VA conceived the idea for the study and supervised the whole study process. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. 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]. Am J Sports Med 48(13):31633169, Bin SI, Nha KW, Cheong JY, Shin YS (2018) Midterm and long-term results of medial versus lateral meniscal allograft transplantation: a meta-analysis. How can I strengthen my knee meniscus? Reference article, Radiopaedia.org (Accessed on 01 May 2023) https://doi.org/10.53347/rID-70702. Where possible, doctors will recommend nonsurgical forms of treatment. Symptoms include pain in the hip or stiffness. Correspondence to Arthroscopy 31(12):2380-2391.e2, Ren S, Zhang X, You T, Jiang X, Jin D, Zhang W (2018) Clinical and radiologic outcomes after a modified bone plug technique with anatomical meniscal root reinsertion for meniscal allograft transplantation and a minimum 18-month follow-up. The early results of MAT are encouraging, as pain relief and improved knee function are reported [15,16,17, 62, 104,105,106,107,108,109]. Although meta-analyses validate the superiority of root repair over partial meniscectomy in terms of clinical outcomes, they also highlight the inability of root repair to successfully reduce ME [68, 69]. 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. Getting hit or tackled can make you twist your knee, tearing the cartilage. It is known that ACL and meniscal function cannot be fully restored even after surgical repair [86, 90]. Causes of the injury include trauma and degenerative changes to the knee joint. Knee 27(5):15601566, Zheng T, Song G, Li Y, Zhang Z, Ni Q, Cao Y et al (2021) Clinical, radiographic, and arthroscopic outcomes of surgical repair for radial and avulsed lesions on the lateral meniscus posterior root during ACL reconstruction: a systematic review. People with arthritis in their knees are also more prone to meniscus tears. It has been suggested that a 510% reduction of implant size from the estimated one reduces postoperative extrusion [2, 105, 123]. Generally speaking, the treatment options for meniscus tears include: rest, physical therapy, activity modification, and occasionally a surgery we refer to as an The inner two-thirds of the meniscus, however, lacks a blood supply. [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. More serious meniscus tears may not heal on their own. Experts say choosing between knee repair and knee reconstruction surgery isn't a simple decision. TK and DG designed the manuscript and helped to draft the manuscript and review it. J Orthop Res Off Publ Orthop Res Soc 24(6):12081217, Wenger A, Englund M, Wirth W, Hudelmaier M, Kwoh K, Eckstein F et al (2012) Relationship of 3D meniscal morphology and position with knee pain in subjects with knee osteoarthritis: a pilot study. Recovery after a meniscectomy takes 36 weeks, and recovery after a meniscus repair takes 36 months. People who play sports (like tennis, soccer, basketball or football) that involve sudden twisting movements are most likely to tear a meniscus. Here's what you need to know as well as a chart. A hip labral tear can be caused by injury, structural problems, or degenerative issues. X-rays are useful in finding other causes of knee pain, but they will not show a meniscus tear. Knee 23(4):627630, Ishii Y, Ishikawa M, Kurumadani H, Hayashi S, Nakamae A, Nakasa T et al (2020) Increase in medial meniscal extrusion in the weight-bearing position observed on ultrasonography correlates with lateral thrust in early-stage knee osteoarthritis. A tear can result from a trauma, such as twisting the leg, or age-related degeneration of the knee joint. On imaging, it is often seen as a meniscal loss with the destruction of expected architecture. A person may feel a pop when they tear the meniscus. Torn Meniscus | Johns Hopkins Medicine Knee Surg Sports Traumatol Arthrosc 27(10):33113317, Costa CR, Morrison WB, Carrino JA (2004) Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear? If your injury doesnt improve with RICE, NSAIDs and physical therapy, your healthcare provider may recommend arthroscopic surgery. Semin Arthritis Rheum 45(3):257267, Liu Y, Joseph GB, Foreman SC, Li X, Lane NE, Nevitt MC et al (2020) Determining a threshold of medial meniscal extrusion for prediction of knee pain and cartilage damage progression over 4 years: data from the osteoarthritis initiative. Knee Surg Sports Traumatol Arthrosc 29(4):11971205, Song JH, Bin SI, Kim JM, Lee BS (2020) Postoperative subchondral bone marrow lesion is associated with graft extrusion after lateral meniscal allograft transplantation. Knee 24(6):14081413, Phua JKS, Razak HRBA, Mitra AK (2020) Arthroscopic procedures could delay the need for a subsequent knee arthroplasty in older patients with end-stage osteoarthritis. Treatment usually starts with the RICE method: Rest. WebYour doctor will remove a piece of the torn meniscus so your knee can function normally. However, the incidence of severe knee OA is much higher in patients who have been subjected to ACLR than individuals with intact ACL [86, 87]. 2017;25(1):76-84. Today, in general, doctors recommend conservative treatment, not surgery, when meniscus tears result from degeneration. 29(4):295301, Moon HS, Choi CH, Jung M, Lee DY, Hong SP, Kim SH (2020) Early surgical repair of medial meniscus posterior root tear minimizes the progression of meniscal extrusion: 2-year follow-up of clinical and radiographic parameters after arthroscopic transtibial pull-out repair. Sometimes, degeneration from arthritis causes a tear, even without a knee injury. Meniscus tears are the most frequently treated knee injuries. This value is identified as the optimal cutoff point for a complete PRT of the LM and has 100% sensitivity and 83% specificity [92]. Feeling like your knee might give out beneath you. Last medically reviewed on February 8, 2022, The knee is one of the body's more complicated joints and is susceptible to various injuries. Although meniscal allografts that are secured with the suture-only technique tend to show a greater degree of extrusion than the bony-fixation techniques, bony-fixation techniques still show high extrusion rates (2550%). ME is strongly correlated with posterior root tears of the menisci [6]. In a biomechanical study, Paletta et at. Osteoarthritis Cartilage 25(7):10761083, Naredo E, Cabero F, Palop MJ, Collado P, Cruz A, Crespo M (2005) Ultrasonographic findings in knee osteoarthritis: a comparative study with clinical and radiographic assessment. CARTILAGE 21:1947603520934525, Lee DH, Lee BS, Kim JM, Yang KS, Cha EJ, Park JH et al (2011) Predictors of degenerative medial meniscus extrusion: radial component and knee osteoarthritis. Arthritis Rheum 64(6):18881898, Kim DH, Lee GC, Kim HH, Cha DH (2020) Correlation between meniscal extrusion and symptom duration, alignment, and arthritic changes in medial meniscus posterior root tear: research article. Careful preoperative planning for correct sizing and accurate placement of the allograft is critical for preventing ME. Int J Rheum Dis 17(5):536540, PubMed Conversely, since tears within the white zone have only a limited blood supply, they do not heal on their own and do not respond to conservative treatment. 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. A systematic review of radiological outcomes. Arch Orthop Trauma Surg 132(3):321327, Kamatsuki Y, Furumatsu T, Fujii M, Kodama Y, Miyazawa S, Hino T et al (2018) Complete tear of the lateral meniscus posterior root is associated with meniscal extrusion in anterior cruciate ligament deficient knees. MPRT are defined as an avulsion fracture or a radial lesion occurring within 1cm of the bony tibial attachment [56]. People whose cartilage wears down (due to age or arthritis) can tear a meniscus from a motion as simple as stepping on an uneven surface. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction. Post-ACLR ME is also a concern and should be prevented by repairing concurrent meniscal tears and centralizing the meniscus along with the ACLR. It can happen playing sports, exercising or just doing daily activities. A nonsurgical treatment approach typically involves rest and avoiding activities that trigger symptoms.

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