Meniscal injury is one of the most common injuries to the knee. The menisci are important for normal knee function. And loss of a meniscus increases the risk of subsequent development of degenerative changes in the knee. Now there are different techniques available for meniscal injury. These techniques include expectant treatment, meniscectomy, meniscal repair, meniscal replacement, and meniscal tissue engineering. Expectant treatment is the appropriate treatment for minor tears of the menisci. Meniscectomy being favored at the beginning is now obsolete. Meniscus repair has become a standard procedure. Meniscal replacement and tissue engineering are used to deal with considerable meniscal injuries. The purpose of this paper is to provide current knowledge regarding the anatomy and function of the menisci, incidence, aetiology, symptoms, signs, investigations and treatments of meniscal injury.
Animals ; Humans ; Knee Injuries ; surgery ; Menisci, Tibial ; anatomy & histology ; physiology ; Tibial Meniscus Injuries ; Tissue Engineering

OBJECTIVE: To summarize the product registration declaration ideas and registration technical review of the all-inside meniscal suture system, and to systematically think about of the technical review concerns of the all-inside meniscal suture system products to provide technical guidance for improving the quality of registration and application and regulatory efficiency. METHODS: Consult the public information of such products at home and abroad, and summarize the experience of registration review of such products. RESULTS: The technical review of the all-inside meniscus suture system registration mainly focuses on product basic information, pre-clinical research, clinical evaluation and product technical requirements. CONCLUSIONS The difficulty of product registration and declaration of the all-inside meniscus suture system lies in the provision of pre-clinical research data of the product, and the applicant needs to strengthen the basic research ability, formulate scientific technical indicators and test methods to ensure the safety and effectiveness of the product, and also provide sufficient supporting data for the registration declaration.
Humans ; Menisci, Tibial/surgery* ; Suture Techniques ; Tibial Meniscus Injuries/surgery* ; Sutures ; Arthroscopy/methods*

BACKGROUNDDiscoid lateral meniscus of the knee is common in Chinese population. There has been considerable debate about the best treatment for discoid lateral meniscus tears. The purpose of this study was to observe the effect of arthroscopic meniscectomy for the treatment of discoid lateral meniscus tears.

METHODSBetween July 1999 and December 2004, arthroscopic meniscectomy was performed on 62 menisci of 57 patients with discoid lateral meniscus tears (52 unilateral, 5 bilateral). 41 menisci were "complete discoid meniscus", 21 "incomplete". According to the extent of the meniscus tears, partial meniscectomy was performed on 52 knees, total meniscectomy on 7 knees, and partial meniscectomy combined with meniscus suture on 3 knees through an arthroscope. After the operations, early rehabilitation training programs, including straight-leg-raising and range-of-motion exercises, were carried out. 51 patients were followed up for 1 year 2 months to 6 years 5 months (mean, 3 years 3 months), 6 patients were lost. Lysholm-II scoring system was used to assess the function of the knee joints before the operation and during the follow-up.

RESULTSThe operations on all the 62 knees were successful without complications. The patients could walk normally after completing the 2-week postoperation rehabilitation program. After 3 - 4 weeks they could lead a normal life and participate in a moderate amount of sports or other physical activities. The mean Lysholm-II score was 89 (60 - 100) during the follow-up, which was significantly higher than that before the operation (50, range 34 - 74; P < 0.01). 88% of the patients achieved excellent or good clinical results.

CONCLUSIONSArthroscopic meniscectomy is an alternative for treatment of discoid lateral meniscus tears with minimal traumatic effects. It can achieve early mobilization and a low complication rate, as well as the preservation of the meniscus structure and functions to the largest extent. In combination with proper rehabilitation training, the operation can lead to good or excellent results.

Adolescent ; Adult ; Arthroscopy ; Female ; Humans ; Male ; Menisci, Tibial ; surgery ; Middle Aged ; Tibial Meniscus Injuries

OBJECTIVETo explore the clinical efficacy of the arthroscopic Mender II stapler for the treatment of patients with meniscus anterior horn injury needing meniscal suture repair.

METHODSAmong 47 patients with meniscus anterior horn injury, 29 patients were male and 18 patients were female, ranging in age from 12 to 31 years old, with a mean age of (20.53± 4.12) years old. The duration of disease ranged from 3 to 35 days, and the average duration was (12.43±5.74) days. The Mender II stapler was used to carry out arthroscopic suture from outside to inside. The Lysholm knee scoring system was used to evaluate and analyze preoperative and postoperative symptoms, such as pain, limping embolism and so on.

RESULTSForty-six patients were followed up, and the duration ranged from 12 to 48 months, with a mean of (20.53±4.12) years. The incision healed at the first stage without important vessels and nerves injuries. The symptoms of the locked knee joint disappeared, and symptoms such as pain, limp, swelling and limitation of activity improved. The Lysholm score increased from preoperative 52.33±7.31 to postoperative 86.74±6.92.

CONCLUSIONUsing Mender II stapler to treat patients with meniscus anterior horn injury who were treated with arthroscopic suture from outside to inside is effective to improve symptoms, and to obtain good short-term results.

Adolescent ; Adult ; Arthroscopy ; methods ; Child ; Female ; Humans ; Male ; Menisci, Tibial ; surgery ; Suture Techniques ; Tibial Meniscus Injuries

OBJECTIVE: To evaluate the surgical technique and clinical effect of arthroscopic pullout suture repair of posterior root tear of the medial meniscus via the double tibial tunnels. METHODS: From May 2014 to May 2017, 22 patients with posterior root tear of medial meniscus were treated by pullout suture repair via the double tibial tunnels, including 8 males and 14 females, aged 34 to 53 years old, with a mean of averaged(45.7±4.7) years old. The patients were followed up for 12 to 24 months, with a mean of (16.4±5.2) months. RESULTS: The Lysholm score of knee joint before operation was 61.8±4.3, IKDC score before operation was 59.9±2.9, Lysholm score at the latest follow-up was 89.1±3.0, and IKDC score was 89.0±2.5. The difference was statistically significant. CONCLUSIONS Arthroscopic pullout suture repair via the double tibial tunnelsis an effective treatment for symptomatic posterior root tear of medial meniscus, and it can significantly improve the knee functional outcome.
Adult ; Arthroscopy ; Female ; Humans ; Male ; Menisci, Tibial ; Middle Aged ; Suture Techniques ; Sutures ; Tibial Meniscus Injuries ; surgery

OBJECTIVETo study the results of arthroscopic partial meniscectomy for medial meniscal tear in late middle-aged adults.

METHODSFrom October 2010 to October 2012,49 patients meeting inclusion criteria were treated with arthroscopic partial meniscectomy for medial meniscal tear. There were 31 males and 18 females,with an average age of (55.3±2.8) years old. There were 22 left knees and 27 right knees. The average flexion angle was (116.01±12.03)°. The pre-operative HSS Knee Score was 48.73±8.43, and the Lysholm score was 63.95±5.45. The patients were followed up and evaluated. All the patients received a standard surgery, in which the torn tissue was removed, and the anterior part of the meniscus was left in situ.

RESULTSAll the surgeries were successful with no serious complications. All the patients were followed up,and the duration ranged from 12 to 36 months. All the patients had 5 degrees of muscle strength. The average flexion angle was (136.77±18.56)°. There was significant difference between the two angles before operation and after operation. The pre-operative HSS Knee Score was 90.17±4.10, and the Lysholm score was 87.84±5.16. Statistically, the difference between preoperative score and the postoperative score was significant.

CONCLUSIONArthroscopic partial meniscectomy is a good option for medial meniscal tear in late middle-aged adults. Operative indication is crucial and the excellent surgical technique is also critical for the good clinical outcome. All the patients could get good clinical results, although there are some patients with motion restrictions in the early stage after operation.

Arthroscopy ; methods ; Female ; Humans ; Knee Injuries ; surgery ; Male ; Menisci, Tibial ; physiopathology ; surgery ; Middle Aged ; Tibial Meniscus Injuries

Adolescent ; Adult ; Arthroscopy ; methods ; Humans ; Knee Injuries ; surgery ; Male ; Menisci, Tibial ; surgery ; Middle Aged ; Tibial Meniscus Injuries ; Young Adult

We report here on a new arthroscopic direct repair technique for a radial tear of the posterior root of the medial meniscus (PRMM) using a posterior trans-septal portal. Radial tears of the PRMM are commonly observed in the elderly population of Korea and Japan, and the life style of these people requires squatting and kneeling down in daily life. A radial tear of the PRMM results in the loss of hoop tension and this accelerates degenerative changes in the knee joint and causes early osteoarthritis. Several reports in the medical literature have focused on various repair techniques for these tears by using pull out sutures. These techniques result in nonanatomic fixation of the meniscus, which may lead to disturbed meniscal excursion and failure to restore hoop tension. Arthroscopic direct repair may contribute to restoring hoop tension and preventing accelerated degenerative changes in the knee joint of these patients.
Arthroscopy/methods ; Humans ; Menisci, Tibial/*injuries/*surgery ; Middle Aged ; Rupture/surgery

Adult ; Humans ; Knee Injuries ; surgery ; Male ; Menisci, Tibial ; surgery ; Transplantation, Homologous ; methods

PURPOSE: To retrospectively analyze the clinical outcomes of meniscus repair with simultaneous anterior cruciate ligament (ACL) reconstruction and explore the causes of failure of meniscus repair. METHODS: From May 2013 to July 2018, the clinical data of 165 patients who were treated with meniscus surgery and simultaneous ACL reconstruction, including 69 cases of meniscus repair (repair group) and 96 cases of partial meniscectomy (partial meniscectomy group) were retrospectively analyzed. The exclusion criteria were as follows: (1) ACL rupture associated with fracture, collateral ligament injury, or complex ligament injury; (2) a history of knee surgery; or (3) a significant degree of osteoarthritis. The 69 patients in the repair group were divided into the non-failure group (62 cases) and the failure group (7 cases) depending on the repair effect. Postoperative outcomes of the repair group and the partial meniscectomy group were compared. General conditions and postoperative outcomes of the failure group and the non-failure group were compared. During the median follow-up period of 28 months (range, 4 - 65 months) after the second arthroscopy, postoperative outcomes of seven patients in the failure group were summarized. SPSS 25.0 statistical software was used for statistical analysis. A p value less than 0.05 was considered statistically significant. RESULTS: Seven patients in the failure group who underwent the second arthroscopy were followed up for (30 ± 17.4) months and their postoperative outcomes were summarized. Compared with the partial meniscectomy group, the International Knee Documentation Committee scores of patients in the repair group improved significantly (p = 0.031). Compared with the non-failure group, more patients in the failure group were younger than 24 years (p = 0.030). The median follow-up period was 39.5 months. All patients recovered well after subsequent partial meniscectomy and relieved clinical symptoms. Visual analog scale scores decreased significantly (p = 0.026), and the International Knee Documentation Committee and Lysholm scores improved significantly (p = 0.046 for both). CONCLUSION The failure rate of meniscus repair in this study was 10.1% (7/69), all of which were medial meniscus tears. However, the surgical outcomes of ACL reconstruction were not affected, and there might be a role for graft protection. Therefore, meniscus retears can be successful treated by performing subsequent partial meniscectomy in patients with repair failure.
Anterior Cruciate Ligament Injuries/surgery* ; Anterior Cruciate Ligament Reconstruction ; Humans ; Menisci, Tibial/surgery* ; Meniscus ; Retrospective Studies