The Long‐term Course of Various Meniscal Treatments in Anterior Cruciate Ligament Deficient Knees

Sommerlath, Karola; Gillquist, Jan

doi:10.1111/j.1532-950x.1993.tb00388.x

Cited by 12 publications

(21 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It has also been shown that subsequent degenerative changes cannot be avoided, even after the latest surgical techniques which take full account of ACL anatomy and biomechanics (Sommerlath and Gillquist 1992). Such degenerative changes may be less important in conservatively treated patients ; our limited data support these observations.…”

Section: Discussionsupporting

confidence: 77%

Non-Operative Management of Anterior Cruciate Ligament Injuries in the General Population

Casteleyn

Handelberg

1996

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

The operative treatment of lesions of the anterior cruciate ligament (ACL) in athletes has been widely advocated and performed. We have investigated the outcome of non-operative management in a lowerdemand, general population. We reviewed a consecutive group of 228 patients, which excluded professional and high-level athletes, for two to 12 years after an ACL lesion had been diagnosed by arthroscopy.There was a low incidence of secondary ACL and meniscal surgery, 5.4% and 3.5% respectively, and all these procedures were performed during the first three years after the ACL injury.We studied a subgroup of 109 patients with follow-up of at least five years (mean 8.5 years) and evaluated them using the IKDC score. The general outcome was reasonably satisfactory, with 23% in grade A, 50% in grade B, 21% in grade C and only 6.4% in grade D. We found no statistically significant prognostic effect within this group as regards age, activity levels, or the incidence of associated lesions.J Bone Joint Surg [Br] ] 1996;78-B:446-51. Received 25 August 1995; Accepted after revision 29 November 1995Lesions of the anterior cruciate ligament (ACL) in athletes have been studied extensively in orthopaedic sports medicine, and operative treatment using grafts is widely advocated for this particular group of patients (Fetto and Marshall 1980;Noyes et al 1983a;Kannus and Järvinen 1987;Andersson et al 1989;Barrack et al 1990;Daniel and Fithian 1994). Many ACL lesions, however, are seen in nonathletes as a result of accidents or low-grade recreational activities (Jain, Swanson and Murdoch 1983;Casteleyn, Handelberg and Opdecam 1988). We aimed to investigate the outcome of the conservative treatment of ACL lesions in a lower-demand population. PATIENTS AND METHODSOver a period of 12 years, we managed a total of 274 patients with acute traumatic knee haemarthrosis. All had examination under anaesthesia and arthroscopy.Of these, we treated 46 by ACL reconstruction. They included patients with gross or multidirectional joint laxity (grade-3 or grade-4 pivot shift, combined lesions of the ACL and lateral collateral ligament (LCL) or posterior cruciate ligament (PCL)) and in addition all high-level or professional athletes. These 46 cases (16.8%) were excluded from the study group.This left a consecutive group of 228 patients (83%) who were managed conservatively. There was an almost fourfold male to female ratio and the mean age at the time of injury was 33.2 years (16 to 66). The main causes of injury were daily living activities (28.1%), traffic accidents (11.8%), and recreational activities (60.1%) ( Table I). Initial management. In 83% of the cases, arthroscopic evaluation was within three weeks of the index injury. The proportions of isolated ACL ruptures and those associated with meniscal and ligamentous lesions were comparable with those reported in previous studies (Casteleyn et al 1988) (Tables I and II); only 21 of the ACL tears (9%) were partial. Intrasynovial ACL lesions (14; 6.1%) were left as much as possible within the synov...

show abstract

Section: Discussionsupporting

confidence: 77%

Non-Operative Management of Anterior Cruciate Ligament Injuries in the General Population

Casteleyn

Handelberg

1996

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

show abstract

“…The menisci provide several vital mechanical functions in the knee joint and loss of these structures leads to instability, symptoms of pain and swelling, loss of tibiofemoral joint space, and articular cartilage degeneration [ 35,47,105,107,117,133,135,138,144,147 ] . The menisci act as spacers between the femoral condyles and tibial plateaus and, when there are no compressive weight-bearing loads across the joint, limit contact between the articular surfaces.…”

Section: Review Of Biomechanics and Function Of The Meniscimentioning

confidence: 99%

“…2.2 ) have an increased risk of developing early arthritis compared to those that do not sustain meniscus damage (see also Chap. 3 ) 144,147 ] . In addition, knees with combined ACL tears and meniscus tears may exhibit a higher expression of catabolic markers than those with isolated meniscus tears, which may lead to a higher risk for the development of osteoarthritis [ 27 ] .…”

Section: Introductionmentioning

confidence: 99%

“…Further compounding the problem is the occurrence of subsequent meniscus tears that are reported in the majority of natural history studies [ 8,16,23,26,34,35,49,58,61,78,85,117,120,121,147,160 ] , along with chondral injuries and articular cartilage lesions that presumably result from further giving-way episodes [ 26,35,37,46,49,58,78,92,144,149 ] or increased catabolic activity [ 27 ] . Levy and Meier [ 92 ] reported that the frequency of articular cartilage damage in chronic ACL-de fi cient knees was 79 % overall, with increases from 40 % at 1 year, 60 % at 5 years, and >80 % 10 years following the injury.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Consequences of Complete ACL Ruptures

Barber-Westin

Noyes

2012

ACL Injuries in the Female Athlete

View full text Add to dashboard Cite

“…5 The allinside technique has become popular due to benefits of decreased surgical time, smaller surgical incisions, and reduced risk of neurovascular injury. Additionally, newgeneration all-inside devices have comparable clinical results and fixation strength to the inside-out repairs.…”

mentioning

confidence: 99%

Inside-Out Repair for Radial Meniscus Tears

Pareek

O’Malley

Levy

et al. 2016

Arthroscopy Techniques

View full text Add to dashboard Cite

Understanding of meniscal function through basic science, natural history, and biomechanics has highlighted the importance of preserving the meniscus to maintain normal knee biomechanics. Tears that may alter these biomechanics can contribute to the progressive nature of degenerative joint disease in the knee. Radial tears result in the disruption of the circumferential fibers causing inability of the native meniscus to resist normal hoop stresses, thereby leading to increased focal areas of pressure that cause complications such as early onset arthrosis. In this technical note, we describe our preferred operative technique to repair radial meniscal tears using an arthroscopic inside-out approach with satisfactory clinical outcomes and healing response.

show abstract

The Long‐term Course of Various Meniscal Treatments in Anterior Cruciate Ligament Deficient Knees

Cited by 12 publications

References 0 publications

Non-Operative Management of Anterior Cruciate Ligament Injuries in the General Population

Non-Operative Management of Anterior Cruciate Ligament Injuries in the General Population

Consequences of Complete ACL Ruptures

Inside-Out Repair for Radial Meniscus Tears

Contact Info

Product

Resources

About