Small Medial Meniscocapsular Separations: A Potential Cause of Chronic Medial-Side Knee Pain

Hetsroni, Iftach; Lillemoe, Kaitlyn; Marx, Robert G.

doi:10.1016/j.arthro.2011.06.025

Cited by 29 publications

(40 citation statements)

References 8 publications

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“…The authors also reported that only 1 stitch was sufficient for repairing this lesion. 6 Similar to their findings, in our patient, a minor injury caused meniscocapsular separation, the separation was not detected on MRI, and 1 suture was sufficient for repairing the lesion. However, we could easily identify the meniscocapsular separation preoperatively and intraoperatively with ultrasonography.…”

Section: Discussionsupporting

confidence: 73%

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Ultrasound for Treating Meniscocapsular Separation Together With Arthroscopy

Akatsu

Akagi

Fukawa

et al. 2016

Arthroscopy Techniques

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Magnetic resonance imaging (MRI) can be used to identify most types of meniscal tears; however, meniscocapsular separation of the medial meniscus can be difficult to identify with MRI. Here we present a technical note on the intrasurgical use of ultrasonography for the detection of meniscocapsular separation and confirmation of the beneficial effect of suturing on the stability of this lesion in a representative case of meniscocapsular separation that could be diagnosed with ultrasonography but not MRI preoperatively. Ultrasonography can detect meniscocapsular separation as a vertical low echoic area and be performed together with arthroscopy using the picture-in-picture function of the ultrasonography machine. Ultrasonography is an effective tool for diagnosing meniscocapsular separation and is helpful during arthroscopic surgery.

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Section: Discussionsupporting

confidence: 73%

“…3,5 Hetsroni et al 6 reported that minor knee injury can cause small medial meniscocapsular separation resulting in persistent knee pain and that the separation can be overlooked on MRI and hard to visualize with arthroscopy. The authors also reported that only 1 stitch was sufficient for repairing this lesion.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound for Treating Meniscocapsular Separation Together With Arthroscopy

Akatsu

Akagi

Fukawa

et al. 2016

Arthroscopy Techniques

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“…MCS is most often in the posterior horn section, is often a lesion in the meniscotibial ligament and accompanies microtrauma and anterior cruciate ligament (ACL) tears [1, 4, 13]. Several studies have reported a high rate of recovery after MCS repair [9, 10, 12]. As the blood circulation is good in the meniscocapsular region and in the peripheral third of the meniscus, studies have reported that the recovery rate is high and the re-operation risk is low [18, 19].…”

Section: Introductionmentioning

confidence: 99%

Does the location of placement of meniscal sutures have a clinical effect in the all-inside repair of meniscocapsular tears?

Tiftikçi

Serbest

2017

J Orthop Surg Res

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BackgroundMeniscocapsular separation (MCS) is a lesion of the area which is attached from the peripheral section of the meniscus to the capsule and is seen less often than other meniscus injuries. The aim of this study was to investigate which of the different side applications of all-inside MCS repair of the meniscus was better in respect of clinical and functional results.MethodsIn this retrospective study, 53 patients with MCS pattern in their knee joints were treated with arthroscopic meniscus repair made with the all-inside method. The patients were separated into three groups according to the surface from which the fixation was applied: group 1, from the femoral joint surface of the meniscus (n = 17), group 2, from the tibial joint surface of the meniscus (n = 21) and group 3, from the femoral and tibial joint surfaces of the meniscus (n = 15). The participants were assessed using the subjective International Knee Documentation Committee Scoring (IKDC), Lysholm Knee Scale, Tegner Activity Level Scale, Barrett criteria and Kellgren–Lawrence classification after a 45 ± 12.1 months (range, 24–70 months) follow-up.ResultsPostoperatively, all the groups exhibited significantly increased subjective IKDC score, Lysholm score and Tegner activity score compared with their preoperative results (p < 0.001). At 6 months postoperatively, a statistically significant difference was determined between the groups in respect of the subjective IKDC score, Tegner activity score and Lysholm score with group 2 showing better results than the other groups (p < 0.001). At the final follow-up examination, no statistically significant difference was determined between the groups in respect of the subjective IKDC score, Tegner activity score or Lysholm score. A statistically significantly lower level of pulling and stress sensation was determined in group 2 (p < 0.001).ConclusionsMCS repair made with the all-inside method is successful clinically and functionally and in respect of MRI findings. In addition, it was seen that the fixation method applied from the tibial surface of the meniscus does not disturb the anatomic position of the meniscus in MCS repair. The tibial joint surface is the most appropriate area for suturation in all-inside repair of MCS.Level of evidenceLevel IV.

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“…8 The factors to be considered in repairing meniscocapsular separations are the need for repair, the proximity to neurovascular structures, the complexity of the procedure, the risk of cartilage damage, the presence of capsular over-tightening, the need for placement of multiple sutures, and the thin capsular tissue posteriorly.…”

Section: Discussionmentioning

confidence: 99%

“…Most authors now agree that posteromedial meniscocapsular separations need to be repaired. [1][2][3][4][5][6][7][8] Posteromedial meniscocapsular separation is typically associated with ACL injuries. 4 The incidence of such lesions has been reported from 16.6% to as high as 23.2%.…”

mentioning

confidence: 99%

Repairing Posteromedial Meniscocapsular Separation: A Technique Using Inside-Out Meniscal Repair Needles

Joshi¹,

Usman²,

Sabnis³

et al. 2016

Arthroscopy Techniques

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Posteromedial meniscocapsular separation of the knee has received renewed interest, with many articles describing a high incidence in association with anterior cruciate ligament injury. Various techniques have been described to address these lesions using all-inside meniscal repair sutures or using rotator cuff repair instruments through the posteromedial portal. Most orthopaedic surgeons are accustomed to using the "inside-out" meniscal repair technique with a double-armed suture. This technique is cost-effective and, in our opinion, more efficient in repairing such tears. We present our technique of repairing peripheral meniscocapsular lesions using an inside-out meniscal repair system. We believe that this technique is easily reproducible, is less time-consuming, and ensures a good "bite" of the capsular tissue, producing a robust repair.

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Small Medial Meniscocapsular Separations: A Potential Cause of Chronic Medial-Side Knee Pain

Cited by 29 publications

References 8 publications

Ultrasound for Treating Meniscocapsular Separation Together With Arthroscopy

Ultrasound for Treating Meniscocapsular Separation Together With Arthroscopy

Does the location of placement of meniscal sutures have a clinical effect in the all-inside repair of meniscocapsular tears?

Repairing Posteromedial Meniscocapsular Separation: A Technique Using Inside-Out Meniscal Repair Needles

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