Introduction: Meniscal tears are among the most common indications for knee arthroscopy. Artificial polyurethane scaffolds have demonstrated efficacy in reducing pain and promoting the growth of normal meniscal tissue, with high absorption rates facilitating full tissue regeneration.
Aims: This study aimed to evaluate the remodeling of polyurethane meniscal implants post-reconstruction using ultrasonography. This imaging technique not only assesses changes in implant properties, such as echogenicity, but also the shape changes during functional examination.
Methods: The assessment of meniscal extrusion, comparing size at rest and under weight-bearing, is an indirect parameter that provides insight into the physical properties of the remodeling implant, with greater extrusion indicating reduced stiffness and inferior physical properties of the meniscus. Ultrasonography has the valuable advantage of allowing for assessment of the blood supply to the meniscus through Power Doppler imaging.
Results: The presence of vessels within the meniscal implants serves as evidence of ongoing remodeling. The study included 35 patients (13 female, 22 male; mean age 41.6 years, range 18-66) who underwent arthroscopic meniscal reconstruction with polyurethane implants, with an average time from surgery of 2.8 years (range 0.3-4.5 years). Results showed complete (29.7%), significant (45.9%), or moderate (16.2%) remodeling into natural meniscal tissue in 91.8% of the implants.
Conclusion: The mean values of extrusion in the supine position and during 90-degree flexion were significantly greater in the operated limb (2.603) compared to the contralateral limb (1.978; t(35) = 2.442; P < 0.05). No significant differences in extrusion were found between the limbs in a standing position, indicating favorable physical properties of the polyurethane meniscal implants. Further ultrasonography studies of meniscal scaffolds are deemed relevant.
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http://dx.doi.org/10.2174/0115734056281005231030070341 | DOI Listing |
Arthrosc Tech
November 2024
Arthroscopy and Arthroplasty Unit, RNH Hospital, Nagpur, India.
Anterior cruciate ligament avulsion fractures are more commonly seen in children with open physes than in adults. Arthroscopic fixation is considered the gold standard in the management of such injuries. Our technique of anterior-row fixation for these injuries provides various advantages in the form of physeal-sparing, complete anatomic reduction with no anterior beaking, no arthrofibrosis, no residual instability, no intra-articular hardware, no need for a second operation to remove implants, and finally, a full range of movement with no loss of extension.
View Article and Find Full Text PDFOrthop Traumatol Surg Res
December 2024
Ramsay Santé, Hôpital Privé d'Antony, 1 rue Velpeau, 92160 Antony, France.
Introduction: Patellar instability is a multifactorial pathology requiring precise evaluation of its contributing factors, particularly patella alta. Patellotibial height measurement indexes, such as the Caton-Deschamps index, have the disadvantage of being referenced to the tibia. Patellotrochlear indexes are more appropriate but fail to account for variable knee flexion during magnetic resonance imaging (MRI).
View Article and Find Full Text PDFJ Orthop Res
December 2024
Department of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Magnetic resonance imaging (MRI) of the knee is the recommended diagnostic method before invasive arthroscopy surgery. Nevertheless, interpreting knee MRI scans is a time-consuming process that is vulnerable to inaccuracies and inconsistencies. We proposed a multitask learning network MCSNet which efficiently introduces segmentation prior features and enhances classification results through multiscale feature fusion and spatial attention modules.
View Article and Find Full Text PDFJ Mech Behav Biomed Mater
February 2025
Centre for Regenerative Medicine, Department for Health Science, University for Continuing Education Krems, Krems an der Donau, Austria; Austrian Cluster for Tissue Regeneration, Austria.
Objective: To investigate the suitability of different material compositions and structural designs for 3D-printed meniscus implants using finite element analysis (FEA) to improve joint function after meniscal injury and guide future implant development.
Design: This experimental study involved in-silico testing of a meniscus model developed from two materials: a specially formulated hydrogel composed of silk fibroin (SF), gelatine, and decellularized meniscus-derived extracellular matrix (MD-dECM), and polyurethane (PU) with stiffness levels of 54 and 205 MPa. Both single-material implants and a two-volumetric meniscus model with an SF/gelatine/MD-dECM core and a PU shell were analysed using FEA to simulate the biomechanical performance under physiological conditions.
Arthroscopy
November 2024
Advanced Orthopedic Sports Medicine Specialists Denver, Colorado, U.S.A.
Purpose: To evaluate the clinical outcomes in the use of a synthetic medial meniscus implant in patients symptomatic after medial meniscectomy and not responsive to nonoperative treatment.
Methods: This single-arm, multicenter, prospective study enrolled subjects between ages 30 and 75 with postmeniscectomy pain. Changes from baseline to 24 months were measured in the pain subscale of the knee injury and osteoarthritis outcome score (KOOS) and in KOOS overall (average of all 5 subscales) in patients that had received a medial meniscus implant.
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