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D’Ambrosi R, Annibaldi A, Carrozzo A, Vieira TD, An JS, Freychet B, Sonnery-Cottet B. Evaluating the Reliability of YouTube as a Source of Information for Meniscal Ramp Lesions. Orthop J Sports Med 2024; 12:23259671231219815. [PMID: 38188623 PMCID: PMC10768595 DOI: 10.1177/23259671231219815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/31/2023] [Indexed: 01/09/2024] Open
Abstract
Background Videos uploaded to YouTube do not go through a review process, and therefore, videos related to medial meniscal ramp lesions may have little educational value. Purpose To assess the educational quality of YouTube videos regarding ramp lesions of the meniscus. Study Design Cross-sectional study. Methods A standard search was performed on the YouTube website using the following terms: "ramp lesion" and "posterior meniscal detachment" and "ramp" and "meniscocapsular" and "meniscotibial detachment," and the top 100 videos based on the number of views were included for analysis. The video duration, publication data, and number of likes and views were retrieved, and the videos were categorized based on video source (health professionals, orthopaedic company, private user), the type of information (anatomy, biomechanics, clinical examination, overview, radiologic, surgical technique), and video content (education, patient support, patient experience/testimony).The content analysis of the information on the videos was evaluated with the use of the DISCERN instrument (score range, 16-80), the Journal of the American Medical Association (JAMA) benchmark criteria (score range, 0-4), and the Global Quality Score (GQS; score range, 1-5). Results A total of 74 videos were included. Of these videos, 70 (94.6%) were published by health professionals, while the remaining 4 (5.4%) were published by orthopaedic companies. Most of the videos were about surgical technique (n = 36; 48.6%) and all had an educational aim (n = 74; 100%). The mean length of the videos was 10.35 ± 17.65 minutes, and the mean online period was 18.64 ± 13.85 months. The mean DISCERN score, JAMA benchmark score, and GQS were 31.84 ± 17.14 (range, 16-72), 1.65 ± 0.87 (range, 1-4), and 2.04 ± 1.21 (range, 1-5), respectively. Videos that reported an overview about ramp lesions were the best in terms of quality for DISCERN and JAMA benchmark score, while biomechanics videos were the best according to GQS. The worst category of videos was about surgical technique, with all having lower scores. Conclusion The educational content of YouTube regarding medial meniscal ramp lesions showed low quality and validity based on DISCERN score, JAMA benchmark score, and GQS.
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Affiliation(s)
- Riccardo D’Ambrosi
- IRCCS Ospedale Galeazzi-Sant’Ambrogio, Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Alessandro Annibaldi
- Orthopaedic Unit, Sant’Andrea Hospital, University of Rome La Sapienza, Rome, Italy
| | - Alessandro Carrozzo
- Orthopaedic Unit, Sant’Andrea Hospital, University of Rome La Sapienza, Rome, Italy
| | - Thais Dutra Vieira
- Centre Orthopédique Santy, FIFA Medical Center of Excellence, Hopital Mermoz, Groupe Ramsay, Lyon, France
| | - Jae-Sung An
- Centre Orthopédique Santy, FIFA Medical Center of Excellence, Hopital Mermoz, Groupe Ramsay, Lyon, France
| | - Benjamin Freychet
- Centre Orthopédique Santy, FIFA Medical Center of Excellence, Hopital Mermoz, Groupe Ramsay, Lyon, France
| | - Bertrand Sonnery-Cottet
- Centre Orthopédique Santy, FIFA Medical Center of Excellence, Hopital Mermoz, Groupe Ramsay, Lyon, France
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Tomsan H, Gorbachova T, Fritz RC, Abrams GD, Sherman SL, Shea KG, Boutin RD. Knee MRI: Meniscus Roots, Ramps, Repairs, and Repercussions. Radiographics 2023; 43:e220208. [PMID: 37384542 DOI: 10.1148/rg.220208] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Menisci play an essential role in maintaining normal pain-free function of the knee. While there are decades of MRI literature on the tears involving the meniscus body and horns, there is now a surge in knowledge regarding injuries at the meniscus roots and periphery. The authors briefly highlight new insights into meniscus anatomy and then summarize recent developments in the understanding of meniscus injuries that matter, emphasizing meniscus injuries at the root and peripheral (eg, ramp) regions that may be missed easily at MRI and arthroscopy. Root and ramp tears are important to diagnose because they may be amenable to repair. However, if these tears are left untreated, ongoing pain and accelerated cartilage degeneration may ensue. The posterior roots of the medial and lateral menisci are most commonly affected by injury, and each of these injuries is associated with distinctive clinical profiles, MRI findings, and tear patterns. Specific diagnostic pitfalls can make the roots challenging to evaluate, including MRI artifacts and anatomic variations. As with root tears, MRI interpretation and orthopedic treatment have important differences for injuries at the medial versus lateral meniscus (LM) periphery (located at or near the meniscocapsular junction). Medially, ramp lesions typically occur in the setting of an anterior cruciate ligament rupture and are generally classified into five patterns. Laterally, the meniscocapsular junction may be injured in association with tibial plateau fractures, but disruption of the popliteomeniscal fascicles may also result in a hypermobile LM. Updated knowledge of the meniscus root and ramp tears is crucial in optimizing diagnostic imaging before repair and understanding the clinical repercussions. ©RSNA, 2023 Online supplemental material is available for this article. Quiz questions for this article are available in the Online Learning Center.
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Affiliation(s)
- Hanna Tomsan
- From the Departments of Radiology (H.T., R.D.B.) and Orthopaedic Surgery (G.D.A., S.L.S.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5119; Department of Radiology, Einstein Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa (T.G.); Department of Musculoskeletal Radiology, National Orthopedic Imaging Associates, Greenbrae, Calif (R.C.F.); and Department of Orthopaedic Surgery, Lucile Packard Children's Hospital at Stanford, Palo Alto, Calif (K.G.S.)
| | - Tetyana Gorbachova
- From the Departments of Radiology (H.T., R.D.B.) and Orthopaedic Surgery (G.D.A., S.L.S.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5119; Department of Radiology, Einstein Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa (T.G.); Department of Musculoskeletal Radiology, National Orthopedic Imaging Associates, Greenbrae, Calif (R.C.F.); and Department of Orthopaedic Surgery, Lucile Packard Children's Hospital at Stanford, Palo Alto, Calif (K.G.S.)
| | - Russell C Fritz
- From the Departments of Radiology (H.T., R.D.B.) and Orthopaedic Surgery (G.D.A., S.L.S.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5119; Department of Radiology, Einstein Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa (T.G.); Department of Musculoskeletal Radiology, National Orthopedic Imaging Associates, Greenbrae, Calif (R.C.F.); and Department of Orthopaedic Surgery, Lucile Packard Children's Hospital at Stanford, Palo Alto, Calif (K.G.S.)
| | - Geoffrey D Abrams
- From the Departments of Radiology (H.T., R.D.B.) and Orthopaedic Surgery (G.D.A., S.L.S.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5119; Department of Radiology, Einstein Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa (T.G.); Department of Musculoskeletal Radiology, National Orthopedic Imaging Associates, Greenbrae, Calif (R.C.F.); and Department of Orthopaedic Surgery, Lucile Packard Children's Hospital at Stanford, Palo Alto, Calif (K.G.S.)
| | - Seth L Sherman
- From the Departments of Radiology (H.T., R.D.B.) and Orthopaedic Surgery (G.D.A., S.L.S.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5119; Department of Radiology, Einstein Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa (T.G.); Department of Musculoskeletal Radiology, National Orthopedic Imaging Associates, Greenbrae, Calif (R.C.F.); and Department of Orthopaedic Surgery, Lucile Packard Children's Hospital at Stanford, Palo Alto, Calif (K.G.S.)
| | - Kevin G Shea
- From the Departments of Radiology (H.T., R.D.B.) and Orthopaedic Surgery (G.D.A., S.L.S.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5119; Department of Radiology, Einstein Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa (T.G.); Department of Musculoskeletal Radiology, National Orthopedic Imaging Associates, Greenbrae, Calif (R.C.F.); and Department of Orthopaedic Surgery, Lucile Packard Children's Hospital at Stanford, Palo Alto, Calif (K.G.S.)
| | - Robert D Boutin
- From the Departments of Radiology (H.T., R.D.B.) and Orthopaedic Surgery (G.D.A., S.L.S.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5119; Department of Radiology, Einstein Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa (T.G.); Department of Musculoskeletal Radiology, National Orthopedic Imaging Associates, Greenbrae, Calif (R.C.F.); and Department of Orthopaedic Surgery, Lucile Packard Children's Hospital at Stanford, Palo Alto, Calif (K.G.S.)
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Menéndez SE, González PG, Morís ARM, Soto MDV, Fernández AM. Reproducibility of MRI in the diagnosis of meniscal ramp lesions: an inter-observer study. Acta Radiol 2023; 64:1078-1085. [PMID: 35607260 DOI: 10.1177/02841851221101878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Meniscal ramp lesions have gained much prominence in recent years due to a significant increase in their diagnosis and their important biomechanical involvement in the knee. A new proposed classification of these lesions has recently been published. PURPOSE To evaluate the reproducibility of the new classification of meniscal ramp lesions recently published using magnetic resonance imaging (MRI). MATERIAL AND METHODS A total of 249 post-traumatic knee MRI studies were evaluated by three musculoskeletal radiologists independently. Patients with an anterior cruciate ligament (ACL) tear on MRI in addition to a recent history of trauma to the knee for <12 months were included in the study, for a total of 95. We carried out an inter-observer concordance study to analyze whether the new classification is reproducible to detect meniscal ramp lesions and to classify them into their different types. RESULTS Among our study cohort of 95 patients, we found 47 (49.5%) ramp lesions. In the inter-observer study, we obtained a good concordance (k = 0.733) in the detection of these lesions and an excellent one (k = 0.843) when the type of lesion is described. CONCLUSION This study demonstrates that the new classification of meniscal ramp lesions has good reproducibility on MRI.
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Affiliation(s)
| | | | - Ana Rosa Meana Morís
- Department of Radiology, 16475Hospital Universitario de Cabueñes, Gijón, Asturias, Spain
| | - Miguel Del Valle Soto
- Department of Morphology and Cell Biology, 16763University of Oviedo, Oviedo, Asturias, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Asturias, Spain
| | - Antonio Maestro Fernández
- Department of Orthopedic Surgery, Clínica Molinón, Gijón, Asturias, Spain
- Real Sporting de Gijón. Spain
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Keyhani S, Soleymanha M, Verdonk R, Amouzadeh F, Movahedinia M, Kazemi SM. Posterior knee arthroscopy facilitates the safe and effective all-inside repair of locked bucket-handle medial meniscal tear using a suture hook technique. Knee Surg Sports Traumatol Arthrosc 2022; 30:1311-1315. [PMID: 33871661 DOI: 10.1007/s00167-021-06576-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 04/09/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE This study reported the outcomes of locked bucket-handle medial meniscal tear (BHMMT) repairs using an arthroscopic posterior approach during anterior cruciate ligament (ACL) reconstruction. METHODS Between 2011 and 2014, 48 patients with BHMMTs and ACL tears who met the eligibility criteria were enrolled in the present study. BHMMTs were assessed using a posterolateral transseptal portal and repaired using a posteromedial portal. Transportal ACL reconstruction was performed using hamstrings autograft. Patients were assessed based on their IKDC and Lysholm scores and Tegner activity level. Meniscal healing was clinically evaluated based on the absence of swelling, joint line tenderness, locking, and catching; McMurray test results; and the need for meniscectomy. RESULTS According to follow-up assessments, the average IKDC and Lysholm scores improved significantly after 3-5 years (P < 0.001) CONCLUSION: Excellent clinical outcomes were obtained when locked BHMMTs were repaired using an all-inside suture technique that employed posteromedial and posterolateral transseptal portals. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Sohrab Keyhani
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran.
| | | | - Rene Verdonk
- Department of Orthopedics and Traumatology, Gent University, Ghent, Belgium
| | - Farzad Amouzadeh
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran
| | - Mohammad Movahedinia
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran
| | - Seyyed Morteza Kazemi
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran
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Abreu FG, Canuto SMDG, Canuto MMDG, Chagas EF, Zutin TLM, Pádua VBCD. Incidência de lesões da rampa meniscal nas reconstruções do ligamento cruzado anterior. Rev Bras Ortop 2022; 57:422-428. [PMID: 35785120 PMCID: PMC9246525 DOI: 10.1055/s-0041-1735942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 06/02/2021] [Indexed: 10/31/2022] Open
Abstract
Resumo
Objetivo Avaliar a incidência e o perfil epidemiológico das lesões da rampa meniscal nos pacientes submetidos a cirurgia de reconstrução do ligamento cruzado anterior (LCA), e determinar os fatores de risco relacionados.
Métodos Foram analisados retrospectivamente 824 pacientes submetidos a cirurgia de reconstrução do LCA. Os pacientes que apresentaram instabilidade meniscal medial foram submetidos a avaliação do compartimento posteromedial do joelho. Em caso de lesão, o reparo cirúrgico foi realizado. Potenciais fatores de risco associados às lesões foram analisados.
Resultados A incidência geral de lesões da rampa na população estudada foi de 10,6% (87 lesões em 824 pacientes). A análise multivariada pelo teste do Qui-quadrado demonstrou que a presença de lesões da rampa meniscal foi significativamente associada aos seguintes fatores de risco: lateralidade direita e lesões crônicas. Sexo, idade e atividade esportiva não foram estatisticamente significantes. O futebol foi a causa mais frequente de lesões da rampa relacionadas ao esporte, com 78,2% dos casos. No entanto, não se mostrou ser um fator de risco. De 2014 a 2019, a incidência anual variou de 4,0% a 20,6%.
Conclusão A incidência das lesões da rampa meniscal foi de 10,6% nas cirurgias de reconstrução do LCA, sendo mais frequente em pacientes com lesões crônicas. A incidência anual foi crescente, e variou de 4,0%, em 2014, a 20,6%, em 2019.
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