Meniscal Repair in the Goat Model

Ritchie, Joseph R.; Miller, Mark D.; Bents, Robert T.; Smith, Douglas K.

doi:10.1177/03635465980260022001

Cited by 61 publications

(8 citation statements)

References 25 publications

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“…The use of a fibrin clot can also be an effective technique to support a reparative response in the avascular zone of the meniscus [34, 35, 37]. Findings demonstrated that the rasping technique is more effective than fibrin clot application to improve meniscal healing [179]. Kobayashi et al reported healing rates in the peripheral zone of the menisci in an on-organ culture model.…”

Section: Discussionmentioning

confidence: 99%

Biological Strategies to Enhance Healing of the Avascular Area of the Meniscus

Longo

Campi

Romeo

et al. 2012

Stem Cells International

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Meniscal injuries in the vascularized peripheral part of the meniscus have a better healing potential than tears in the central avascular zone because meniscal healing principally depends on its vascular supply. Several biological strategies have been proposed to enhance healing of the avascular area of the meniscus: abrasion therapy, fibrin clot, organ culture, cell therapy, and applications of growth factors. However, data are too heterogeneous to achieve definitive conclusions on the use of these techniques for routine management of meniscal lesions. Although most preclinical and clinical studies are very promising, they are still at an experimental stage. More prospective randomised controlled trials are needed to compare the different techniques for clinical results, applicability, and cost-effectiveness.

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Section: Discussionmentioning

confidence: 99%

Biological Strategies to Enhance Healing of the Avascular Area of the Meniscus

Longo

Campi

Romeo

et al. 2012

Stem Cells International

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“…Infiltration of the joint by the paramagnetic contrast can increase the sensitivity and specificity of the exam. In an experimental model using goats, Ritchie 21 demonstrated the 100% accuracy of arthro-MRI for the evaluation of complete meniscal healing, compared with 33% for conventional MRI. The diagnosis of a lesion or failed healing is done by visualizing the penetration of contrast medium at the site of the lesion.…”

Section: Discussionmentioning

confidence: 99%

Meniscal Repair Results Comparing Mri, Arthro-Mri, and Arthro-Ct

et al. 2018

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Objective To clinically and radiologically evaluate patients who received meniscal suture using the outside-in technique, comparing magnetic resonance imaging (MRI), arthro-magnetic resonance imaging (arthro-MRI), and arthro-computed tomography (arthro-CT) to evaluate the healing of meniscal sutures.Methods We evaluated eight patients with an average follow-up of 15 months. The evaluation analyzed clinical parameters using the Lysholm and IKDC scores as well as MRI, arthro-MRI, and arthro-CT imaging.Results At the end of the follow-up period, mean Lysholm score was 89.5 and mean IKDC score was 78.6. In the MRI, signs of meniscal healing were observed in 50% of the cases. The arthro-MRI and arthro-CT showed signs of healing in 75% of cases. There was a positive correlation between arthro-MRI and arthro-CT results in all the cases studied (kappa correlation index=1).Conclusion Meniscal suture using the outside-in technique presented good or excellent results in 87.5% of our patients. The arthro-CT and arthro-MRI showed the same level of accuracy in detecting healing of the sutured region of the meniscus. Level of Evidence IV; Case series.

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“…Synovial abrasion has been proposed as one method to improve healing response, because many growth factors are released and neovascularization is observed. 97 Trephination allows communication between the vascular peripheral third and the avascular zone. Its theoretical advantage is to reconduct the vascular flow through the white zone.…”

Section: How To Enhance Meniscal Healingmentioning

confidence: 99%

“…102 Its use has demonstrated increased healing in peripheral tears both in animal models and human patients. 97,103,104 However, in central tears its rate of success diminishes, probably influenced by the fact that healing in the inner third is different from the peripheral zone. 97…”

Section: How To Enhance Meniscal Healingmentioning

confidence: 99%

Arthroscopic repair of the meniscus

Vaquero-Picado

Rodríguez-Merchán

2018

EFORT Open Reviews

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From the biomechanical and biological points of view, an arthroscopic meniscal repair (AMR) should always be considered as an option. However, AMR has a higher reoperation rate compared with arthroscopic partial meniscectomy, so it should be carefully indicated.Compared with meniscectomy, AMR outcomes are better and the incidence of osteoarthritis is lower when it is well indicated.Factors influencing healing and satisfactory results must be carefully evaluated before indicating an AMR.Tears in the peripheral third are more likely to heal than those in the inner thirds.Vertical peripheral longitudinal tears are the best scenario in terms of success when facing an AMR.‘Inside-out’ techniques were considered as the gold standard for large repairs on mid-body and posterior parts of the meniscus. However, recent studies do not demonstrate differences regarding failure rate, functional outcomes and complications, when compared with the ‘all-inside’ techniques.Some biological therapies try to enhance meniscal repair success but their efficacy needs further research. These are: mechanical stimulation, supplemental bone marrow stimulation, platelet rich plasma, stem cell therapy, and scaffolds and membranes.Meniscal root tear/avulsion dramatically compromises meniscal stability, accelerating cartilage degeneration. Several options for reattachment have been proposed, but no differences between them have been established. However, repair of these lesions is actually the reference of the treatment.Meniscal ramp lesions consist of disruption of the peripheral attachment of the meniscus. In contrast, with meniscal root tears, the treatment of reference has not yet been well established.Cite this article: EFORT Open Rev 2018;3:584-594. DOI: 10.1302/2058-5241.3.170059

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Meniscal Repair in the Goat Model

Cited by 61 publications

References 25 publications

Biological Strategies to Enhance Healing of the Avascular Area of the Meniscus

Biological Strategies to Enhance Healing of the Avascular Area of the Meniscus

Meniscal Repair Results Comparing Mri, Arthro-Mri, and Arthro-Ct

Arthroscopic repair of the meniscus

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