The Double-Edged Sword: Anterior Cruciate Ligament Reconstructions on Adolescent Patients-Growth Plate Surgical Challenges and Future Considerations.

The management of anterior cruciate ligament (ACL) injuries in pediatric patients presents unique challenges due to the presence of open growth plates in the proximal tibia and distal femur. Delaying ACL reconstruction until skeletal maturity may protect the physes but increases the risk of secondary injuries, such as meniscal tears and chondral damage, due to prolonged joint instability. Conversely, early surgical intervention restores knee stability but raises concerns about potential growth disturbances, including leg-length discrepancies and angular deformities.

Intra-articular Injections of CXCR4-Overexpressing Human Cartilage-Derived Progenitor Cells Improve Meniscus Healing and Protect Against Posttraumatic Osteoarthritis in Immunocompetent Rabbits.

Background: Meniscal injuries that fail to heal instigate catabolic changes in the knee's microenvironment, posing a high risk for developing posttraumatic osteoarthritis (PTOA). Previous research has suggested that human cartilage-derived progenitor cells (hCPCs) can stimulate meniscal repair in a manner that depends on stromal cell-derived factor 1 (SDF-1) pathway activity.

Hypothesis: Overexpressing the SDF-1 receptor CXCR4 in hCPCs will increase cell trafficking and further improve the repair efficacy of meniscal injuries.

A Systematic Review and Meta-Analysis of Medial Meniscus Root Tears: Is Surgery the Key to Better Outcomes?

Medial meniscus root tears (MMRTs) are serious injuries that disrupt knee biomechanics, often accelerating cartilage degeneration and osteoarthritis when left untreated. These injuries are increasingly recognized as a major cause of knee pain and functional limitations, particularly among middle-aged and older adults. This systematic review and meta-analysis aimed to evaluate the outcomes of conservative management compared to surgical intervention for MMRT, focusing on pain relief, functional recovery, and the progression of osteoarthritis.

The effect of supplementation with type I and type III collagen peptide and type II hydrolyzed collagen on pain, quality of life and physical function in patients with meniscopathy: a randomized, double-blind, placebo-controlled study.

Background: Menisci, one of the most important anatomical structures of the knee joint, plays a role in load transfer, stability, shock absorption, prevention of articular cartilage degeneration, and proprioception. Type I collagen, the main component of the meniscus, and type II collagen fibers play an important role in the stability of the knee joint. This study aimed to evaluate the effects of Naturagen® 4 Joint product containing type I, II, and III collagen on pain, quality of life, and physical functions in patients with meniscopathy.

Association of Smokeless Tobacco Use With Perioperative Complications and Revision Surgery After Anterior Cruciate Ligament Reconstruction.

Background: Tobacco use is a known modifiable risk factor for postoperative complications and revision surgery after anterior cruciate ligament reconstruction (ACLR). Previous studies focus on tobacco as a broad categorization of traditional smoking, smokeless tobacco, and other forms of nicotine use. It is unclear if differences in the type of nicotine used lead to similar adverse outcomes after ACLR.

Research on the application effect of arthroscopic access modification in meniscal injury repair.

Objective: To investigate the application value of arthroscopic channel modification in meniscal injury repair.

Methods: We retrospectively analyzed the data of 100 patients with meniscus injuries treated with knee arthroscopy from December 2022 to December 2023 and divided them into a control group and a modified group according to the application of "arthroscopic access modification technology". We compared the operation time, postoperative hospitalization time, VAS score, Lysholm knee function score, postoperative complications, and postoperative images of the patients in these two groups.

Longitudinal Changes in Medial Meniscal Extrusion After ACL Injury and Reconstruction and Its Relationship With Cartilage Degeneration Assessed Using MRI-Based T1ρ and T2 Analysis.

Background: Anterior cruciate ligament (ACL) injury often leads to posttraumatic osteoarthritis (PTOA), despite ACL reconstruction (ACLR). Medial meniscal extrusion (MME) is implicated in PTOA progression but remains understudied after ACL injury and ACLR.

Hypothesis/purpose: It was hypothesized that MME would increase longitudinally after ACL injury and ACLR, with greater changes in the ipsilateral knee compared with the contralateral knee, leading to cartilage degeneration.

Return to Sport After ACL Reconstruction With Meniscal Allograft Transplantation Versus Isolated ACL Reconstruction: A Matched-Cohort Study.

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.

Epidemiology and Characteristics of Meniscal Tears in Patients With Combined ACL and Medial Collateral Ligament Injuries Versus Isolated ACL Tears: A Case-Control Study From the Francophone Arthroscopic Society.

Background: The co-occurrence of anterior cruciate ligament (ACL) rupture with medial collateral ligament (MCL) rupture is a compound injury that can be associated with meniscal tears.

Purpose: To report the characteristics of meniscal tears in knees with isolated ACL versus combined ACL and MCL injuries, analyzing their frequency, distribution by site, and lesion type.

Study Design: Cross-sectional study; Level of evidence, 3.

Response to Letter to the Editor Regarding "Early Surgery Versus Exercise Therapy and Patient Education for Traumatic and Nontraumatic Meniscal Tears in Young Adults: An Exploratory Analysis From the Dream Trial".

Author response to the Letter to the Editor-in-Chief "Letter to the Editor Regarding "Early Surgery Versus Exercise Therapy and Patient Education for Traumatic and Nontraumatic Meniscal Tears in Young Adults-an Exploratory Analysis From the DREAM Trial"" .

Letter to the Editor Regarding "Early Surgery Versus Exercise Therapy and Patient Education for Traumatic and Nontraumatic Meniscal Tears in Young Adults: An Exploratory Analysis From the DREAM Trial".

Letter to the Editor-in-Chief in response to article "Early Surgery Versus Exercise Therapy and Patient Education for Traumatic and Nontraumatic Meniscal Tears in Young Adults-an Exploratory Analysis From the DREAM Trial" by Damsted et al. .

Medial and Lateral Meniscus Root Tear: Etiopathogenesis and Morphological Pattern in Indian Population.

Objective: This study aims to enhance our understanding of the morphological pattern, causes and pathogenesis of meniscal root injuries in the Indian population.

Materials And Methods: Sixty-four patients with meniscus root tears were included in the study. The patients were categorized into two groups based on the location of the meniscus tear: Group 1 ( = 41) comprised patients with lateral meniscus root injury (LMRI), and Group 2 ( = 23) included patients with medial meniscus root injury (MMRI).

Greater Rotational Knee Laxity Observed at Second-Look Arthroscopy in Patients With Failed Meniscal Repair Performed at the Time of Anterior Cruciate Ligament Reconstruction.

Purpose: To evaluate the healing of meniscal repair performed concomitantly with anterior cruciate ligament reconstruction (ACLR) using second-look arthroscopy, as well as the relationship between meniscal healing and knee laxity using quantitative evaluation under anesthesia.

Methods: This retrospective study included patients who underwent primary double-bundle ACLR with meniscal repair between June 2016 and June 2021, with a 2-year minimum follow-up. Meniscal healing was evaluated by second-look arthroscopy at least 1 year postoperatively, and knee laxity was measured under general anesthesia preoperatively, intraoperatively, and at second-look arthroscopy.

Efficacy of Arthroscopic Meniscal Surgery Versus Conservative Management on Knee Pain and Functional Outcomes: A Meta-Analysis of Randomized Controlled Trials.

Knee pain is a prevalent issue among older adults, often resulting from degenerative joint changes, and significantly impacts functionality and quality of life. While arthroscopic meniscal surgery is a common intervention for managing knee pain, its effectiveness compared to conservative treatments remains debated. This meta-analysis aims to compare the efficacy of arthroscopic meniscal surgery versus conservative management in alleviating knee pain and enhancing functional outcomes in patients with degenerative meniscal tears.

Arteriovenous fistula and pseudoaneurysm in a pediatric patient with persistent postoperative hemarthrosis: A rare complication following arthroscopic repair of a bucket handle medial meniscal tear.

This case report highlights a rare complication of arthroscopic meniscal tear which is an arteriovenous fistula and pseudoaneurysm of the superior medial geniculate artery. A 14-year-old male patient presented with persistent hemarthrosis following arthroscopic repair of a bucket handle medial meniscal tear. The patient was investigated due to suspicion of vascular damage.

The rat osteoarthritis bone score for histological pathology relevant to human bone marrow lesions and pain.

Objectives: Histological osteochondral characteristics of inflammation, fibrosis, vascularity, cartilage islands, vessels entering cartilage, thickened trabeculae and cysts are associated with bone marrow lesions (BMLs) in human knee osteoarthritis (OA). We identified and developed a method for scoring comparable pathology in two rat OA knee pain models.

Methods: Rats (n ​= ​8-10 per group) were injected with monoiodoacetate (MIA) or saline, or underwent meniscal transection (MNX) or sham surgery.

Vascular Smooth Muscle Cells Transdifferentiate into Chondrocyte-Like Cells and Facilitate Meniscal Fibrocartilage Regeneration.

The effective and translational strategy to regenerate knee meniscal fibrocartilage remained challenging. Herein, we first identified vascular smooth muscle cells (VSMCs) transdifferentiated into fibrochondrocytes and participated in spontaneous meniscal regeneration using smooth muscle cell lineage tracing transgenic mice meniscal defect model. Then, we identified low-intensity pulsed ultrasound (LIPUS) acoustic stimulus enhanced fibrochondrogenic transdifferentiation of VSMCs in vitro and in vivo.

Arthroscopic Anterior-Row Fixation for Anterior Cruciate Ligament Avulsion Injuries.

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.

Medial Meniscus Repair Using "AJStitch": A Cost-Effective All-Inside All-Suture Meniscal Repair System.

All-inside techniques are based on devices that use PEEK (polyether ether ketone) or biocomposite anchors placed at extracapsular locations such as anchorage points over which the sutures are tied. However, because of complications like irritability and intra-articular migration of these hard anchors, suture-based all-inside meniscal repair systems are now gaining popularity. Although these devices have advantages over conventional all-inside devices, they are costly, thus limiting their widespread use.

Transtibial Pullout for Medial Meniscus Posterior Root Reconstruction With Split-Gracilis Autograft.

Meniscal root tears are recognized as an important pathology. Failure to recognize and to treat this pathology could lead to early-onset osteoarthritis, similar to a total meniscectomy. Surgical treatment is essential to restore meniscal function and to normalize compartment contact pressures, whenever there is joint overload and not severe cartilaginous damage.

Posterior Meniscal Root Repair with Epidural Needle through the Combination of Arthroscopic Portals and Transtibial Tunnel.

Posterior meniscal root repair is an expensive procedure because its performance often requires the use of specific devices. This issue is a limiting factor, especially in the public health system. Given this context, the development of alternative methods to treat these injuries became necessary.

Effect of Anatomic Variations in the Anterior Tibial Artery on Risk of Injury During Orthopaedic Knee Surgeries.

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.

Comparing Postoperative Outcomes of Isolated Anterior Cruciate Ligament Reconstruction and the "Terrible Triad" Anterior Cruciate Ligament Reconstruction With Medial Meniscus Ramp and Lateral Meniscus Root Repairs.

Background: A new "terrible triad" has been reported to be an anterior cruciate ligament (ACL) tear with a concomitant medial meniscus ramp tear and lateral meniscus root tear. Patient-reported outcomes (PROs) for isolated ACL reconstruction (ACLR) versus an ACLR with concomitant medial meniscus ramp and lateral meniscus root repairs are not well known.

Purpose: To compare postoperative outcomes between isolated ACLR and ACLR with concomitant medial meniscus ramp and lateral meniscus root repairs.

Meniscal tear analysis in anterior cruciate ligament rupture: A retrospective comparison of early versus delayed intervention.

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).

Increased Lateral Femoral Condyle Ratio Is Associated With a Greater Risk of Anterior Cruciate Ligament Injury and Concomitant Anterolateral Ligament and Meniscus Injuries.

Purpose: To investigate whether lateral femoral condyle ratio (LFCR) and lateral femoral condyle index (LFCI) were associated with a greater risk of anterior cruciate ligament (ACL) injury and concomitant injuries.

Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered on PROSPERO. PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to April 1, 2024.