Utilization of Transtibial Centralization Suture Best Minimizes Extrusion and Restores Tibiofemoral Contact Mechanics for Anatomic Medial Meniscal Root Repairs in a Cadaveric Model
Background Although posterior medial meniscal root (PMMR) repairs are often successful, postoperative meniscal extrusion after a root repair has been identified as a potential clinical problem. Purpose/Hypothesis The purpose was to quantitatively evaluate the tibiofemoral contact mechanics and extent [...]
Quantitative and Qualitative Assessment of Posterolateral Meniscal Anatomy: Defining the Popliteal Hiatus, Popliteomeniscal Fascicles, and the Lateral Meniscotibial Ligament
Background: Surgical treatment of lateral meniscal tears can be challenging due to the greater mobility of the lateral meniscus, thin capsule, and management of the popliteal hiatus. There has been a lack of quantitative assessments of the structural attachments [...]
Utilization of Transtibial Centralization Suture Best Minimizes Extrusion and Restores Tibiofemoral Contact Mechanics for Anatomic Medial Meniscal Root Repairs in A Cadaveric Model
Background: Although posterior medial meniscal root (PMMR) repairs are often successful, postoperative meniscal extrusion after a root repair has been identified as a potential clinical problem. Purpose/Hypothesis: The purpose was to quantitatively evaluate the tibiofemoral contact mechanics and extent [...]
Biomechanical Comparison of Vertical Mattress and Cross-stitch Suture Techniques and Single- and Double-Row Configurations for the Treatment of Bucket-Handle Medial Meniscal Tears
Background: Given the variety of suturing techniques for bucket-handle meniscal repair, it is important to assess which suturing technique best restores native biomechanics. Purpose/Hypothesis: To biomechanically compare vertical mattress and cross-stitch suture techniques, in single- and double-row configurations, in [...]
Biomechanical Comparison of 3 Novel Repair Techniques for Radial Tears of the Medial Meniscus
2018 AJSMComplete radial tears of the medial meniscus have been functionally described as being similar to a total meniscectomy, and they represent a challenging problem to treat. Without treatment, radial tears of the medial meniscus can lead to rapid joint [...]
The Role of Meniscal Tears in Spontaneous Osteonecrosis of the Knee
2017 AJSM Osteonecrosis of the knee is a debilitating disease that can progress to end-stage osteoarthritis. Spontaneous osteonecrosis of the knee (SONK or SPONK) is 1 of 3 categories that are used to substratify osteonecrosis, the other 2 being secondary [...]
Current Concepts Review: Meniscal Repair
The meniscus was once considered a functionless remnant of muscle that should be removed in its entirety at any sign of abnormality. Its role in load distribution, knee stability, and arthritis prevention has since been well established. The medial and [...]
Early Osteoarthritis After Untreated Anterior Meniscal Root Tears
2017 AJSM Menisci are crescent-shaped, fibrocartilaginous wedges that play an important role in complex knee mechanics and function. The menisci are primarily responsible for distributing loads through the tibiofemoral joint, joint stabilization, and congruency. The circumferential collagen fibers in the [...]
Two-Tunnel Transtibial Repair of Radial Meniscus Tears Produces Comparable Results to Inside-Out Repair of Vertical Meniscus Tears
2017 AJSM Complete radial meniscus tears constitute a unique subset of meniscus injuries, resulting in disruption of the circumferential fibers and compromising their ability to with-stand hoop stresses. This results in decreased contact area and increased tibiofemoral contact pressure, which [...]
An Evidence-Based Approach to the Diagnosis and Treatment of Meniscal Root Tears
The purpose of this review was to summarize recent advances in the diagnosis and treatment of meniscus root tears. Over the past decade, meniscal root tears have become increasingly recognized as a significant source of pain and disability. Meniscal root [...]
Posterior Meniscal Root Repairs – Outcomes of an Anatomic Transtibial Pull-Out Technique
AJSM 2016 Background: Outcomes after transtibial pull-out repair for posterior meniscal root tears remain underreported, and factors that may affect outcomes are unknown. Purpose/Hypothesis: The purpose of this study was to compare patient-centered outcomes after transtibial pull-out repair for posterior [...]
Meniscal Ramp Lesions
2016 OJSM Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas [...]
A Novel Repair Method for Radial Tears of the Medial Meniscus
AJSM 2015 Complete radial tears of the medial meniscus have been reported to be functionally similar to a total meniscectomy. At present, there is no consensus on an ideal technique for repair of radial midbody tears of the medial meniscus. [...]
Posterior Meniscus Root Tears: Associated Pathologies to Assist as Diagnostic Tools
2015 Springer The purpose of this study was to investigate associated pathologies identified at arthroscopy in patients with meniscus root tears. This study was Institutional Review Board approved. All patients who underwent arthroscopic knee surgery where a complete meniscus root tear [...]
Recent Advances in Posterior Meniscal Root Repair Techniques
JAAOS 2015 Posterior root avulsions of the medial and lateral menisci result in decreased areas of tibiofemoral contact and increased tibiofemoral contact pressures. These avulsions may lead to the development of osteoarthritis. Therefore, two surgical techniques, the transtibial pullout repair [...]
Biomechanical Consequences of a Nonanatomic Posterior Medial Meniscal Root Repair
AJSM 2015 Posterior medial meniscal root tears have been reported to extrude with the meniscus becoming adhered posteromedially along the posterior capsule. While anatomic repair has been reported to restore tibiofemoral contact mechanics, it is unknown whether nonanatomic positioning of [...]
Biomechanical Evaluation of the Transtibial Pull-Out Technique for Posterior Medial Meniscal Root Repairs Using 1 and 2 Transtibial Bone Tunnels
AJSM 2015 Current methods of the transtibial pull-out meniscal root repair significantly displace under cyclic loading in porcine models but have not been evaluated in human models. One potential explanation for the displacement is that a single transtibial tunnel may [...]
Cyclic Displacement After Meniscal Root Repair Fixation
AJSM 2015 Recent biomechanical evidence suggests that the meniscus-suture interface contributes the most displacement to the transtibial pull-out repair for meniscal root tears. Therefore, optimization of surgical technique at the meniscus-suture interface may minimize displacement and improve the strength of [...]
Meniscal Root Tears
AJSM 2014 Meniscal root tears present in many forms and can have profound consequences on the health of knee articular cartilage. While the biomechanics, natural history, and treatment of root tears have been increasingly investigated, the spectrum of meniscal root [...]
Anterior Meniscus Root Avulsion Following Intramedullary Nailing for a Tibial Shaft Fracture
KSSTA 2014 This study presents the first reported case of iatrogenic injury to the anterior medial meniscal root attachment following intramedullary nailing for a tibial shaft fracture. The patient experienced a closed right tibia-fibula fracture 7 years prior to presentation, [...]
Altered Tibiofemoral Contact Mechanics Due to Lateral Meniscus Posterior Horn Root Avulsions and Radial Tears Can Be Restored with in Situ Pull-Out Suture Repairs
THE JOURNAL OF BONE AND JOINT SURGERY 2014 An avulsion of the posterior root attachement of the lateral meniscus or a radial tear close to the root attachment can lead to degenerative knee arthritis. The study hypothesized that in situ [...]