The role of patient characteristics and the effects of angiogenic therapies on the microvasculature of the meniscus: A systematic review

Lelij, Thies J N van der; Gerritsen, Laura M.; Arkel, Ewoud R.A. van; Munnik-Hagewoud, Roelina; Zuurmond, Rutger G; Keereweer, Stijn; Schie, Peter van; Driel, Pieter B A A van

doi:10.1016/j.knee.2022.07.007

Cited by 7 publications

(4 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A prolonged time of return to daily and sport activities and worst functional scores were found among smokers [9]. Blood supply during meniscal healing is compromised in smokers [5, 20, 59].…”

Section: Discussionmentioning

confidence: 99%

Outside‐in repair technique is effective in traumatic tears of the meniscus in active adults: a systematic review

Migliorini

Pilone

Bell³

et al. 2023

Knee surg. sports traumatol. arthrosc.

View full text Add to dashboard Cite

Purpose Meniscal injuries are common. Outside-in meniscal repair is one of the techniques advocated for the management of traumatic meniscal tears. This systematic review investigated the outcomes of the outside-in repair technique for the management of traumatic tears of the menisci. The outcomes of interest were to investigate whether PROMs improved and to evaluate the rate of complications. Methods Following the 2020 PRISMA statement, in May 2023, PubMed, Web of Science, Google Scholar, and Embase were accessed with no time constraints. All the clinical investigations which reported data on meniscal repair using the outside-in technique were considered for inclusion. Only studies which reported data on acute traumatic meniscal tears in adults were considered. Only studies which reported a minimum of 24 months of follow-up were eligible. Results Data from 458 patients were extracted. 34% (155 of 458) were women. 65% (297 of 458) of tears involved the medial meniscus. The mean operative time was 52.9 ± 13.6 min. Patients returned to their normal activities at 4.8 ± 0.8 months. At a mean of 67-month follow-up, all PROMs of interest improved: Tegner scale (P = 0.003), Lysholm score (P < 0.0001), International Knee Documentation Committee (P < 0.0001). 5.9% (27 of 458) of repairs were considered failures. Four of 186 (2.2%) patients experienced a re-injury, and 5 of 458 (1.1%) patients required re-operation. Conclusion Meniscal repair using the outside-in technique can be effectively performed to improve the quality of life and the activity level of patients with acute meniscal tears. Level of evidence Level IV.

show abstract

Section: Discussionmentioning

confidence: 99%

Outside‐in repair technique is effective in traumatic tears of the meniscus in active adults: a systematic review

Migliorini

Pilone

Bell³

et al. 2023

Knee surg. sports traumatol. arthrosc.

View full text Add to dashboard Cite

show abstract

“…In the case of menisci, the time needed is more difficult to determine given the vascular anatomy of the tissue. The location of the tear plays an important role, since the periphery of the meniscus is well vascularized and, therefore, more likely to heal than the central part 11 . In general, the meniscus requires a minimum of 6 weeks to heal 12 .…”

Section: Introductionmentioning

confidence: 99%

“…The location of the tear plays an important role, since the periphery of the meniscus is well vascularized and, therefore, more likely to heal than the central part. 11 In general, the meniscus requires a minimum of 6 weeks to heal. 12 In this light, due to its degradation time, Vicryl should be used with caution on tissues whose healing time exceeds 3 weeks.…”

mentioning

confidence: 99%

Modification of the properties of a suture thread with a tough gel coating: A baseline ex‐vivo study

Mazy

Chung‐Tze‐Cheong

et al. 2023

Journal Orthopaedic Research

View full text Add to dashboard Cite

The mechanical properties of sutures are important for wound closure and meniscus repair. A tough gel coating technology has been developed to modify and functionalize sutures, but its effects on suture degradation remain unexplored. Our aim is to investigate how a tough gel coating mediates the properties of the suture. The Polyglactin910 (Vicryl) suture was chosen because it is widely used, strong, easy to handle, and degradable. This study compared six pristine Vicryl sutures and six coated Vicryl sutures at 0, 2, 4, and 6 weeks. All the sutures were soaked in phosphate-buffered saline (PBS), to mimic degradation in physiological conditions, and tensile strength was tested at each time point.The pH of the soaking mediums was measured weekly and compared at 4, 5, and 6 weeks. No significant difference (p = 0.059 and p = 0.576) was found between the absolute and normalized breaking force of coated and pristine Vicryl sutures at 0, 2, 4, and 6 weeks. After 4 weeks of immersion, the soaking medium became more acidic for both suture types. The decrease in pH was less significant for coated Vicryl sutures than for pristine ones (p < 0.001) at 4, 5, and 6 weeks of immersion. Although coating does not affect the strength of Vicryl sutures soaked in PBS, it can effectively act as a buffer to the acidic environment caused by suture degradation, which could help reduce inflammation.Hydrogel coating is a promising technology to modify suture characteristics.

show abstract

“…Indeed, a systematic review highlighted that the composition, vascularization and biomechanics of the meniscus, as well as the technical constraints associated with arthroscopy made the tissue adhesives currently used unsuitable [25][26][27]. Specifically, the meniscus bears a huge mechanical load, contains few cells, and has a blood supply that tends to decrease with age and is mostly peripheral which makes healing very complex [28]. Moreover, arthroscopies are performed in a very tight space and generally with a continuous flow of fluid [29].…”

Section: Introductionmentioning

confidence: 99%

Tough gel adhesive is an effective method for meniscal repair in a bovine cadaveric study

Mazy,

Chung‐Tze‐Cheong,

et al. 2023

J. exp. orthop.

View full text Add to dashboard Cite

Purpose To test tough gel adhesives to repair meniscus tears under relevant loading conditions and determine if they have adequate biomechanical properties to repair meniscus tears in a bovine cadaveric study. Methods Cyclic compression tests on 24 dissected bovine knees were performed. The tough gel adhesive was used either as an adhesive patch or as a coating bonded onto commercially available surgical sutures. Forty-eight menisci were tested in this study; 24 complete radial tears and 24 bucket-handle tears. After preconditioning, the specimens underwent 100 cycles of compression, (800 N/0.5 Hz) on an Instron© machine and the size of the gaps measured. One third of the menisci were repaired with pristine sutures, one third with adhesive patches, and one third with sutures coated in adhesive gel. The size of the gaps was compared after 100 and 500 cycles of compression. Results The mean gap measured at the tear site without treatment was 6.46 mm (± 1.41 mm) for radial tears and 1.92 mm (± 0.65 mm) for bucket-handle tears. After treatment and 500 cycles of compression, the mean gap was 1.63 mm (± 1.41 mm) for pristine sutures, 1.50 mm (± 1.16 mm) for adhesive sutures and 2.06 mm (± 1.53 mm) for adhesive gel patches. There was no significant difference between treatments regardless of the type of tear. Also, the gaps for radial tears increased significantly with the number of compression cycles applied (p > 0.001). Conclusion From a biomechanical standpoint, the tough adhesive gel patch is as effective as suturing. In addition, it would allow the repair of non-suturable tears and thus broaden the indications for meniscus repair. Level of evidence Controlled laboratory study.

show abstract

The role of patient characteristics and the effects of angiogenic therapies on the microvasculature of the meniscus: A systematic review

Cited by 7 publications

References 81 publications

Outside‐in repair technique is effective in traumatic tears of the meniscus in active adults: a systematic review

Outside‐in repair technique is effective in traumatic tears of the meniscus in active adults: a systematic review

Modification of the properties of a suture thread with a tough gel coating: A baseline ex‐vivo study

Tough gel adhesive is an effective method for meniscal repair in a bovine cadaveric study

Contact Info

Product

Resources

About