Meniscal repair and regeneration: Current strategies and future perspectives

Shimomura, Kazunori; Hamamoto, Shuichi; Hart, David A.; Yoshikawa, Hideki; Nakamura, Norimasa

doi:10.1016/j.jcot.2018.07.008

Cited by 62 publications

(46 citation statements)

References 87 publications

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“…Experts were deciding to use bone marrow cells, biomaterials or autologous adipose tissue as meniscus repair methods. All of these approaches that involve the use of cells and biomaterial scaffolds have gained an increasing attention as potential regenerative therapies in the eld of musculoskeletal medicine very recently [4]. Therefore the observation than non-experts are less frequently choosing these options could be explained with their less experience with new therapeutic options for patients, as they still gain experience with traditional meniscus treatment methods.…”

Section: Discussionmentioning

confidence: 99%

“…The menisci injury is a common ailment of the knee injury [1]. Due to its hypovascularity and hypocellularity, a meniscus tear does not heal spontaneously [2,3,4] and prolonged untreated damage may lead to the development of osteoarthritis [5,6,7]. Current orthopedic practice aims to preserve meniscal integrity and restore its function [8,9,10,11].…”

Section: Introductionmentioning

confidence: 99%

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Clinical practice and post-operative rehabilitation after knee arthroscopy varies according to surgeon's expertise: a survey among Polish Arthroscopy Society members.

Bąkowski

Bąkowska-Żywicka²,

Piontek

2020

Preprint

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Background: Meniscal repair has received increasing attention. Currently, there is a variety of arthroscopic methods of meniscus repair available. The purpose of this study was to determine a consensus in meniscus tear treatment in the environment of Polish orthopedists.Methods: 205 registered orthopedic surgeons took part in surveys. The survey consisted of 35 questions regarding general arthroscopy and postoperative management, including physician’s level of expertise, arthroscopy anesthesia, postoperative treatment, rehabilitation and procedures performed. Comparisons were made between knee arthroscopy experts (> 100 arthroscopies performed per year) and non-experts (≤ 100 cases) on aspects of patient care.Results: The most important finding of this study is an agreement in almost all aspects of knee arthroscopy approach. A consensus between polish surgeons was noticed in choosing regional anesthesia for knee arthroscopy, no need for knee braces nor knee medications, using LMW heparin as thromboprophylaxis, 1-2 days hospitalization, recommendation of rehabilitation and magnetic resonance as a diagnostic test for meniscus damage. Surgical expertise was significantly associated with the performance of meniscus sewing procedures (p = 0.009). Experts recommended starting rehabilitation already on the day of surgery (p=0.007) and more likely used objective physical tests (p=0.003). Non-expert surgeons recommended longer period from meniscus suture to a full range knee motion (p=0.001) and admitted that patient’s age does matter for meniscus repair qualification (p=0.002).Conclusions: There is a consensus in almost all issues of meniscus tear treatment in the environment of the Polish orthopedists, however the rehabilitation issues and the use of advanced meniscus repair techniques is associated with surgical expertise.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical practice and post-operative rehabilitation after knee arthroscopy varies according to surgeon's expertise: a survey among Polish Arthroscopy Society members.

Bąkowski

Bąkowska-Żywicka²,

Piontek

2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Experts were deciding to use bone marrow cells, biomaterials or autologous adipose tissue as meniscus repair methods. All of these approaches that involve the use of cells and biomaterial scaffolds have recently gained increasing attention as potential regenerative therapies in the eld of musculoskeletal medicine [4]. Therefore, the observation that non-experts are less frequently choosing these options could be explained by their limited experience with new therapeutic options for patients, as they are still gaining experience with traditional meniscus treatment methods.…”

Section: Discussionmentioning

confidence: 99%

“…Meniscus injuries represent a common ailment of knee damage [1]. Due to the hypovascularity and hypocellularity of the meniscus, meniscus tears do not heal spontaneously [2,3,4], and prolonged untreated damage may lead to the development of osteoarthritis [5,6,7]. Current orthopaedic practice aims to preserve meniscal integrity and restore function [8,9,10,11].…”

Section: Introductionmentioning

confidence: 99%

Clinical practice and postoperative rehabilitation after knee arthroscopy vary according to surgeons’ expertise: a survey among Polish Arthroscopy Society members.

Bąkowski

Bąkowska-Żywicka²,

Piontek

2020

Preprint

View full text Add to dashboard Cite

Background: Meniscus repair is a challenging task in knee arthroscopy. Currently, there are a variety of arthroscopic methods available for meniscus repair. The purpose of this study was to determine a consensus in meniscus tear treatment in the environment of Polish orthopaedists.Methods: A total of 205 registered orthopaedic surgeons participated in the surveys. The survey consisted of 35 questions regarding general arthroscopy and postoperative management, including physicians’ level of expertise, anaesthesia, postoperative treatment, rehabilitation and procedures performed. Comparisons were made between knee arthroscopy experts (> 100 arthroscopies performed per year) and non-experts (≤ 100 cases) on aspects of patient care.Results: The most important finding of this study was the agreement among almost all aspects of the knee arthroscopy approach. Consensus among Polish surgeons was noticed in choosing regional anaesthesia for knee arthroscopy, the lack of need for knee braces and knee medications, the of use of LMW heparin for thromboprophylaxis, 1-2 days of hospitalization, the recommendation of rehabilitation and the use of magnetic resonance as a diagnostic test for meniscus damage. Surgical expertise was significantly associated with the performance of meniscus suture procedures (p = 0.009). Experts recommended starting rehabilitation on the day of surgery (p=0.007) and were more likely to use objective physical tests (p=0.003). Non-expert surgeons recommended a longer period from meniscus suture to full-range knee motion (p=0.001) and admitted that patient age does matter for meniscus repair qualification (p=0.002).Conclusions: There is consensus among almost all issues of meniscus tear treatment in the environment of Polish orthopaedists; however, the issues of rehabilitation and the use of advanced meniscus repair techniques are associated with surgical expertise.

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“…Increasingly more studies have suggested [15][16][17] that meniscus injury or defect will lead to an increase in the incidence of osteoarthritis, and thus meniscal repair has received increasingly more attention. Among the repair methods of meniscus injury [18] , meniscal suture repair is the mainstream repair method at present, and includes three types of repair: outside-in repair, inside-out repair and all-inside repair. Although the technique of inside-out repair is the gold standard for the treatment of the body and posterior angle of the meniscal tear, clinical studies have shown [19][20][21][22] that the clinical efficacy of all-inside repair is the same as that of inside-out repair, where all-inside repair has shorter operation time and fewer complications.…”

Section: Discussionmentioning

confidence: 99%

The modified cross-suture technique for unilateral pulled-out anchor during all-inside meniscal repair

Shi

Fan

et al. 2019

Preprint

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Background: In consideration of meniscal repair has received increasingly more attention, but for inexperienced doctors, various technical errors may occur when meniscal suture repair is performed, particularly during all-inside meniscal suture repairing. When the errors is happened intraoperatively, how to minimize the loss under the effectiveness of treatment is a topic worth studying. Methods: From May 2014 to May 2017, 28 cases diagnosed with injures of meniscus and anterior cruciate ligaments were enrolled in the study as observation group. All cases underwent anterior cruciate ligament (ACL) reconstruction concurrently. All meniscus injuries were repaired with an allinside meniscal repair technique, and 1-3 needles of unilateral suture anchor pulling out occurred intraoperatively. The method of modified cross-suture was used to remedy the error of anchor pulling out and to eventually complete the effective repair. During postoperative follow-up, the range of motion, Lachman test and pivot shift test were confirmed by physical examination. The clinical healing of meniscus was evaluated according to the Barrett standard. Meniscus healing status was also confirmed with magnetic resonance imaging (MRI). The function of the knee joint was evaluated with the IKDC, Lysholm and Tegner scores. Results: 25 cases of observation group and 28 cases of control group received complete follow-up with an average follow-up of 18.4±5.2 months. All operations were finished by the same surgeon. Atthe follow-up one year after operation, the average knee ROM of two groups were 125.2±4.3 degrees and 124.7±3.8 degrees, the clinical healing rate of the meniscus of two groups were 92.0% (23/25) and 92.9% (26/28), the MRI healing rate of the menniscus of two groups were 72.0% (18/25) and 71.4% (20/28), the IKDC, Lysholm and Tegner scores of two groups were 90.52±2.8, 89.17±3.1, 6.81±1.7 and 91.42±1.9, 90.32±3.4, 7.02±1.4, the differences were not statistically significant (P>0.05).Conclusions: The method of modified cross-suture is effective for arthroscopic remediation for unilateral suture anchor pulling out of an all-inside meniscal repair system. BackgroundMeniscus injury is a kind of common and frequent sports injury, and its treatment should maintain the

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Meniscal repair and regeneration: Current strategies and future perspectives

Cited by 62 publications

References 87 publications

Clinical practice and post-operative rehabilitation after knee arthroscopy varies according to surgeon's expertise: a survey among Polish Arthroscopy Society members.

Clinical practice and post-operative rehabilitation after knee arthroscopy varies according to surgeon's expertise: a survey among Polish Arthroscopy Society members.

Clinical practice and postoperative rehabilitation after knee arthroscopy vary according to surgeons’ expertise: a survey among Polish Arthroscopy Society members.

The modified cross-suture technique for unilateral pulled-out anchor during all-inside meniscal repair

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