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Meniscal Root Tear Repair: Why, When and How?

Bonasia DE, Pellegrino P, D'Amelio A, Cottino U, Rossi R - Orthop Rev (Pavia) (2015)

Bottom Line: Although the treatment of meniscal root tears is still controversial, many different techniques have been described for root repair.The goal of this review is to summarize the existing knowledge regarding meniscal root tears, including anatomy, biomechanics and imaging.In addition, the most common surgical techniques, together with the clinical outcomes, are described.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics and Traumatology, CTO Hospital, University of Turin , Italy.

ABSTRACT
The integrity of the meniscal root insertions is fundamental to preserve correct knee kinematics and avoid degenerative changes of the knee. Injuries to the meniscal attachments can lead to meniscal extrusion, decreased contact surface, increased cartilage stress, and ultimately articular degeneration. Recent and well designed studies have clarified the anatomy and biomechanics of the medial and lateral meniscal roots. Although the treatment of meniscal root tears is still controversial, many different techniques have been described for root repair. The goal of this review is to summarize the existing knowledge regarding meniscal root tears, including anatomy, biomechanics and imaging. In addition, the most common surgical techniques, together with the clinical outcomes, are described.

No MeSH data available.


Related in: MedlinePlus

Specimens showing different repair techniques, according to different lesion patterns; A) Avulsion of the posterior root of the lateral meniscus. In this case a pull-out technique can be used. Alternatively a suture anchor technique is an equivalent option. B) Lateral meniscus posterior root radial tear, with preserved tibial attachment. In this case an all-inside side to side suture is recommended. C) Complex T shaped tear of the posterior root of the lateral meniscus. In this cases multiple stitches are required according to the preferred meniscal suturing technique (all-inside, out-in, in-out). M, medial compartment; L, lateral compartment.
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fig004: Specimens showing different repair techniques, according to different lesion patterns; A) Avulsion of the posterior root of the lateral meniscus. In this case a pull-out technique can be used. Alternatively a suture anchor technique is an equivalent option. B) Lateral meniscus posterior root radial tear, with preserved tibial attachment. In this case an all-inside side to side suture is recommended. C) Complex T shaped tear of the posterior root of the lateral meniscus. In this cases multiple stitches are required according to the preferred meniscal suturing technique (all-inside, out-in, in-out). M, medial compartment; L, lateral compartment.

Mentions: Patient’s prepping, positioning, and arthroscopic knee balance is as described for meniscectomy. The tear pattern is evaluated. Depending on the tear pattern, repair techniques include pull-out (transosseous), suture anchors, and side to side repair (Figure 4).47,48 Additional posteromedial and posterolateral portals can be established to facilitate the procedure.


Meniscal Root Tear Repair: Why, When and How?

Bonasia DE, Pellegrino P, D'Amelio A, Cottino U, Rossi R - Orthop Rev (Pavia) (2015)

Specimens showing different repair techniques, according to different lesion patterns; A) Avulsion of the posterior root of the lateral meniscus. In this case a pull-out technique can be used. Alternatively a suture anchor technique is an equivalent option. B) Lateral meniscus posterior root radial tear, with preserved tibial attachment. In this case an all-inside side to side suture is recommended. C) Complex T shaped tear of the posterior root of the lateral meniscus. In this cases multiple stitches are required according to the preferred meniscal suturing technique (all-inside, out-in, in-out). M, medial compartment; L, lateral compartment.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508558&req=5

fig004: Specimens showing different repair techniques, according to different lesion patterns; A) Avulsion of the posterior root of the lateral meniscus. In this case a pull-out technique can be used. Alternatively a suture anchor technique is an equivalent option. B) Lateral meniscus posterior root radial tear, with preserved tibial attachment. In this case an all-inside side to side suture is recommended. C) Complex T shaped tear of the posterior root of the lateral meniscus. In this cases multiple stitches are required according to the preferred meniscal suturing technique (all-inside, out-in, in-out). M, medial compartment; L, lateral compartment.
Mentions: Patient’s prepping, positioning, and arthroscopic knee balance is as described for meniscectomy. The tear pattern is evaluated. Depending on the tear pattern, repair techniques include pull-out (transosseous), suture anchors, and side to side repair (Figure 4).47,48 Additional posteromedial and posterolateral portals can be established to facilitate the procedure.

Bottom Line: Although the treatment of meniscal root tears is still controversial, many different techniques have been described for root repair.The goal of this review is to summarize the existing knowledge regarding meniscal root tears, including anatomy, biomechanics and imaging.In addition, the most common surgical techniques, together with the clinical outcomes, are described.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics and Traumatology, CTO Hospital, University of Turin , Italy.

ABSTRACT
The integrity of the meniscal root insertions is fundamental to preserve correct knee kinematics and avoid degenerative changes of the knee. Injuries to the meniscal attachments can lead to meniscal extrusion, decreased contact surface, increased cartilage stress, and ultimately articular degeneration. Recent and well designed studies have clarified the anatomy and biomechanics of the medial and lateral meniscal roots. Although the treatment of meniscal root tears is still controversial, many different techniques have been described for root repair. The goal of this review is to summarize the existing knowledge regarding meniscal root tears, including anatomy, biomechanics and imaging. In addition, the most common surgical techniques, together with the clinical outcomes, are described.

No MeSH data available.


Related in: MedlinePlus