Subchondral microfracture of the knee without osteonecrosis after arthroscopic medial meniscectomy

Nakamura, Norimasa; Horibe, Shuji; Nakamura, Shigeko; Mitsuoka, Tomoki

doi:10.1053/jars.2002.30058

Cited by 39 publications

(15 citation statements)

References 11 publications

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“…After meniscectomy, the contact area between the femur and tibia changes [3] and contact mechanical load between the femur and tibia increases [3]. Therefore, meniscectomy leads to subchondral bone microfracture [48,49], subchondral bone scleroses in covered regions [30], and cartilage degeneration [30,33,50]. Our findings strongly support the reports that suggest that subchondral bone scleroses and cartilage degeneration often occur after meniscectomy.…”

Section: Discussionsupporting

confidence: 82%

Immature articular cartilage and subchondral bone covered by menisci are potentially susceptive to mechanical load

Iijima

Aoyama

Ito

et al. 2014

BMC Musculoskelet Disord

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BackgroundThe differences of mechanical and histological properties between cartilage covered by menisci and uncovered by menisci may contribute to the osteoarthritis after meniscectomy and these differences are not fully understood. The purpose of this study is to investigate potential differences in the mechanical and histological properties, and in particular the collagen architecture, of the superficial cartilage layer and subchondral bone between regions covered and uncovered by menisci using immature knee.MethodsOsteochondral plugs were obtained from porcine tibial cartilage that was either covered or uncovered by menisci. Investigation of the thickness, mechanical properties, histology, and water content of the cartilage as well as micro-computed tomography analysis of the subchondral bone was performed to compare these regions. Collagen architecture was also assessed by using scanning electron microscopy.ResultsCompared to the cartilage uncovered by menisci, that covered by menisci was thinner and showed a higher deformity to compression loading and higher water content. In the superficial layer of cartilage in the uncovered regions, collagen fibers showed high density, whereas they showed low density in covered regions. Furthermore, subchondral bone architecture varied between the 2 regions, and showed low bone density in covered regions.ConclusionsCartilage covered by menisci differed from that uncovered in both its mechanical and histological properties, especially with regards to the density of the superficial collagen layer. These regional differences may be related to local mechanical environment in normal condition and indicate that cartilage covered by menisci is tightly guarded by menisci from extreme mechanical loading. Our results indicate that immature cartilage degeneration and subchondral microfracture may occur easily to extreme direct mechanical loading in covered region after meniscectomy.

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Section: Discussionsupporting

confidence: 82%

Immature articular cartilage and subchondral bone covered by menisci are potentially susceptive to mechanical load

Iijima

Aoyama

Ito

et al. 2014

BMC Musculoskelet Disord

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“…The authors also correlate the occurrence of osteonecrosis with meniscal injury. Nakamura et al 13 describe a case of subchondral fracture of the femoral condyle after meniscectomy. The authors found in this case an identical image to the so-called idiopathic osteonecrosis at MR.…”

Section: Discussionmentioning

confidence: 99%

Lesão meniscal por fadiga

Camanho

2009

Acta ortop. bras.

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Objective: The purpose of the present study was to review a group of patients with meniscal injuries resulting from structural failure unrelated to trauma or degenerative problems to which was given the name "meniscal injury due to fatigue". Material and Method: Evaluations were made on 140 patients with meniscal injuries without any apparent cause, who were therefore considered to have meniscal injuries due to fatigue. Among these, 85 patients were male and 55 were female. The medial meniscus was the most affected site (92% of the cases).Results: All these Study conducted at

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“…Artroskopi sonrası gelişen osteonekrozda genellikle bir menistektomi, shaver ya da radyo frekans cihazı kullanılarak yapılan kondroplasti öyküsü vardır, artroskopi sonrası dört ile doksan iki hafta sonra gelişen osteonekrozlar bildirilmiştir (11). Hastalığın patofizyolojisi halen anlaşılamamıştır, ancak yakın zamanda yapılan çalışmalarda, hastalığın ortaya çıkmasında subkondral kırığın primer rolü olduğu düşünülmektedir (12,13). Hastalığın erken döneminde tanısı ve sınıflamasında MRG standart görüntüleme yöntemi haline gelmiştir.…”

Section: Olguunclassified

A Rare Case of Osteonecrosis Caused by Arthroscopy: A Case Report

Bağcıer¹,

Erdal²,

Onaç³

2016

Tod

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SummaryAvascular necrosis, which is caused by non-traumatic factors, is not a specific disease entity but the final common result of many conditions leading to death of bone cells by the impairment of blood supply. Although associated diseases and conditions (steroid administration, alcoholism, systemic lupus erythematosus, etc.) are well known, avascular necrosis is thought to arise from a multifactorial etiology of mechanical, hormonal and hematologic factors. The goals of treatment are to maintain range of motion, to stop the progression of disease, and to reduce symptoms. If conservative treatment fails, arthroscopic debridement, core decompression, grafting, and arthroplasty are surgical alternatives according to the stage of disease. Keywords: Avascular necrosis, arthroscopy, radiology Nadir Görülen Artroskopi Sonrası Osteonekroz: Bir Olgu Sunumu A Rare Case of Osteonecrosis Caused by Arthroscopy: A Case ReportTravma dışı nedenlerle oluşan avasküler nekroz, kan akımının bozulması sonucu kemik hücrelerinin ölümü ile sonuçlanan bir antitedir. Avasküler nekroza neden olan hastalıklar (steroid kullanımı, alkolizm, sistemik lupus eritematozus vb.) bilinse de, hastalığın patogenezinde mekanik, hormonal ve hematolojik faktörlerin rol oynadığı çok etkenli etiyoloji olduğu düşünülmektedir. Tedavide amaç eklem hareket açıklığını korumak, hastalığın progresyonunu durdurmak ve semptomları azaltmaktır. Konservatif tedaviye yanıtsızlık durumunda hastalığın evresine göre artroskopik debridman, kor dekompresyon, greftleme ve artroplasti uygulanabilir.

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Subchondral microfracture of the knee without osteonecrosis after arthroscopic medial meniscectomy

Cited by 39 publications

References 11 publications

Immature articular cartilage and subchondral bone covered by menisci are potentially susceptive to mechanical load

Immature articular cartilage and subchondral bone covered by menisci are potentially susceptive to mechanical load

Lesão meniscal por fadiga

A Rare Case of Osteonecrosis Caused by Arthroscopy: A Case Report

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