Meniscectomies in children

Medlar, Robert C.; Mandiberg, Joseph J.; Lyne, E D

doi:10.1177/036354658000800205

Cited by 100 publications

(17 citation statements)

References 18 publications

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“…The effectiveness of meniscal repairs, in comparison with resection, is an important area of the study. Medlar et al 17 demonstrated that nearly 60% of children who underwent partial meniscectomy had knee pain and early degenerative arthritic changes on radiographs. In comparison, Majewski et al 16 performed a similar study and demonstrated that 24% of children had osteoarthritic changes seen radiographically.…”

Section: Discussionmentioning

confidence: 99%

Meniscal Repairs in the Adolescent Knee: Can the Number of Fixation Sites Improve Outcomes?

Schlechter

Nguyen

Fletcher

2019

Orthopaedic Journal of Sports Medicine

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Background:Meniscal pathology in children and adolescents is now a common occurrence because of their ever-increasing participation in youth sports.Purpose:To investigate the outcomes of arthroscopic meniscal repair in an adolescent cohort and analyze the variables that may affect outcomes, specifically the number of fixation sites utilized during repair.Study Design:Case series; Level of evidence, 4.Methods:A retrospective review of all children and adolescents younger than 18 years who underwent arthroscopic meniscal repair at a single institution was performed. Patient characteristics, operative details (eg, tear pattern, tear location, method of repair, and number of fixation sites [determined based on the number of sutures used for repair]), and concomitant procedures were recorded.Results:A total of 175 primary meniscal repairs met inclusion criteria and were analyzed. Of this cohort, 115 were able to be contacted and were included in the final study cohort. The mean follow-up was 41 months. The mean age of the children was 14.9 years, and 91 (79%) had concomitant anterior cruciate ligament reconstructions with their meniscal repair. The mean Pediatric International Knee Documentation Committee functional outcome score was 91 (range, 43-100), and the mean Lysholm functional outcome score was 91 (range, 47-100). Of the 115 meniscal repairs, there were a total of 19 reoperations (17%); 15 (13%) were because of meniscal repair failures. The only variable that statistically increased the risk of meniscal repair failure was low number of fixation sites, with the failure group having a mean of 1.79 sutures and the nonfailure group having a mean of 2.97 sutures (P = .03).Conclusion:Successful meniscal repairs and a lower failure rate may be achieved with a greater number of fixation sites with promising results at a minimum 2-year follow-up. Validated functional outcome scores were good, with a 13% failure rate. Larger cohort, longer term, multicenter multisurgeon data are still needed to further elucidate the number of fixation sites needed when performing a meniscal repair in the pediatric and adolescent knee.

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Section: Discussionmentioning

confidence: 99%

Meniscal Repairs in the Adolescent Knee: Can the Number of Fixation Sites Improve Outcomes?

Schlechter

Nguyen

Fletcher

2019

Orthopaedic Journal of Sports Medicine

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“…Similarly, in 219 male soccer players, 14 years after ACL injury (age range at injury, 16–42 years), the prevalence of radiographic knee OA was 41% in the injured knees versus 4% in the uninjured knees 97. In long-term follow-up of young athletes undergoing meniscus surgery, more than 50% developed knee OA with accompanying pain and physical decline 98–103. These epidemiologic studies are supported by evidence from animal models of ACL/meniscus injury and OA development 104,105…”

Section: Physical/physiological Risks For Injury In Elite Youth Athletesmentioning

confidence: 99%

The elite young athlete: strategies to ensure physical and emotional health

Sabato¹,

Walch²,

Caine³

2016

OAJSM

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This article presents a current review of the risk of physical and psychological injury associated with participation in elite youth sport, and suggests strategies to ensure the physical and emotional health of these young athletes. Although there is lack of epidemiological data, especially with regard to psychological injury, preliminary data suggest that the risk of injury is high in this population. While there is lack of incident and follow-up data, there is also concern regarding burnout, disordered eating, and the long-term consequences of injury. Modifiable injury risk factors identified include postural control, competition anxiety, life events, previous injury, and volume of training. There are presently no studies designed to determine the effectiveness of injury prevention measures in elite youth sports. However, there is adequate evidence arising from injury prevention studies of youth sports participants – including neuromuscular training, protective equipment, mental training to enhance self-esteem, and sport rules modification – to prevent injuries in elite youth sports settings. Although not tested, psychosocial prevention strategies such as adoption of task-oriented coping mechanisms, autonomous support from parents, and a proactive organizational approach also show promise in injury prevention.

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“…The meniscus has an important role in the knee joint, including load transmission, shock absorption, stability, and lubrication (2,6,19,23). Injury or removal of the meniscus alters the loading environment in the knee joint, resulting in increased contact pressures and stresses on the articular cartilage, which is associated with the accelerated onset of osteoarthritis (11,18,28).…”

mentioning

confidence: 99%

The Use of Blood Vessel–Derived Stem Cells for Meniscal Regeneration and Repair

Osawa

Harner

Gharaibeh

et al. 2013

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose Surgical repairs of tears in the vascular region of the meniscus usually heal better than repairs performed in the avascular region; thus, we hypothesized that this region might possess a richer supply of vascular-derived stem cells than the avascular region. Methods In this study, we analyzed 6 menisci extracted from aborted human fetuses and 12 human lateral menisci extracted from adult human subjects undergoing total knee arthroplasty. Menisci were immunostained for CD34 (a stem cell marker) and CD146 (a pericyte marker) in situ, whereas other menisci were dissected into two regions (peripheral and inner) and used to isolate meniscus-derived cells by flow cytometry. Cell populations expressing CD34 and CD146 were tested for their multi-lineage differentiation potentials, including chondrogenic, osteogenic, and adipogenic lineages. Fetal peripheral meniscus cells were transplanted by intracapsular injection into the knee joints of an athymic rat meniscal tear model. Rat menisci were extracted and histologically evaluated after 4 wk posttransplantation. Results Immunohistochemistry and flow cytometric analyses demonstrated that a higher number of CD34- and CD146-positive cells were found in the peripheral region compared with the inner region. The CD34- and CD146-positive cells isolated from the vascular region of both fetal and adult menisci demonstrated multilineage differentiation capacities and were more potent than cells isolated from the inner (avascular) region. Fetal CD34- and CD146-positive cells transplanted into the athymic rat knee joint were recruited into the meniscal tear sites and contributed to meniscus repair. Conclusions The vascularized region of the meniscus contains more stem cells than the avascular region. These meniscal-derived stem cells were multi-potent and contributed to meniscal regeneration.

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Meniscectomies in children

Cited by 100 publications

References 18 publications

Meniscal Repairs in the Adolescent Knee: Can the Number of Fixation Sites Improve Outcomes?

Meniscal Repairs in the Adolescent Knee: Can the Number of Fixation Sites Improve Outcomes?

The elite young athlete: strategies to ensure physical and emotional health

The Use of Blood Vessel–Derived Stem Cells for Meniscal Regeneration and Repair

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