potential of the cells to facilitate regeneration, and neutralizing the inflammatory environment and enhancing the anabolic environment may be required for MSC-based interventions to fulfill their potential. Thus, success may depend on first eliminating negative influences (e.g., inflammation) in an environment, and secondly, implanting optimally cultured MSC or tissue engineered constructs into an anabolic environment to achieve the best outcomes. Furthermore, such interventions should be considered early rather than later on in a disease process, at a time when sufficient endogenous cells remain to serve as a template for repair and regeneration. This review discusses how the interface between inflammation and cell-based regeneration of damaged tissues may be at odds, and outlines approaches to improve outcomes. In addition, other variables that could contribute to the success of cell therapies are discussed. Thus, there may be a need to adopt a Precision Medicine approach to optimize tissue repair and regeneration following injury to these important tissues.

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Isolated meniscus injuries in skeletally immature children and adolescents: state of the art

Cited by 18 publications

References 75 publications

Chinese Experts Consensus and Practice Guideline on Discoid Lateral Meniscus

Chinese Experts Consensus and Practice Guideline on Discoid Lateral Meniscus

Clinical considerations of anatomy and magnetic resonance imaging in pediatric meniscus tear, with imaging-based treatment options

Creating an Optimal In Vivo Environment to Enhance Outcomes Using Cell Therapy to Repair/Regenerate Injured Tissues of the Musculoskeletal System

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