The human meniscus: A review of anatomy, function, injury, and advances in treatment

Fox, Allison M.; Wanivenhaus, Florian; Burge, Alissa J.; Warren, Russell F.; Rodeo, Scott A.

doi:10.1002/ca.22456

Cited by 371 publications

(368 citation statements)

References 186 publications

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“…On sagittal images, the bucket handle fragment of the medial meniscus can be seen as a dark band anterior to the posterior cruciate ligament (PCL), an appearance called the 'double PCL sign' [14]. If the displaced segment is seen [16]. On MRI, these variations appear as dark bands on T2W images, and can be misinterpreted as a displaced meniscal fragment or an intra-articular body [17,18].…”

Section: Meniscal Lesions and Variantsmentioning

confidence: 97%

T2 black lesions on routine knee MRI: differential considerations

et al. 2015

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The majority of abnormal findings or lesions on T2-weighted fast spin-echo (FSE) magnetic resonance imaging (MRI) are hyperintense due to increased perfusion or fluid content, such as infections, tumours or synovitis. Hypointense lesions on T2-weighted images (both fat-suppressed and non-fat-suppressed) are less common and can sometimes be overlooked. Such lesions have limited differential diagnostic possibilities, and include vacuum phenomenon, loose body, tenosynovial giant cell tumour, rheumatoid arthritis, haemochromatosis, gout, amyloid, chondrocalcinosis, hydroxyapetite deposition disease, lipoma arborescens, arthrofibrosis and iatrogenic lesions. These lesions often show characteristic appearances and predilections in the knee. In this article, the authors describe the MRI features of hypointense T2 lesions on routine knee MRI and outline a systematic diagnostic approach towards their evaluation. Key Points • Hypointense lesions on T2 images (T2 Dark Lesions) encompass limited diagnostic possibilities. • T2 Dark lesions often show characteristic appearances and predilections in the knee. • A systematic diagnostic approach will help radiologists make the correct diagnosis.

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Section: Meniscal Lesions and Variantsmentioning

confidence: 97%

T2 black lesions on routine knee MRI: differential considerations

et al. 2015

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“…The meniscus, articular cartilage (AC), and nucleus pulposus (NP) are all significant tissues in the progression of pathologies such as osteoarthritis (OA) (Loeser et al , 2012), rheumatoid arthritis (RA) (Goldring, 2003), meniscus tears (Fox et al , 2015), and degenerative disc diseases (Tian et al , 2013). What defines these three tissues as unique compared to other tissues, and subject to regenerative approaches, is their overall avascularity, inability to heal properly in vivo , and difficult clinical and translational remediation (Fox et al , 2015; Hunziker, 2002; Tian et al , 2013).…”

Section: Introductionmentioning

confidence: 99%

“…What defines these three tissues as unique compared to other tissues, and subject to regenerative approaches, is their overall avascularity, inability to heal properly in vivo , and difficult clinical and translational remediation (Fox et al , 2015; Hunziker, 2002; Tian et al , 2013). Because these tissues assume similar functions (distribution and transfer of weight across surfaces) and are composed of similar cell types (fibrochondrocytes, chondrocytes, and chondrocyte-like cells), it may be presumed that regenerative approaches would also be similar.…”

Section: Introductionmentioning

confidence: 99%

“…Each tissue exhibits differing levels of ultrastructure, composed of varying cellular components, ECM, and levels of oxygen distribution; the meniscus with red-red, red-white, and white-white zones (Fox et al , 2015), AC with four layers (superficial, transitional, deep, and calcified) (Becerra et al , 2010), and NP with central and peripheral regions (Roberts et al , 1995). As surgical procedures become less invasive and more easily conducted (Frank and Cole, 2013), the field of regenerative medicine will see increased opportunities for tissue explants (Musumeci et al , 2014).…”

Section: Introductionmentioning

confidence: 99%

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Meniscus, articular cartilage and nucleus pulposus: a comparative review of cartilage-like tissues in anatomy, development and function

et al. 2017

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The degradation of cartilage in the human body is impacted by aging, disease, genetic predisposition, and continued insults resulting from daily activity. The burden of cartilage defects (osteoarthritis, rheumatoid arthritis, intervertebral disc damage, knee replacement surgeries, etc.) is daunting in light of substantial economic and social stresses. This review strives to broaden the scope of regenerative medicine and tissue engineering approaches used for cartilage repair by comparing and contrasting the anatomical and functional nature of the meniscus, articular cartilage (AC), and nucleus pulposus (NP). Many review papers have provided detailed evaluations of these cartilages and cartilage-like tissues individually, but none have comprehensively examined the parallels and inconsistencies in signaling, genetic expression, and extracellular matrix (ECM) composition between tissues. For the first time, this review outlines the importance of understanding these three tissues as unique entities, providing a comparative analysis of anatomy, ultrastructure, biochemistry, and function for each tissue. This novel approach highlights the similarities and differences between tissues, progressing research toward an understanding of what defines each tissue as distinctive. The goal of this paper is to provide researchers with the fundamental knowledge to correctly engineer the meniscus, AC, and NP without inadvertently developing the wrong tissue function or biochemistry.

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“…In the intervertebral disc annulus fibrosus, cracks (i.e., tears) occur as the disc degenerates, causing pain or mechanical disruption (Osti et al, 1992; Vernon-Roberts et al, 2007; Haughton et al, 2000; Lee et al, 2004; Peng et al, 2005; Videman and Nurminen, 2004). Overload of the knee meniscus, such as in sport-related injuries, can also create cracks (Isaac et al, 2010; Drosos and Pozo, 2004; Fox et al, 2015; Snoeker et al, 2013). Meniscus cracks cause pain, compromise knee motion and, most importantly, promote osteoarthritis (Englund et al, 2012; Bedi et al, 2010; Mononen et al, 2013; Maffulli et al, 2010; Berthiaume et al, 2005; Lento and Akuthota, 2000; Lohmander et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

A comparison of stress in cracked fibrous tissue specimens with varied crack location, loading, and orientation using finite element analysis

Peloquin

Elliott

2016

Journal of the Mechanical Behavior of Biomedical Materials

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Cracks in fibrous soft tissue, such as the intervertebral disc annulus fibrosus and knee meniscus, cause pain and compromise joint mechanics. A crack concentrates stress at its tip, making further failure and crack extension (fracture) more likely. Ex vivo mechanical testing is an important tool for studying the loading conditions required for crack extension, but prior work has shown that it is difficult to reproduce crack extension. Most prior work used edge crack specimens in uniaxial tension, with the crack 90° to the edge of the specimen. This configuration does not necessarily represent the loading conditions that cause in vivo crack extension. To find a potentially better choice for experiments aiming to reproduce crack extension, we used finite element analysis to compare, in factorial combination, (1) center crack vs. edge crack location, (2) biaxial vs. uniaxial loading, and (3) crack-fiber angles ranging from 0° to 90°. The simulated material was annulus fibrosus fibrocartilage with a single fiber family. We hypothesized that one of the simulated test cases would produce a stronger stress concentration than the commonly used uniaxially loaded 90° crack-fiber angle edge crack case. Stress concentrations were compared between cases in terms of fiber-parallel stress (representing risk of fiber rupture), fiber-perpendicular stress (representing risk of matrix rupture), and fiber shear stress (representing risk of fiber sliding). Fiber-perpendicular stress and fiber shear stress concentrations were greatest in edge crack specimens (of any crack-fiber angle) and center crack specimens with a 90° crack-fiber angle. However, unless the crack is parallel to the fiber direction, these stress components alone are insufficient to cause crack opening and extension. Fiber-parallel stress concentrations were greatest in center crack specimens with a 45° crack-fiber angle, either biaxially or uniaxially loaded. We therefore recommend that the 45° center crack case be tried in future experiments intended to study crack extension by fiber rupture.

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The human meniscus: A review of anatomy, function, injury, and advances in treatment

Cited by 371 publications

References 186 publications

T2 black lesions on routine knee MRI: differential considerations

T2 black lesions on routine knee MRI: differential considerations

Meniscus, articular cartilage and nucleus pulposus: a comparative review of cartilage-like tissues in anatomy, development and function

A comparison of stress in cracked fibrous tissue specimens with varied crack location, loading, and orientation using finite element analysis

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