Meniscus tear surgery and meniscus replacement

Abstract

Objective: the menisci are easily injured and difficult to repair. The aim of this study was to analyze the current state of meniscal surgery aimed at preserving morphology and conserving the biomechanics of the knee to prevent joint degeneration. Methodology: a search of the electronic medical literature database Medline was conducted, from http://www.ncbi.nlm.nih.gov/pubmed. The search was not limited by language. Candidate articles were identified by searching for those that included the keywords meniscus, surgery, suture, implant, allograft. The limits were included for clinical research and clinical trials. Basic research was not included. The studies selected were evaluated and classified in three different categories: basic science, reconstruction (suture and meniscectomy) and implants (scaffolds and allograft). Results: the consequences of meniscectomy performed at a young age can lead to a joint cartilage degeneration twenty years later. There are few surgical options for the repair of meniscal injuries in order both to preserve the meniscus and to ensure the long term survival of the knee joint, meniscectomy, repair, suturing the tear, or reconstruction, when a meniscal allograft or synthetic substitute is used to replace the meniscus, but the biomechanical properties of the native meniscus are not reproduced entirely by the scaffolds that exist today.Conclusion: therapies that successfully repair or replace the meniscus are therefore likely to prevent or delay osteoarthritis progression.

Multiple hybrid sutures of bucket handle injury on the lateral and medial meniscus of the knee

“…The use of hybrid sutures is based on the fact that there is no superiority between the types of meniscal sutures13 and the excellent results presented in the studies using combined techniques 4 9 11 14. It is known that all possibilities of sutures avoid risks and associated benefits 15–21…”

The Meniscus Tear: A Review of Stem Cell Therapies

“…Meniscal replacement strategies in the form of a collagen meniscal implant and a polyurethane polymer scaffold have been employed over recent years with promising clinical results. However, these implants have been unsuccessful in emulating normal meniscal biomechanics and radiological follow-up does not demonstrate images resembling that of normal meniscus [8][9][10][11]. Meniscal allograft transplantation has also been an option in selected healthcare systems but has several limitations ranging from graft availability, congruence, biocompatibility, fixation problems, and potential infection [8].…”

“…However, these implants have been unsuccessful in emulating normal meniscal biomechanics and radiological follow-up does not demonstrate images resembling that of normal meniscus [8][9][10][11]. Meniscal allograft transplantation has also been an option in selected healthcare systems but has several limitations ranging from graft availability, congruence, biocompatibility, fixation problems, and potential infection [8]. With the current preferred management option being meniscal repair, the purpose of this article is to comprehensively review the current status of stem cell treatments in both pre-clinical and clinical studies, dividing them into injection-based and tissue-engineered cell therapies.…”

The implications of non-anatomical positioning of a meniscus prosthesis on predicted human knee joint biomechanics

“…For a meniscus prosthesis, the geometry, material properties, fixation type, and prosthesis positioning are believed to be crucial factors [6][7][8], which need to be assessed thoroughly before clinical implementation. The influence of geometrical specifications of the medial meniscus prosthesis [9][10][11] and the material properties of the prosthesis [12][13][14] on the knee biomechanics have previously been studied, as have different meniscus prosthesis fixation types [15,16].…”