Int Orthop 43(11):25492556, Figueroa F, Figueroa D, Calvo R, Vaisman A, Espregueira-Mendes J (2019) Meniscus allograft transplantation: indications, techniques and outcomes. Furthermore, supplementary centralization of the meniscus appears to be able to adequately reduce the ME, as it also addresses potential MTL lesions. Krych et al. Pharmaceuticals 14(3):205, Raynauld JP, Pelletier JP, Abram F, Dodin P, Delorme P, Martel-Pelletier J (2016) Long-term effects of glucosamine and chondroitin sulfate on the progression of structural changes in knee osteoarthritis: six-year followup data from the osteoarthritis initiative. For example: Surgery may be a meniscus repair or a trimming of the meniscus tissue, which is called a partial meniscectomy. J Orthop Surg 24(13):97. 3. Nevertheless, there is still controversy in the literature regarding the optimal threshold, as a few studies have proposed a value lower than 3mm [9, 10], whereas other researchers suggest that a cutoff value higher than 3mm is optimal [11,12,13]. That can increase your risk of other knee injuries like an ACL tear or other torn ligament. occasionally a surgery we refer to as an arthroscopy. Conservative treatment constitutes the first line of therapy in mild or moderate knee OA [46, 47]. Today, in general, doctors recommend conservative treatment, not surgery, when meniscus tears result from degeneration. Skeletal Radiol 26(7):424427, Article This cartilage is the meniscus. root tear: typically radial-type tear located at the meniscal root. Prepatellar bursitis is a common complaint of people who work on their knees or who engage in activities that risk blows to the knee. National Institute of Arthritis and Musculoskeletal and Skin Diseases. The rubbery wedges of cartilage act like shock absorbers for your knee, providing cushioning for your bones and knee joint. Springer Nature. Clin Rheumatol 36(11):25572564, Kim JY, Bin SI, Kim JM, Lee BS, Oh SM, Park MH (2019) Tear gap and severity of osteoarthritis are associated with meniscal extrusion in degenerative medial meniscus posterior root tears. Arthroscopy 27(7):914922, Kim JH, Lee S, Ha DH, Lee SM, Jung K, Choi W (2018) The effects of graft shrinkage and extrusion on early clinical outcomes after meniscal allograft transplantation. It is often used with chronic degenerative conditions although some authors also propose this term in the setting of a tear (macerated tear) 2.On imaging, it Your healthcare provider will physically examine your knee, looking for signs of swelling. Knee 26(6):12921298, Zhang ZZ, Zhou YF, Luo H, Zhang HZ, Chen Z, Jiang C et al (2020) A novel surgical technique for arthroscopic repair of type II posterior lateral meniscal root tear. J Am Acad Orthop Surg 23(2):7176, Kwak YH, Lee S, Lee MC, Han HS (2018) Large meniscus extrusion ratio is a poor prognostic factor of conservative treatment for medial meniscus posterior root tear. These tests include: However, these may not have the best accuracy. Following surgery, a doctor may advise engaging in 2030 minutes of exercise twothree times per day. In another study where they examined MRI series both before and after medial MPRT, they showed that MTL disruption and ME predated the MPRT, thus emphasizing the potential role that MTL could play as a causal factor of ME, and even suggesting that disruption of MTL should be addressed alongside MPRT repair in order to reduce ME [75]. Manage cookies/Do not sell my data we use in the preference centre. For a simple tear here, doctors may advise a short course of rest and physical therapy to see whether spontaneous healing occurs. Getting hit or tackled can make you twist your knee, tearing the cartilage. [77] performed arthroscopic centralization of nine extruded lateral menisci with the use of suture anchors, and ME was significantly reduced in 2years of follow-up. Arthrosc Tech 8(9):e941e946, Leafblad ND, Smith PA, Stuart MJ, Krych AJ (2021) Arthroscopic centralization of the extruded medial meniscus. TK and DG designed the manuscript and helped to draft the manuscript and review it. To perform this exercise, a person should do the following: An intermediate exercise routine may include straight leg raises. 2023 BioMed Central Ltd unless otherwise stated. Your doctor will likely recommend physical therapy. A doctor may recommend one of the following nonsurgical treatment options for people who do not experience persistent symptoms or symptoms of knee locking or swelling: If nonsurgical methods do not alleviate a persons symptoms, a doctor may suggest arthroscopic surgery. MK, VSI and GP participated in the study design and helped to draft the manuscript. Meniscus tears are very common. Although it has never been reported, it is worth researching, as it could have a beneficial effect. Am J Sports Med 49(3):684692, Ichiba A, Makuya K (2012) Radial displacement of the lateral meniscus before and after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 28(4):11771194, Swamy N, Wadhwa V, Bajaj G, Chhabra A, Pandey T (2018) Medial meniscal extrusion: detection, evaluation and clinical implications. Zheng J, Zhai W, Li Q, Jia Q, Lin D. A Special Tear Pattern of Anterior Horn of the Lateral Meniscus: Macerated Tear. This value is identified as the optimal cutoff point for a complete PRT of the LM and has 100% sensitivity and 83% specificity [92]. Your provider may recommend knee arthroscopy to better view and accurately diagnose your injury. Knee Surg Sports Traumatol Arthrosc. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. You may also get imaging tests, such as X-rays or an MRI, to assess the damage. Knee arthroscopy, a minimally invasive procedure, is often used to treat meniscal tears. Bend the unaffected leg, touching the toe to the floor as necessary for balance. Not all are severe, but some can last longer than others. Meniscal tears: Current understanding, diagnosis, and management. It is often used with chronic degenerative conditions although some authors also propose this term in the setting of a tear (macerated tear)2. And finally, the proper anatomical placement of the allograft is essential. X-rays are useful in finding other causes of knee pain, but they will not show a meniscus tear. Osteoarthritis Cartilage 13(7):568574, Chan KKW, Sit RWS, Wu RWK, Ngai AHY (2014) Clinical, radiological and ultrasonographic findings related to knee pain in osteoarthritis. 2b, c) [78,79,80,81,82]. Reference article, Radiopaedia.org (Accessed on 01 May 2023) https://doi.org/10.53347/rID-70702. In addition, when there is ACL rupture and the preoperative extrusion of the LM is 1.1mm, the surgeon should consider the possibility of a complete posterior root tear (PRT) of the LM. https://doi.org/10.1186/s43019-022-00163-1, DOI: https://doi.org/10.1186/s43019-022-00163-1. Babu J, et al. Google Scholar, Raynauld JP, Martel-Pelletier J, Bias P, Laufer S, Haraoui B, Choquette D et al (2009) Protective effects of licofelone, a 5-lipoxygenase and cyclo-oxygenase inhibitor, versus naproxen on cartilage loss in knee osteoarthritis: a first multicentre clinical trial using quantitative MRI. This site should be used for informational purposes only. Therefore, nonoperative treatment should be reserved for nonsurgical candidates [61]. Accessed 22 May 2021. You can learn more about how we ensure our content is accurate and current by reading our. J ISAKOS 6(1):3545, Beaufils P, Becker R, Kopf S, Englund M, Verdonk R, Ollivier M et al (2017) Surgical management of degenerative meniscus lesions: the 2016 ESSKA meniscus consensus. Arthroscopy. The survival of the graft depends substantially on the condition of the articular cartilage [117,118,119]. Here, find nine gentle exercises that may help strengthen and heal a torn meniscus. The Relationship Between Meniscal Pathology and Osteoarthritis Depends on the Type of Meniscal Damage Visible on Magnetic Resonance Images: Data from the Osteoarthritis Initiative. Sci Rep 15(7):44470, Kijima H, Yamada S, Nozaka K, Saito H, Shimada Y (2015) Relationship between pain and medial meniscal extrusion in knee osteoarthritis. Knee arthroscopy versus conservative management in patients with degenerative knee disease: A systematic review. ME can occur in knee OA [8, 10], and its presence is significantly correlated with increased articular cartilage loss in the tibiofemoral joint and osteophyte formation [29, 30]. There is no consensus whether medial or lateral MAT is superior in terms of medium-term (510years) and long-term (>10years) survival. J Orthop Surg Hong Kong 28(1):2309499020906745, McCormack DJ, Puttock D, Godsiff SP (2021) Medial compartment osteoarthritis of the knee: a review of surgical options. Chin Med J (Engl) 132(21):25502558, Goto N, Okazaki K, Akiyama T, Akasaki Y, Mizu-uchi H, Hamai S et al (2019) Alignment factors affecting the medial meniscus extrusion increases the risk of osteoarthritis development. To perform this exercise, a person should do the following: The red zone has a blood supply, and therefore, a meniscus injury in this area may heal on its own. Am J Sports Med 38(8):15421548, Yanagisawa S, Kimura M, Hagiwara K, Ogoshi A (2020) Association between postoperative meniscal extrusion and clinical outcomes of the pullout fixation technique for medial meniscus posterior root tear. Furthermore, at 2-year follow-up, patients experienced significantly less pain, with improved clinical outcomes. PubMed The medial meniscus covers 5060% of the medial tibial plateau, and the lateral meniscus covers 7080% of the lateral tibial plateau. Treatments for macerated skin caused by wounds include specific types of bandages and dressings, including: Occlusive dressings. On the other hand, the suture-only technique has its own advantages and is therefore chosen by many surgeons [104, 111]. It should be highlighted that the clinical significance of meniscal allograft extrusion has not yet been clearly elucidated, since it is difficult to draw firm conclusions. To address the problems of patients with meniscectomy, efforts are constantly being made to develop techniques that aim at meniscal regeneration or development of meniscal scaffolds. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. According to the American Academy of Orthopaedic Surgeons, treatment of a meniscus tear depends on the location of the injury, alongside other factors, including a persons: Below, we outline some potential treatment options. Jones JC, et al. 60 patients were performed arthroscopic meniscus repairs Webinferior leaet of the meniscus tear. After healing occurs, a doctor will recommend a rehabilitation program of exercises to improve range of motion and strength. Knee Surg Sports Traumatol Arthrosc 27(8):26172623, Astur DC, Novaretti JV, Gomes ML, Rodrigues AG, Kaleka CC, Cavalcante ELB et al (2020) Medial opening wedge high tibial osteotomy decreases medial meniscal extrusion and improves clinical outcomes and return to activity. At the time the article was created Yuranga Weerakkody had no recorded disclosures. The knee meniscus: Management of traumatic tears and degenerative lesions. Whilst APM is one of the most commonly performed orthopaedic procedures [], meniscal repair is the treatment of choice for the young athlete with an acute meniscal tear [].Meniscal repair is most commonly performed in younger populations aged under 35 years [10, 2127] and aims to preserve the entire meniscus, without excision.The Recovery time is 6 to 8 weeks with conservative treatment. Arthroscopy 35(6):16581666, Jiang D, Ao YF, Gong X, Wang YJ, Zheng ZZ, Yu JK (2014) Comparative study on immediate versus delayed meniscus allograft transplantation: 4- to 6-year follow-up. Osteoarthritis Cartilage 25(7):10761083, Naredo E, Cabero F, Palop MJ, Collado P, Cruz A, Crespo M (2005) Ultrasonographic findings in knee osteoarthritis: a comparative study with clinical and radiographic assessment. According to this technique, a more posterolateral position of the tibial tunnel aperture within the ACL footprint reduces the RTD (reference point to tibial tunnel distance) and increases the extrusion of the LM following ACLR [93]. An MRI will confirm a suspected diagnosis. Knee Surg Sports Traumatol Arthrosc 29(4):11971205, Song JH, Bin SI, Kim JM, Lee BS (2020) Postoperative subchondral bone marrow lesion is associated with graft extrusion after lateral meniscal allograft transplantation. Knee 23(4):627630, Ishii Y, Ishikawa M, Kurumadani H, Hayashi S, Nakamae A, Nakasa T et al (2020) Increase in medial meniscal extrusion in the weight-bearing position observed on ultrasonography correlates with lateral thrust in early-stage knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 24(5):14551468, Feucht MJ, Khle J, Bode G, Mehl J, Schmal H, Sdkamp NP et al (2015) Arthroscopic transtibial pullout repair for posterior medial meniscus root tears: a systematic review of clinical, radiographic, and second-look arthroscopic results. Therefore, the relative values may be significant [17]. In a biomechanical study, Paletta et at. Although there is still controversy in the literature in respect of the optimal cutoff value, a threshold of 3mm is considered significant. A hip labral tear can be treated nonsurgically, or with surgery in severe cases. ME is found in several knee pathologies and is well correlated with rapid knee OA progression as well as increased morbidity. EFORT Open Rev 6(2):113117, Wang YX, Li ZL, Li J, Zhao ZD, Wang HR, Hou C et al (2019) Effect of medial meniscus extrusion on arthroscopic surgery outcome in the osteoarthritic knee associated with medial meniscus tear: a minimum 4-year follow-up. The recovery time is longer than in the case of a meniscectomy. Orthop J Sports Med. Generally speaking, the treatment options for meniscus tears include: rest, physical therapy, activity modification, and occasionally a surgery we refer to as an Knee Surg Sports Traumatol Arthrosc 27(10):33113317, Costa CR, Morrison WB, Carrino JA (2004) Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear? MAT is not a simple surgical procedure, has a high learning curve, and if it is not performed under certain indications (Table 1) it fails, leaving both the surgeon and the patient dissatisfied [106, 109]. Do I need surgery to repair or remove the torn meniscus? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359983/, https://orthoinfo.aaos.org/en/recovery/knee-arthroscopy-exercise-guide/, https://orthoinfo.aaos.org/en/diseases--conditions/meniscus-tears/, https://www.ncbi.nlm.nih.gov/books/NBK431067/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5444079/, New clues to slow aging? Ann Rheum Dis 68(6):938947, Ishii Y, Deie M, Fujita N, Kurumadani H, Ishikawa M, Nakamae A et al (2017) Effects of lateral wedge insole application on medial compartment knee osteoarthritis severity evaluated by ultrasound. A doctor can do physical and imaging tests, such as an X-ray or MRI, to determine what kind of damage you have and discuss possible treatment options with you. Am J Sports Med 40(7):15911596, Lee BS, Kim JM, Kim JM, Kim KA, Bin SI (2015) Patient-related risk factors for the extrusion of lateral meniscal allograft transplants. A physical therapist can provide a daily routine of exercises and stretches to improve your muscle strength, flexibility, range of motion, and stability. A threshold of 3mm, which was initially introduced, is most commonly used to define a significant ME [8]. Traditional Ayurvedic treatments are widely used in South Asia to reduce swelling, pain, and motion restrictions in meniscus tears and knee osteoarthritis. Putting ice on your knee for 10 to 15 minutes As you get older, the cartilage in your knees wears down and gets weaker. MNT is the registered trade mark of Healthline Media. Conservative treatment constitutes the first line of therapy in mild or moderate knee OA [46, 47].
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