1
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Pawelczyk J, Fanourgiakis I, Feil S, Siebold M, Kougioumtzis I, Siebold R. Good mid- to long-term outcomes after meniscus bucket-handle tear repair: A comparative analysis with and without anterior cruciate ligament reconstruction. J Exp Orthop 2024; 11:e12093. [PMID: 39015340 PMCID: PMC11250138 DOI: 10.1002/jeo2.12093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 06/21/2024] [Indexed: 07/18/2024] Open
Abstract
Purpose To evaluate mid- to long-term clinical outcomes after arthroscopic bucket-handle meniscal tear (BHMT) repair and to assess the impact of concurrent anterior cruciate ligament reconstruction (ACLR). Methods A comparative retrospective case series with blinded outcome assessment was conducted. All consecutive patients treated with arthroscopic BHMT repair with or without concurrent ACLR between 2001 and 2021 were eligible for inclusion. Fifty-five patients with an average follow-up of 7.3 ± 3.4 years were included in the analysis. Outcome measures comprised post-operative IKDC Subjective Knee Form, Lysholm Score, Tegner Activity Scale, KOOS, and visual analogue scale (VAS) for satisfaction. Additionally, failure and reoperation rates were assessed. Results The failure rate was 9%. Medial BHMT repair showed superior post-operative IKDC scores compared to lateral meniscus repair (p = 0.038). Concurrent ACLR did not demonstrate any impact on post-operative KOOS, IKDC, Tegner or patient satisfaction. The mean IKDC score at final follow-up across both groups was 80.4 ± 17.8. The mean Lysholm score was 86.9 ± 16.7. Mean KOOS scores were (i) symptoms: 83.6 ± 18.3, (ii) pain: 90.2 ± 14.4, (iii) activities of daily living: 93.6 ± 15.1, (iv) sports: 78.3 ± 26.0 and (v) quality of life: 70.5 ± 24.5. Mean patient satisfaction (VAS) was 7.9 ± 2.5. The mean Tegner score was 4.9 ± 1.9. A consistent positive correlation between the number of sutures used and post-operative outcome measures was observed but did not reach statistical significance for most items. Conclusion Arthroscopic BHMT repair achieved good clinical outcomes and an acceptable failure rate of 9% at a mean follow-up of 7 years, supporting the clinical value of meniscal repair, including large BHMTs. Concurrent ACLR showed no impact on clinical outcomes. Level of Evidence Level IV (retrospective case series).
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Affiliation(s)
- Johannes Pawelczyk
- International Center for Orthopedics, ATOS ClinicHeidelbergGermany
- Ruprecht Karl UniversityHeidelbergGermany
| | | | - Sven Feil
- International Center for Orthopedics, ATOS ClinicHeidelbergGermany
| | - Maja Siebold
- International Center for Orthopedics, ATOS ClinicHeidelbergGermany
| | | | - Rainer Siebold
- International Center for Orthopedics, ATOS ClinicHeidelbergGermany
- Institute for Anatomy and Cell BiologyRuprecht Karl UniversityHeidelbergGermany
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Meng CY, Feng W, Ren YZ, Liu M, Wang JY, Han CX. A Reverse Suture Anchor Technique for Arthroscopic Medial Meniscus Root Repair. Arthrosc Tech 2024; 13:102970. [PMID: 39036396 PMCID: PMC11258701 DOI: 10.1016/j.eats.2024.102970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/01/2024] [Indexed: 07/23/2024] Open
Abstract
Injuries of the posterior root of the medial meniscus can be accompanied by damage to the anterior cruciate ligament or often occur independently in cases of degenerative meniscal injury in older individuals. Anchor suture repair can achieve favorable biomechanical effects and clinical outcomes. However, anchor placement is technically challenging and requires a posterior medial approach, which increases the risk of iatrogenic injury. To address these issues, we have utilized the reverse anchor technique to repair the posterior root of the medial meniscus. This technique offers advantages such as reduced surgical time, simplified operation, and reduced risk of the "bungee effect" and iatrogenic injury.
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Affiliation(s)
- Chen-yang Meng
- Department of Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Wei Feng
- Department of Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Yi-zhong Ren
- Department of Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Ming Liu
- Department of Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Jun-yi Wang
- Department of Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Chang-xu Han
- Department of Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
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Chen D, Wu R, Lai Y, Xiao B, Lai J, Zhang M. Anterior Cruciate Ligament Rupture Combined with Complete Radial Tear of the Posterior Horn of the Lateral Meniscus: Suture or Resection? J Knee Surg 2024; 37:426-435. [PMID: 37722418 DOI: 10.1055/s-0043-1774800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Anterior cruciate ligament (ACL) rupture often presents with a tear of the posterior horn of the lateral meniscus. There is no clear preference between ACL reconstruction with suture and resection of the meniscus. We aimed to compare the clinical efficacy of ACL reconstruction with suture versus resection in patients presenting with arthroscopic ACL rupture and radial complete tear of the posterior corner of the lateral meniscus. We retrospectively analyzed 157 patients with ACL rupture and complete radial tear of the posterior horn of the lateral meniscus. Between May 2010 and April 2015, 86 of 157 patients underwent ACL reconstruction and meniscus suture (study group, 54.78%) and 71 of 157 patients underwent ACL reconstruction and meniscus resection (control group, 45.22%) in our department. All patients were monitored over the 12 to 72-month follow-up period. The primary evaluation indices were the Lysholm scores, the International Knee Documentation Committee (IKDC) scores, pivot shift test, the Barret criteria, and magnetic resonance imaging (MRI) findings of meniscal healing. The majority of 157 patients were relatively young men (29.64 ± 7.79 years) with low body mass index (BMI) (23.79 ± 2.74). The postoperative Lysholm and IKDC scores of the two groups were significantly improved over the corresponding preoperative scores (p < 0.05). The clinical results and excellent and good rates were significantly better for the study group than for the control group (both, p < 0.05). MRI showed that the meniscal healed rate of the study group was 96.51%. There was no significant difference in BMI between subgroups for any functional outcome. For patients with ACL rupture and complete radial tear of the posterior horn of the lateral meniscus, ACL reconstruction and both simultaneous suture and resection of the posterior horn of the lateral meniscus were found to be safe and effective. There was no association between outcomes and BMI. However, the former was associated with a superior long-term clinical effect and may restore the integrity of the meniscus and is particularly recommended for young patients.
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Affiliation(s)
- Daohua Chen
- Department of Bone and Joint Sports Medicine, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China
| | - Rong Wu
- Department of Bone and Joint Sports Medicine, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China
| | - Yanqing Lai
- Department of Bone and Joint Sports Medicine, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China
| | - Bo Xiao
- Department of Bone and Joint Sports Medicine, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China
| | - Jiajing Lai
- Department of Bone and Joint Sports Medicine, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China
| | - Minghua Zhang
- Department of Bone and Joint Sports Medicine, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China
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Stokes DJ, Frank RM. Editorial Commentary: Meniscus Repair Technique Must Be Determined on a Tear-by-Tear Basis: Hybrid Techniques Plus Biologics Are Optimal. Arthroscopy 2024:S0749-8063(24)00192-0. [PMID: 38479636 DOI: 10.1016/j.arthro.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 07/04/2024]
Abstract
Bucket-handle meniscus tears alter knee biomechanics and significantly elevate the risk of osteoarthritis when the tissue is not preserved. Consequentially, meniscus repair is preferred whenever possible to optimize load distribution and knee stability, with the overall goal of joint preservation. Bucket-handle meniscus tears have a higher rate of repair failure compared with many other tear patterns, and both the inside-out (IO) and all-inside (AI) techniques are acceptable options, each with distinct advantages and disadvantages. Both have demonstrated improved clinical outcomes with similar failure rates. IO is cost-effective and allows less meniscal trauma due to small-diameter needles, whereas disadvantages include increased surgical time, increased risk of infection, and the need for 1 or more skilled assistants. AI avoids extra incisions and extra assistants and shows decreased surgical time, whereas complications can include hardware irritation, chondral and neurovascular injury (particularly for posterolateral repairs), and motion loss. Hybrid repair using AI for posterior tears and IO for middle-third and outside-in for the anterior meniscus is cost-effective and efficacious. Biologics to promote healing through mechanical stimulation of the tear surfaces, notch marrow venting, trephination, and/or platelet-rich plasma can optimize the repair.
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5
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Hakam HT, Prill R, Korte L, Lovreković B, Ostojić M, Ramadanov N, Muehlensiepen F. Human-Written vs AI-Generated Texts in Orthopedic Academic Literature: Comparative Qualitative Analysis. JMIR Form Res 2024; 8:e52164. [PMID: 38363631 PMCID: PMC10907945 DOI: 10.2196/52164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/09/2023] [Accepted: 12/13/2023] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND As large language models (LLMs) are becoming increasingly integrated into different aspects of health care, questions about the implications for medical academic literature have begun to emerge. Key aspects such as authenticity in academic writing are at stake with artificial intelligence (AI) generating highly linguistically accurate and grammatically sound texts. OBJECTIVE The objective of this study is to compare human-written with AI-generated scientific literature in orthopedics and sports medicine. METHODS Five original abstracts were selected from the PubMed database. These abstracts were subsequently rewritten with the assistance of 2 LLMs with different degrees of proficiency. Subsequently, researchers with varying degrees of expertise and with different areas of specialization were asked to rank the abstracts according to linguistic and methodological parameters. Finally, researchers had to classify the articles as AI generated or human written. RESULTS Neither the researchers nor the AI-detection software could successfully identify the AI-generated texts. Furthermore, the criteria previously suggested in the literature did not correlate with whether the researchers deemed a text to be AI generated or whether they judged the article correctly based on these parameters. CONCLUSIONS The primary finding of this study was that researchers were unable to distinguish between LLM-generated and human-written texts. However, due to the small sample size, it is not possible to generalize the results of this study. As is the case with any tool used in academic research, the potential to cause harm can be mitigated by relying on the transparency and integrity of the researchers. With scientific integrity at stake, further research with a similar study design should be conducted to determine the magnitude of this issue.
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Affiliation(s)
- Hassan Tarek Hakam
- Center of Orthopaedics and Trauma Surgery, University Clinic of Brandenburg, Brandenburg Medical School, Brandenburg an der Havel, Germany
- Faculty of Health Sciences, University Clinic of Brandenburg, Brandenburg an der Havel, Germany
- Center of Evidence Based Practice in Brandenburg, a JBI Affiliated Group, Brandenburg an der Havel, Germany
| | - Robert Prill
- Faculty of Health Sciences, University Clinic of Brandenburg, Brandenburg an der Havel, Germany
- Center of Evidence Based Practice in Brandenburg, a JBI Affiliated Group, Brandenburg an der Havel, Germany
| | - Lisa Korte
- Center of Health Services Research, Faculty of Health Sciences, University Clinic of Brandenburg, Rüdersdorf bei Berlin, Germany
| | - Bruno Lovreković
- Faculty of Orthopaedics, University Hospital Merkur, Zagreb, Croatia
| | - Marko Ostojić
- Departement of Orthopaedics, University Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Nikolai Ramadanov
- Center of Orthopaedics and Trauma Surgery, University Clinic of Brandenburg, Brandenburg Medical School, Brandenburg an der Havel, Germany
- Faculty of Health Sciences, University Clinic of Brandenburg, Brandenburg an der Havel, Germany
| | - Felix Muehlensiepen
- Center of Evidence Based Practice in Brandenburg, a JBI Affiliated Group, Brandenburg an der Havel, Germany
- Center of Health Services Research, Faculty of Health Sciences, University Clinic of Brandenburg, Rüdersdorf bei Berlin, Germany
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Meng C, Ren Y, Kong L, Guo J, Zhao Y, Han C. Arthroscopic Lateral Meniscus Root Repair With Reverse Suture Anchor Technique. Arthrosc Tech 2024; 13:102857. [PMID: 38435270 PMCID: PMC10907916 DOI: 10.1016/j.eats.2023.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 09/30/2023] [Indexed: 03/05/2024] Open
Abstract
The stability of the knee joint is crucially dependent on the integrity of the lateral meniscus posterior root, which is often accompanied by anterior cruciate ligament injury. Anchor suture repair for lateral meniscus posterior root injury not only achieves better biomechanical effects but also ensures favorable prognosis. However, the placement of anchors often requires the establishment of a posterior approach, and the insertion of an anchor is a technical challenge. In light of this, we have applied the technique of reverse anchor fixation for repairing the lateral meniscus posterior root, which not only simplifies the procedure but also effectively reduces the "bungee effect."
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Affiliation(s)
- Chenyang Meng
- Department of Sport Medicine, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Yizhong Ren
- Department of Sport Medicine, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Lingyue Kong
- Department of Sport Medicine, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Jiantao Guo
- Department of Surgical, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Yunan Zhao
- Department of Sport Medicine, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Changxu Han
- Department of Sport Medicine, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
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Ciemniewska-Gorzela K, Górecki J, Wojtkowiak D, Henklewski R, Żak-Pałczynska K, Murray J, Talaśka K. Biomechanical Comparison of the Simple Suture Technique, Meniscal Matrix-Assisted Repair, and a Novel Meniscus Cap Suture Technique for Complex Meniscal Repair. Orthop J Sports Med 2023; 11:23259671231217439. [PMID: 38145225 PMCID: PMC10748953 DOI: 10.1177/23259671231217439] [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: 09/13/2023] [Accepted: 10/06/2023] [Indexed: 12/26/2023] Open
Abstract
Background Meniscal repair is the gold standard for simple morphology tears. However, when the morphology and chronicity of the tear are less favorable, the success of the standard techniques is reduced. Purpose/Hypothesis To compare meniscal repair augmented by a new bioresorbable implant (Meniscus Cap) versus a traditional simple suture technique and the currently available augmented repair collagen matrix meniscus wrapping technique. It was hypothesized that the Meniscus Cap suture technique would increase ultimate failure load and less displacement during cyclic loading. Study Design Controlled laboratory study. Methods A total of 80 fresh porcine menisci were harvested. Complex tears were created in 60 menisci, and 20 intact menisci were tested as the control group. Repairs were performed on the 60 meniscal tears using 1 of the 3 techniques (20 menisci each): an inside-out H-suture group (SS), the collagen matrix wrapping technique (CMW), and the Meniscus Cap bioresorbable implant group (CM). The menisci were subjected to 500 loading cycles from 4 to 20 N at a frequency of 1 Hz, and the total displacement was recorded. Then, the specimens underwent load to failure testing at a rate of 3.15 mm/s, and the failure mode was noted. Results After 500 cycles of cyclic loading, there were no significant differences in displacement between the controls and CM group (0.524 vs 0.448 mm; P = .95). The displacement after the CM was significantly smaller compared with the CMW and the SS (0.448 vs 1.077 mm [P = .0009] and 0.448 vs 0.848 mm [P = .04], respectively). The ultimate load to failure was significantly greater for the controls and the CM group compared with the SS and CMW groups (controls, 1278.7 N and CM, 628.5 N vs CMW, 380.1 N and SS, 345.1 N; P < .05). The failure mode was suture breakage (suture failure) for all repairs. Conclusion In a porcine specimen meniscal repair model, the biomechanical properties of a novel Meniscus Cap repair technique were superior to that of the simple suture and CMW techniques. Clinical Relevance The results suggest that the Meniscal Cap repair technique may provide sufficient primary stability of the meniscal fixation even in the cases of complex meniscal tears.
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Affiliation(s)
| | - Jan Górecki
- Institute of Machine Design Faculty of Mechanical Engineering, Poznan University of Technology, Poznan, Poland
| | - Dominik Wojtkowiak
- Institute of Machine Design Faculty of Mechanical Engineering, Poznan University of Technology, Poznan, Poland
| | - Radomir Henklewski
- Department of Veterinary Surgery, Institute of Veterinary Medicine, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University in Torun, Torun, Poland
| | | | | | - Krzysztof Talaśka
- Institute of Machine Design Faculty of Mechanical Engineering, Poznan University of Technology, Poznan, Poland
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Bhattacharyya R, Krishnan H, Bausch N, Pilarski A, McGoldrick N, Thompson P, Metcalfe A, Spalding T. Bone bridge technique for lateral meniscal allograft transplantation: no difference in clinical outcome compared to the soft tissue technique. Knee Surg Sports Traumatol Arthrosc 2023; 31:4162-4170. [PMID: 37154910 DOI: 10.1007/s00167-023-07443-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 04/25/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE There is considerable debate regarding the optimal method of fixation for lateral meniscus allograft transplantation (MAT), with bone bridge techniques technically harder but allowing maintenance of root attachments, while soft tissue techniques are potentially more challenging for healing. The aim of this study was to compare the clinical results of the bone bridge and soft tissue techniques for lateral MAT in terms of failure, re-operation rate, complications and patient reported outcomes. METHODS Retrospective analysis of prospectively collected data for patients undergoing primary lateral MAT with a minimum of 12-month follow-up. Patients following surgery utilising the bone bridge technique (BB) were compared with historical control patients who underwent MAT with the soft tissue technique (ST). Outcome was assessed by failure rate, defined as removal or revision of the meniscus transplant, survivorship by Kaplan-Meir analysis, re-operation rates, and other adverse event. Patient-reported outcome measures (PROMs) were compared using data at the 2-year point or 1 year if not reached 2 years. RESULTS One-hundred and twelve patients following lateral meniscal transplants were included, 31 in the BB group and 81 in the ST historical control group, with no differences in demographics between both groups. Median follow-up for the BB group was 18 (12-43) months compared to 46 (15-62) months for the ST group. There were 3 failures (9.6%) in the BB group v 2 (2.4%) in the ST group (n.s.) with a mean time to failure of 9 months in both groups. 9 patients (29%) required a re-operation (all cause) in the BB group v 24 patients (29.6%) in the ST group (n.s). There was no difference in complications between both groups. There was significant improvement (p < 0.0001) in all PROMs (Tegner, IKDC, KOOS and Lysholm) between baseline and 2-year follow-up for both groups but no between-group differences. CONCLUSION Lateral MAT has a high success rate for symptomatic meniscal deficiency with significant benefits irrespective of the fixation technique. There is no advantage in performing the more technically demanding BB technique over ST fixation. LEVEL OF EVIDENCE Level 2.
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Affiliation(s)
- Rahul Bhattacharyya
- University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Rd, Coventry, CV2 2DX, UK.
| | | | - Nicole Bausch
- University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Rd, Coventry, CV2 2DX, UK
| | - Adam Pilarski
- University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Rd, Coventry, CV2 2DX, UK
| | | | - Peter Thompson
- University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Rd, Coventry, CV2 2DX, UK
| | - Andrew Metcalfe
- University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Rd, Coventry, CV2 2DX, UK
| | - Tim Spalding
- University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Rd, Coventry, CV2 2DX, UK
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Dong Z, Huang L, Wu G, Li P, Wei X. Efficacy and safety of arthroscopic surgery combined with hyaluronic acid for meniscal injuries: A systematic review and meta-analysis of randomized controlled studies. J Orthop Surg (Hong Kong) 2023; 31:10225536231156699. [PMID: 36856463 DOI: 10.1177/10225536231156699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVE The efficacy and safety of arthroscopic surgery combined with hyaluronic acid in the treatment of meniscal injuries were evaluated by Meta-analysis to provide an evidence-based basis for the selection of clinical treatment options. METHODS PubMed, Cochrane Library, EMBASE, Scopus, Web of Science English databases, and Chinese databases of China National Knowledge Infrastructure, WAN FANG, VIP, and China SinoMed had been searched up to June 2021. Quality evaluation was performed concerning the Cochrane Systematic Evaluation Tool. The obtained data were analyzed using the statistical software Review Manager 5.3. RESULTS Eleven randomized controlled trials with a total of 955 patients were eventually included, 473 in the arthroscopic combined with hyaluronic acid group (combined treatment group) and 482 in the arthroscopy alone group (surgery group). The results of the study revealed that the excellent treatment [OR = 3.44, 95% CI (2.10, 5.65), p < .00,001], the VAS score [MD = -0.99, 95% CI (-1.50, -0.48), p = .0002], the Lysholm score [MD = 9.70, 95% CI (6.41, 12.99), p < .00,001] and the joint mobility [MD = 6.31, 95% CI (0.84, 11.78), p = .02] of the combined treatment group were significantly better than the surgery group, the difference was statistically significant. The complications rate was comparable in both groups [OR = 0.86, 95% CI (0.29, 2.53), p = .78], with no statistically significant difference. CONCLUSION Arthroscopic surgery combined with hyaluronic acid for meniscal injury can improve the efficiency of treatment compared with arthroscopic surgery alone, as well as the efficacy in relieving joint pain and improving joint function and mobility, without increasing the incidence of complications. Arthroscopic surgery combined with hyaluronic acid administration has good effectiveness and safety profile. Therefore, hyaluronic acid supplementation is recommended after arthroscopic surgery when treating meniscal injuries.
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Affiliation(s)
- Zhiqiang Dong
- Department of Orthopedics Surgery, Key Laboratory of Bone and Soft Tissue Injury Repair of Shanxi Province, Ringgold: 571717Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Lingan Huang
- Department of Orthopedics Surgery, Key Laboratory of Bone and Soft Tissue Injury Repair of Shanxi Province, Ringgold: 571717Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Gaige Wu
- Department of Orthopedics Surgery, Key Laboratory of Bone and Soft Tissue Injury Repair of Shanxi Province, Ringgold: 571717Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Pengcui Li
- Department of Orthopedics Surgery, Key Laboratory of Bone and Soft Tissue Injury Repair of Shanxi Province, Ringgold: 571717Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiaochun Wei
- Department of Orthopedics Surgery, Key Laboratory of Bone and Soft Tissue Injury Repair of Shanxi Province, Ringgold: 571717Second Hospital of Shanxi Medical University, Taiyuan, China
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10
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Ding Y, Zhang W, Sun B, Mo X, Wu J. Cyclic freeze–thaw grinding to decellularize meniscus for fabricating porous, elastic scaffolds. J Biomed Mater Res A 2022; 110:1824-1839. [DOI: 10.1002/jbm.a.37435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/23/2022] [Accepted: 07/27/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Yangfan Ding
- Shanghai Engineering Research Center of Nano‐Biomaterials and Regenerative Medicine, College of Biologial Science and Medical Engineering Donghua University Shanghai China
| | - Weixing Zhang
- Department of Critical Care Medicine, Shanghai General Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Binbin Sun
- Shanghai Engineering Research Center of Nano‐Biomaterials and Regenerative Medicine, College of Biologial Science and Medical Engineering Donghua University Shanghai China
| | - Xiumei Mo
- Shanghai Engineering Research Center of Nano‐Biomaterials and Regenerative Medicine, College of Biologial Science and Medical Engineering Donghua University Shanghai China
| | - Jinglei Wu
- Shanghai Engineering Research Center of Nano‐Biomaterials and Regenerative Medicine, College of Biologial Science and Medical Engineering Donghua University Shanghai China
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11
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Herbst E, Neumann R, Kittl C, Raschke MJ, Fink C, Herbort M. Umfrage unter AGA-Mitgliedern zu Meniskusnahtsystemen. ARTHROSKOPIE 2021. [DOI: 10.1007/s00142-021-00465-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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12
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Marigi EM, Keyt LK, LaPrade MD, Camp CL, Levy BA, Dahm DL, Stuart MJ, Krych AJ. Surgical Treatment of Isolated Meniscal Tears in Competitive Male Wrestlers: Reoperations, Outcomes, and Return to Sport. Orthop J Sports Med 2021; 9:2325967120969220. [PMID: 33786330 PMCID: PMC7960899 DOI: 10.1177/2325967120969220] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/02/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Wrestlers are highly active, young athletes prone to meniscal injuries that often require surgery. However, there is a lack of data evaluating the results of meniscal repair or partial meniscectomy in this cohort. Purpose: To describe the outcomes (subjective function, return to play, complications, reoperation rates, and progression of osteoarthritis) for treatment (meniscectomy or repair) of meniscal injuries in a cohort of competitive wrestlers. Study Design: Case series; Level of evidence, 4. Methods: All competitive wrestlers (high school, collegiate, or professional leagues) with a history of a meniscal injury and isolated meniscal surgery at a single institution between 2001 and 2017 were retrospectively identified. Failure was defined as a reinjury of the operative meniscus by clinical or advanced imaging examination, reoperation, or any additional surgical treatment of the meniscus after the index procedure. All patients were contacted for determination of reinjury rates, current sport status, and International Knee Documentation Committee and Tegner activity scores. Results: Of 85 male wrestlers with isolated meniscal tears, 34% underwent a meniscal repair, and 66% received a partial meniscectomy. Index surgery failed for 9.4% of the cohort. Among wrestlers treated with initial meniscal repair, 21% required a subsequent partial meniscectomy at a mean 2.2 years, and of those treated with partial meniscectomy, 3% underwent a second operation (P < .001). All secondary operations were revision partial meniscectomies occurring at a mean 3.2 years (95% CI, 0.01-6.4 years) after the index procedure. At final follow-up, 89% of patients were able to return to sport, with 65% returning to wrestling competition. There was significant improvement in the Tegner score from a mean 6.5 (95% CI, 5.9-7.2) preoperatively to 8.3 (95% CI 8.0-8.6) postoperatively (P < .001). Conclusion: The reoperation rate after meniscal surgery in wrestlers was quite low, but only 65% returned to competitive wrestling. Meniscal repair and partial meniscectomy improved patient-reported outcomes and activity levels at short-term follow-up. However, 21% of wrestlers treated with initial meniscal repair required a subsequent partial meniscectomy at a mean 2.2 years.
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Affiliation(s)
- Erick M Marigi
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Lucas K Keyt
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Matthew D LaPrade
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Christopher L Camp
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Bruce A Levy
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Diane L Dahm
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael J Stuart
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Aaron J Krych
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
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