1.Progress in finite element analysis of meniscus.
Bo JIN ; Yun-Gen HU ; Lei HAN
China Journal of Orthopaedics and Traumatology 2019;32(5):485-488
The meniscus biomechanics is one of the hottest areas in medical research. Finite element analysis(FEA) provides a new method for biomechanical studies. Using the FEA, the stress force and strain distribution characteristics of the normal meniscus can be analysed by establishing the finite element model of the meniscus and utilizing finite element softwares. In addition, the finite simulation of the meniscus tears, meniscectomy, and knee tissue injury can assess the changes of meniscus biomechanical properties. These research results provide theoretical basis of biomechanics to prevent and treat knee joint injuries. However, the finite element analysis method has its limitations, future research will be aimed at establishing high quality finite element models, making the models offer more authentic simulations of the meniscus anatomy, and ensuring the FEA could be applied to research a variety of knee injuries.
Biomechanical Phenomena
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Finite Element Analysis
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Humans
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Knee Injuries
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Menisci, Tibial
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Meniscus
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Models, Biological
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Tibial Meniscus Injuries
3.Selection of arthroscopic surgical methods for meniscus tear in the elderly and evaluation of curative effect.
China Journal of Orthopaedics and Traumatology 2019;32(12):1085-1089
OBJECTIVE:
To evaluate the methods and effects of arthroscopic operation in aged patients with meniscal injury.
METHODS:
From January 2014 to June 2018, 86 elderly patients with meniscal injury met the inclusion criteria, including 35 males and 51 females, aged 60 to 76 years old, with an average age of 63.7 years old, 32 patients with definite trauma and 54 without definite trauma. Arthroscopic partial meniscectomy was performed in 75 cases, partial meniscectomy and anterior angle repair in 2 cases, partial meniscectomy and body repair in 2 cases, and partial meniscectomy and repair in 7 cases of horizontal delamination rupture of posterior horn; 28 patients with mild joint degeneration went through drilling decompression of intercond-ylar fossa. Lysholm score and IKDC score were used to evaluate knee joint function and visual analogue scale(VAS) was used to evaluate pain.
RESULTS:
All patients were successfully operated under arthroscope. The follow-up period ranged from 6 to 36 months, with an average of 15 months. The Lysholm score of knee joint increased from preoperative 51.26±12.00 to final follow-up 81.20±4.89 points (=22.07, <0.001); IKDC scores increased from preoperative 48.05±10.68 to final follow-up 76.97±6.26(=23.04, <0.001); and the VAS decreased from preoperative 3.37±0.84 to final follow-up 0.57±0.62(=36.27, <0.001). Two patients with non-traumatic degenerative medial meniscus injury with medial osteoarthritis had no significant improvement after 1 year follow-up, so underwent total knee arthroplasty.
CONCLUSIONS
In elderly patients with knee meniscus injury, arthroscopic partial meniscectomy, or partial meniscectomy and repair can achieve satisfying clinical results. If the injuried joint is accompanied with mild degeneration, drilling hole decompression of intercondylar fossa should be performed at the same time.
Aged
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Arthroscopy
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Female
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Follow-Up Studies
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Humans
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Knee Injuries
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Male
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Menisci, Tibial
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Meniscus
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Middle Aged
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Tibial Meniscus Injuries
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Treatment Outcome
4.Arthroscopic surgery combined with platelet-rich plasma for meniscus injury:a Meta analysis.
Dong WEI ; Xi-Ang CHEN ; Xiao-Dong GU ; Peng-Cui LI ; Xiao-Chun WEI
China Journal of Orthopaedics and Traumatology 2021;34(9):879-886
OBJECTIVE:
To evaluate clinical efficacy of arthroscopic with platelet-rich plasma (PRP) in treating meniscus injury.
METHODS:
From January 2015 to December 2019, clinical control study on repair meniscus injury by arthroscopic with PRP between arthroscopic were searched by PubMed, Science Direct, Cochrane library, Chinese Journal Full-text Database, Wanfang and VIP database. Literature screening, data extraction and quality evaluation according to inclusion and exclusion criteria. Visual analogue scale(VAS) of knee joint and Lysholm score at 1, 6 and 12 months after opertaion between two groups were compared, and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) at 3, 6 and 12 months after opertaion between twogroups were also compared.
RESULTS:
Totally 9 literatures and 329 patients with meniscal injuries were screened, include 146 patients treated by arthroscopic with PRP and 183 patients treated by arthroscopic. There were no statistical differences in VAS between two groups at 1, 6 and 12 months after opertaion. There were differences in Lysholm score at 1 and 6 months after operation between two groups [
CONCLUSION
Arthroscopic with PRP for repair meniscus injury has short term efficacy of knee function and delay arthritis, while has similar effect in long term clinical efficacy and relieve pain.
Arthroscopy
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Humans
;
Knee Joint
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Meniscus
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Osteoarthritis, Knee
;
Platelet-Rich Plasma
;
Tibial Meniscus Injuries/surgery*
;
Treatment Outcome
5.Research progress in diagnosis and treatment of injury of the popliteal meniscal fiber bundle.
Zhu DAI ; Zhou LI ; Yun-Liang LEI ; De-Hong FU
China Journal of Orthopaedics and Traumatology 2018;31(12):1180-1182
Popliteal meniscal fiber bundle injury is relatively infrequent in clinic, which can be either isolated or associated with anterior cruciate ligament rupture, lateral meniscus injury and so on. Popliteal meniscal fiber bundle injury often leads to instability of lateral meniscus. Because of the lack of specific symptoms and signs of injury, the imaging changes are subtle, and it is easy to miss diagnosis and misdiagnosis in clinical. Timely diagnosis and treatment are essential to prevent the chronic pain and instability of the knee joint. This paper summarizes the anatomical characteristics, biomechanics, injury mechanism, diagnostic points and surgical treatment of the popliteal meniscus fiber bundle injury, in order to guide the diagnosis and treatment of the injury of the popliteal meniscus fiber bundle in the clinical work.
Anterior Cruciate Ligament Injuries
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Humans
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Knee Injuries
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Knee Joint
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Menisci, Tibial
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Tibial Meniscus Injuries
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diagnosis
6.Treatment of meniscal injury: a current concept review.
Chinese Journal of Traumatology 2010;13(6):370-376
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
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Humans
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Knee Injuries
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surgery
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Menisci, Tibial
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anatomy & histology
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physiology
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Tibial Meniscus Injuries
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Tissue Engineering
7.Efficacy of the arthroscopic suture in meniscus anterior horn injury.
Zheng-bing SU ; Yue ZHOU ; Xia ZHANG ; Yong HAO ; Min WANG ; Lin-lin LIANG ; Zhi-bing WANG
China Journal of Orthopaedics and Traumatology 2015;28(10):959-962
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
8.Torn discoid lateral meniscus treated with arthroscopic meniscectomy: observations in 62 knees.
Chinese Medical Journal 2007;120(3):211-215
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
9.Tibial Plateau Fracture with Bucket-handle Tears of Both the Medial and Lateral Menisci.
Peng LIN ; Cheng-Gang LIU ; Ying CHEN ; Li-Qiang WANG ; Qian-Zheng ZHU ; Xing-Zuo CHEN
Chinese Medical Journal 2016;129(9):1131-1132
Adult
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Humans
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Male
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Tibial Fractures
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complications
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surgery
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Tibial Meniscus Injuries
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etiology
;
surgery
10.Arthroscopic pullout suture repair of posterior root tear of the medial meniscus via the double tibial tunnels.
Xiao-Ning LIU ; Hai-Chi YU ; Ying-Zhi LI ; Pan XUE ; Bing-Zhe HUANG ; Wei ZHANG
China Journal of Orthopaedics and Traumatology 2019;32(12):1094-1096
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
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Arthroscopy
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Female
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Humans
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Male
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Menisci, Tibial
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Middle Aged
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Suture Techniques
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Sutures
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Tibial Meniscus Injuries
;
surgery