Clin Anat N Y N 28(6):792799, Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA et al (2019) OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. The rubbery wedges of cartilage act like shock absorbers for your knee, providing cushioning for your bones and knee joint. There is no established optimal surgical technique at present for restoring ME to normal values, and thus there will be a strong need for more effective and refined techniques. ME is strongly correlated with posterior root tears of the menisci [6]. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 24(9):29232935, Lee SM, Bin SI, Kim JM, Lee BS, Lee CR, Son DW et al (2019) Long-term outcomes of meniscal allograft transplantation with and without extrusion: mean 12.3-year follow-up study. For a simple tear here, doctors may advise a short course of rest and physical therapy to see whether spontaneous healing occurs. The injury also commonly affects older people and those with arthritis in their knees. PubMed (2017). To perform this exercise, a person should follow these steps: An advanced exercise routine may include an exercise that involves partially bending the knee. Accessed 22 May 2021. Antony B, Driban J, Price L et al. Meniscus tear surgery is very common, with about 850,000 surgeries performed each year in the United States. a Meniscotibial ligament repair with three interconnected suture anchors, b centralization with a transtibial tunnel or c with isolated suture anchors (usually with two or three suture anchors). After healing occurs, a doctor will recommend a rehabilitation program of exercises to improve range of motion and strength. The Relationship Between Meniscal Pathology and Osteoarthritis Depends on the Type of Meniscal Damage Visible on Magnetic Resonance Images: Data from the Osteoarthritis Initiative. The ACL is the main restrictor in the anterior tibial translation, while the posterior part of the medial meniscus (MM) acts as a secondary stabilizer [83, 84]. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 28(4):11771194, Swamy N, Wadhwa V, Bajaj G, Chhabra A, Pandey T (2018) Medial meniscal extrusion: detection, evaluation and clinical implications. But you can reduce your risk of a torn meniscus if you: Most people who tear a meniscus can return to full activity. J Knee Surg. Associations. Knee Surg Sports Traumatol Arthrosc 26(3):781786, Krych AJ, Reardon PJ, Johnson NR, Mohan R, Peter L, Levy BA et al (2017) Non-operative management of medial meniscus posterior horn root tears is associated with worsening arthritis and poor clinical outcome at 5-year follow-up. Wear athletic shoes that are appropriate for the sport youre doing. The outer one-third of the meniscus has a blood supply, and so doctors refer to this area as the red zone. We avoid using tertiary references. Work up slowly to more intense exercise activity. Arthroscopic partial meniscectomy The goal of this Am J Sports Med 47(4):815821, Son DW, Bin SI, Kim JM, Lee BS, Lee CR, Park JG et al (2021) Extrusions do not affect degenerative morphologic changes in lateral meniscus allografts during midterm follow-ups. Correct estimation of the allograft size is also important. (2017). Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 26(12):16331640, Jang SH, Kim JG, Ha JG, Shim JC (2011) Reducing the size of the meniscal allograft decreases the percentage of extrusion after meniscal allograft transplantation. JBJS Rev 4(8):e4, Kodama Y, Furumatsu T, Masuda S, Okazaki Y, Kamatsuki Y, Okazaki Y et al (2020) Transtibial fixation for medial meniscus posterior root tear reduces posterior extrusion and physiological translation of the medial meniscus in middle-aged and elderly patients. See this post to learn more about how a meniscus functions, As mentioned in my recent post, the majority of posterior horn tears are determined to be degenerative. The primary site of destruction is the soft tissue fibers which couple the deep layers of the ACL to the LM and the LM to the tibial plateau. Therefore, care should be taken to manage it appropriately and successfully reduce it. Google Scholar, Okada K, Yamaguchi S, Sato Y, Enomoto T, Ogawa Y, Ohtori S et al (2019) Comparison of meniscal extrusion and osteophyte formation at the intercondylar notch as a predictive biomarker for incidence of knee osteoarthritis-Data from the Osteoarthritis Initiative-. A Meta-analysis Am J Sports Med 46(9):22852290, Smith NA, Parkinson B, Hutchinson CE, Costa ML, Spalding T (2016) Is meniscal allograft transplantation chondroprotective? The results as to which technique is superior to the others remain controversial. The knee meniscus: Management of traumatic tears and degenerative lesions. There were 6 patients with AHLM cysts in macerated tear group and one patient in vertical tear group. A narrative review with focus on relevance for osteoarthritis research. Am J Sports Med 46(5):12431250, Noyes FR, Barber-Westin SD (2016) Long-term survivorship and function of meniscus transplantation. Knee Surg Sports Traumatol Arthrosc 19(2):222229, Oo WM, Linklater JM, Bennell KL, Pryke D, Yu S, Fu K et al (2021) Are OMERACT knee osteoarthritis ultrasound scores associated with pain severity, other symptoms, and radiographic and magnetic resonance imaging findings? Correspondence to Am J Sports Med 45(4):900908, Yoon JR, Kim TS, Lee YM, Jang HW, Kim YC, Yang JH (2011) Transpatellar approach in lateral meniscal allograft transplantation using the keyhole method: can we prevent graft extrusion? A systematic review of radiological outcomes. J Orthop Res Off Publ Orthop Res Soc 36(7):18941900, Kodama Y, Furumatsu T, Miyazawa S, Fujii M, Tanaka T, Inoue H et al (2017) Location of the tibial tunnel aperture affects extrusion of the lateral meniscus following reconstruction of the anterior cruciate ligament. Slowly lower the body, keeping the foot flat. Moreover, it has been shown that allograft extrusion does not correlate with clinical outcomes and tends to be stable postoperatively during follow-up [62, 108, 113]. This can result from disruption of collagen fibers within the meniscus that provide hoop strength 8.. We, Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. (2017). Treatment usually starts with the RICE method: Rest. Orthop Traumatol Surg Res 105(7):13951399, Everhart JS, Magnussen RA, Abouljoud MM, Regalado LE, Kaeding CC, Flanigan DC (2020) Meniscus tears accelerate joint space loss and lateral meniscal extrusion increases risk of knee arthroplasty in middle-aged adults. You can learn more about how we ensure our content is accurate and current by reading our. WebDamage to the medial meniscus root, for example by a complete radial tear, destroys the ability of the knee to withstand hoop strain, resulting in contact pressure increases and kinematic alterations. Its best to see a doctor as soon as possible: Untreated meniscus tears can get worse, or pieces of the meniscus can shed into the joint. Manage cookies/Do not sell my data we use in the preference centre. https://doi.org/10.1186/s43019-022-00163-1, DOI: https://doi.org/10.1186/s43019-022-00163-1. However, over a long-term period, the degenerative changes in the articular cartilage worsened, especially in the lateral tibial plateau, regardless of the healing status of the meniscus [85, 87, 90]. CAS Feel like your knee locks up or might give way underneath you. The menisci are crescent-shaped, fibrocartilaginous structures that play a crucial role in the load transition and distribution of the contact forces along the tibiofemoral articulation. If you have surgery to remove all or part of your meniscus, you may be at higher risk of developing arthritis down the road. It is often used with chronic degenerative conditions although some authors also propose this term in the setting of a tear (macerated tear)2. Current research has directed its focus to meniscotibial ligaments (MTL), which stabilize on the tibial plateau and centralize the meniscus, as an additional potential causative factor for ME. We also explore recovery and when to contact a doctor. (2012). Arthrosc Tech 10(1):e43e48, Okazaki Y, Furumatsu T, Miyazawa S, Kodama Y, Kamatsuki Y, Hino T et al (2019) Meniscal repair concurrent with anterior cruciate ligament reconstruction restores posterior shift of the medial meniscus in the knee-flexed position. Macerated Skin: Pictures, Causes, Treatment, and [42] found that in knees with the same grade of knee OA, extrusion of the medial meniscus was greater in patients who experienced pain in comparison with painless knee OA. In addition, given that the presence of severe ME promotes rapid progression of knee OA [44, 45], the importance of inhibiting this process and delaying the inevitable total knee replacement (TKR) is critical. J Orthop Surg Hong Kong 28(1):2309499020906745, McCormack DJ, Puttock D, Godsiff SP (2021) Medial compartment osteoarthritis of the knee: a review of surgical options. Can diet help improve depression symptoms? Some clinical studies on its effectiveness exist, but more research is needed. Treatment with glucosamine, chondroitin sulfate and licofelone has (2018). Surgical versus conservative interventions for treating meniscal tears of the knee in adults. However, to date there is still no well-designed clinical trial available to ascertain the effectiveness of centralization in reducing ME. For an athlete, playing through knee pain can cause greater problems later. Experts say choosing between knee repair and knee reconstruction surgery isn't a simple decision. Wang et al. Meniscus tears are very common. Knee Surg Sports Traumatol Arthrosc 28(11):34163425, Stein T, Mehling AP, Welsch F, von Eisenhart-Rothe R, Jger A (2010) Long-term outcome after arthroscopic meniscal repair versus arthroscopic partial meniscectomy for traumatic meniscal tears. Your healthcare provider may recommend taking a nonsteroidal anti-inflammatory (NSAID) medicine (such as ibuprofen or aspirin) to relieve pain and reduce swelling. Rheumatol Oxf Engl 53(9):16251629, Podlipsk J, Koski JM, Kaukinen P, Haapea M, Tervonen O, Arokoski JP et al (2017) Structure-symptom relationship with wide-area ultrasound scanning of knee osteoarthritis. [76] showed that induction of MTL lesions in cadaveric knees resulted in ME after only a few cycles of loading and that repair of the lesion led to a significant reduction of ME. Ice. Am J Sports Med 42(10):23292337, Jauregui JJ, Wu ZD, Meredith S, Griffith C, Packer JD, Henn RF (2018) How should we secure our transplanted meniscus? Moreover, extrusion of the LM does not improve after ACLR unless the meniscal tear is repaired [87, 92]. Straighten the opposite knee using the muscles on the front of the thigh. ME can occur in knee OA [8, 10], and its presence is significantly correlated with increased articular cartilage loss in the tibiofemoral joint and osteophyte formation [29, 30]. [55] verified this hypothesis by performing 66 HTO, where they measured ME with MRI preoperatively and postoperatively, and found that at 6weeks postoperatively, the ME had decreased from a mean of 3.90.6mm to a mean of 0.90.5mm. According to this technique, a more posterolateral position of the tibial tunnel aperture within the ACL footprint reduces the RTD (reference point to tibial tunnel distance) and increases the extrusion of the LM following ACLR [93]. Orthopaedics, University General Hospital of Alexandroupolis, St. Niarhos 1, Dragana, 68100, Alexandroupolis, Greece, Konstantinos G. Makiev,Ioannis S. Vasios&Paraskevas Georgoulas, Orthopaedics, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece, Konstantinos Tilkeridis,Georgios Drosos&Athanasios Ververidis, You can also search for this author in