Procedures used by tissue banks in selecting meniscal allografts that will best restore normal contact pressure at the time of surgical implantation into a recipient's knee should be improved. Our objective was to develop regression equations that use dimensions measured from magnetic resonance (MR) images of the contralateral knee to predict values of important meniscal parameters of the injured knee. Another objective was to incorporate these equations into an algorithm for selecting allografts that best match the size and shape of the damaged meniscus (either medial or lateral). In each of 10 knee specimens, four transverse and six cross-sectional parameters of the medial and lateral menisci were quantified from measurements obtained using a laser-based, noncontacting, 3-D coordinate digitizing system. In each of 10 contralateral knee specimens, six transverse and 24 cross-sectional (i.e., perpendicular to transverse plane) dimensions were measured for the medial and lateral menisci from MR images of each knee specimen. Simple linear regression equations related these 10 parameters to each of 38 predictor variables determined from magnetic resonance imaging (MRI) dimensions and the best regression equation for each parameter was identified. Requiring only 9 of the 30 dimensions as predictor variables, the best regression equations predicted 8 of 10 and 10 of 10 medial and lateral menisci parameters, respectively, with R2 values>0.500. The algorithm for selecting meniscal allografts involves: collecting an inventory of meniscal allografts and determining the 10 meniscus parameter values for all allografts in the inventory; measuring the dimensions as required from MRI scans of the uninjured knee; using the dimensions as inputs to the regression equations to predict values of meniscal parameters; and selecting the meniscal allograft from the inventory that best matches the predicted values of meniscal parameters. Selecting meniscal allografts using our new algorithm may enable allografts to better meet the clinical objectives of meniscal transplantation, which are to reduce pain in some patients following meniscal resection and to inhibit the degeneration of the articular cartilage.
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http://dx.doi.org/10.1002/jor.20155 | DOI Listing |
BMJ Open
January 2025
Warwick Clinical Trials Unit, University of Warwick, Warwick Medical School, Coventry, UK.
Objectives: There is a paucity of qualitative research exploring the patient experience of living with a meniscal tear, vital to effective patient management. The aim of this study was to explore the experiences and expectations of treatment of patients aged 18-55 years with a meniscal tear of the knee.
Design: Qualitative study involving semistructured interviews.
Orthop J Sports Med
December 2024
Department of Orthopaedic Surgery, Stanford University, Redwood City, California, USA.
Background: Injury to the posterior vasculature is a potential complication in orthopaedic knee surgery that may be associated with variations in its anatomy, such as the type II-A2 variant, which places the anterior tibial artery (ATA) in closer proximity to the tibia. However, how close surgical instrumentation comes to injuring the ATA is not well described.
Purpose: To determine how the type II-A2 variant of the popliteal vasculature affects proximity of the ATA to instrumentation for orthopaedic knee procedures.
Orthop J Sports Med
December 2024
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Background: Bucket-handle meniscal tears (BHMTs) are a common subtype of meniscal tears that represent a clinical challenge. Arthroscopic inside-out repair has been considered the gold standard in treatment; however, an all-inside approach has gained widespread popularity, with limited long-term evidence.
Purpose/hypothesis: The purpose of this study was to (1) compare long-term clinical outcomes and rates of failure after surgical repair of BHMTs using the all-inside versus inside-out technique, and 2) identify risk factors for failure at long-term follow-up.
J Orthop Traumatol
December 2024
IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy.
Purpose: This study's primary objective was to evaluate the effectiveness of platelet-rich plasma (PRP) administration for meniscal injuries treated with meniscal repair procedures (sutures), using radiologic measures and clinical scales. The secondary objective was to identify potential bias-inducing elements in the analyzed studies.
Methods: In December 2023, a systematic search was conducted in PubMed, Cochrane, Embase, and Scopus for randomized controlled trials.
J Orthop Case Rep
December 2024
Department of Orthopedic Surgery, University of Toledo Medical Center, Toledo, Ohio, USA.
Introduction: The menisci are a pair of fibrocartilaginous structures important for the normal biomechanical function of the knees. Tears are common, and multiple approaches have been used to repair meniscal tears. Of the approaches, the all-inside approach has historically been avoided for tears to the posterior aspect of the lateral meniscus (LM) due to the risk of popliteal and common peroneal neurovascular injury.
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