Case: A 14-year-old adolescent with bilateral discoid menisci who had previously undergone discoid meniscal saucerization presented with pain and mechanical knee symptoms bilaterally. She had a torn left discoid lateral meniscus, a right lateral meniscal deficiency with an associated osteochondral defect, and valgus collapse of the right femur. She underwent successful repair of the left discoid meniscus as well as a femoral osteotomy, a meniscal transplant, and an osteochondral allograft transplantation in the right knee.
Conclusion: New treatment paradigms following initial interventions for discoid menisci are discussed. Patients may benefit from longer follow-up after discoid meniscal surgery, and providers should consider joint-preserving techniques early in the setting of meniscal deficiency.
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http://dx.doi.org/10.2106/JBJS.CC.18.00054 | DOI Listing |
Am J Sports Med
January 2025
The Steadman Clinic, Vail, Colorado, USA.
Background: There is growing evidence that medial meniscotibial ligament (MTL) deficiency and medial meniscus extrusion may precede the development of some medial meniscus posterior root (MMPR) tears. However, no study has investigated the biomechanical consequences of MTL deficiency on the MMPR.
Hypothesis: (1) MTL deficiency leads to increased medial meniscus extrusion, (2) increased medial meniscus extrusion is correlated with increased compression and shear forces at the MMPR, and (3) MTL repair restores medial meniscus extrusion and MMPR forces to native levels.
Orthopadie (Heidelb)
January 2025
Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, 55905, Rochester, MN, USA.
Subchondral insufficiency fractures of the knee (SIFK) are a relatively common cause of knee pain, particularly in middle-aged and older adults. The SIFK is a type of stress fracture that occurs when excessive and repetitive or supraphysiologic loads are applied to subchondral bone [1]. Historically, this type of fracture was termed spontaneous osteonecrosis of the knee (SONK) until advances in MRI identified underlying fractures as well as meniscal deficiency as likely attributable etiologies.
View Article and Find Full Text PDFAm J Sports Med
January 2025
Memorial Hermann Rockets Sports Medicine Institute, Department of Sports Medicine & Rehabilitation, Houston, Texas, USA.
Background: Meniscal allograft transplantation (MAT) is indicated in the setting of anterior cruciate ligament (ACL) reconstruction to restore proper arthrokinematics and load distribution for the meniscus-deficient knee. Objective outcomes after ACL reconstruction with concomitant MAT in athletic populations are scarcely reported and highly variable.
Purpose: To compare patient outcomes using an objective functional performance battery, self-reported outcome measures, and return-to-sport rates between individuals undergoing ACL reconstruction with concomitant MAT and a matched group undergoing isolated ACL reconstruction.
Orthop Traumatol Surg Res
December 2024
Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France; LIBM - EA 7424, Interuniversity Laboratory of Biology of Mobility, Claude Bernard Lyon 1 University, Lyon, France.
Introduction: Combined anterior cruciate ligament (ACL) and meniscal tear patterns and their effect on knee stability have been widely researched, however, their evolution and repairability from time of injury have been scarcely addressed. When addressed with delay, meniscal lesions associated with ACL tears may increase in severity and irreparability. This study aims to investigate the incidence, rate and pattern of meniscus tears in the context of ACL deficient knees and to assess the meniscal condition in early versus late ACL reconstruction (ACLR).
View Article and Find Full Text PDFBMJ Open
December 2024
Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Introduction: Knee osteotomy combined with meniscal allograft transplantation (MAT) showed promising results to treat unicompartmental knee osteoarthritis (OA) secondary to meniscal deficiency and knee malalignment. However, there is still no high-level evidence to demonstrate whether the combination of these two treatments is superior to osteotomy alone.
Methods And Analysis: 52 patients with unicompartmental knee OA Kellgren-Lawrence grade ≤3 secondary to meniscal deficiency and knee malalignment (aged 20-60 years) are randomised to undergo knee osteotomy associated with MAT or knee osteotomy alone in a 1:1 ratio.
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