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Meniscal Lesions Today: Evidence for Treatment

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Part of the book series: European Instructional Lectures ((EICL,volume 13))

Abstract

There is not just one but many methods of meniscal tears treatment.

When an Orthopaedic surgeon is faced with a meniscal lesion that is assumed to be responsible for the patient’s symptoms, two fundamental questions need to be answered [1]: is it necessary to treat this lesion surgically? Refraining from operative treatment must be seriously considered; and [2] if there is a need for surgical treatment, should meniscectomy or meniscal repair be performed?

The most important guideline in the decision-making process is the principle of meniscal sparing. Therefore, meniscectomy should only be contemplated when neither of the above options is applicable.

Two completely different conditions have to be considered: traumatic lesions, associated or not with an anterior cruciate ligament tear, and degenerate meniscal lesions.

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References

  1. Ahn JH, Wang JH, Yoo JC (2004) Arthroscopic all-inside suture repair of medial meniscus lesion in anterior cruciate ligament – deficient knees: results of second-look arthroscopies in 39 cases. Arthroscopy 20:936–945

    PubMed  Google Scholar 

  2. Arnoczky SP, Cooper TG, Stadelmaier DM, Hannafin JA (1994) Magnetic resonance signals in healing menisci: an experimental study in dogs. Arthroscopy 10:552–557

    Article  PubMed  CAS  Google Scholar 

  3. Bach BR Jr, Dennis M, Balin J, Hayden J (2005) Arthroscopic meniscal repair: analysis of treatment failures. J Knee Surg 18:278–284

    Article  PubMed  Google Scholar 

  4. Beaufils P, Cassard X (2004) Meniscal repair. Rev Chir Orthop Reparatrice Appar Mot 90:3S49–3S75

    PubMed  Google Scholar 

  5. Beaufils P, Hulet C, Dhénain M, Nizard R, Nourissat G, Pujol N (2009) Clinical practice guidelines for the management of meniscal lesions and isolated lesions of the anterior cruciate ligament of the knee in adults. Orthop Traumatol Surg Res 95:437–442

    Article  PubMed  CAS  Google Scholar 

  6. Beaufils P (2010) Synthesis – indications. In: Beaufils P, Verdonk R (eds) The meniscus. Springer, Berlin/New York, pp 235–238

    Chapter  Google Scholar 

  7. Biedert RM (2000) Treatment of intrasubstance meniscal lesions: a randomized prospective study of four different methods. Knee Surg Sports Traumatol Arthrosc 8:104–108

    Article  PubMed  CAS  Google Scholar 

  8. Bhattacharyya T, Gale D, Dewire P, Totterman S, Gale ME, McLaughlin S et al (2003) The clinical importance of meniscal tears demonstrated by magnetic resonance imaging in osteoarthritis of the knee. J Bone Joint Surg Am 85A:4–9

    Google Scholar 

  9. Chatain F, Robinson AH, Adeleine P, Chambat P, Neyret P (2001) The natural history of the knee following arthroscopic medial meniscectomy. Knee Surg Sports Traumatol Arthrosc 9:15–18

    Article  PubMed  CAS  Google Scholar 

  10. Costa CR, Morrison WB, Carrino JA (2004) Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear? AJR Am J Roentgenol 183:17–23

    Article  PubMed  Google Scholar 

  11. Eggli S, Wegmuller H, Kosina J, Huckell C, Jakob RP (1995) Long-term results of arthroscopic meniscal repair. An analysis of isolated tears. Am J Sports Med 23:715–720

    Article  PubMed  CAS  Google Scholar 

  12. Englund M, Roos EM, Lohmander LS (2003) Impact of type of meniscal tear on radiographic and symptomatic knee osteoarthritis: a sixteen-year follow up of meniscectomy with matched controls. Arthritis Rheum 48:2178

    Article  PubMed  CAS  Google Scholar 

  13. Fairbank TJ (1948) Knee joint changes after meniscectomy. J Bone Joint Surg Am 30B:664–670

    CAS  Google Scholar 

  14. Haas AL, Schepsis AA, Hornstein J, Edgar CM (2005) Meniscal repair using the FasT-Fix all-inside meniscal repair device. Arthroscopy 21:167–175

    Article  PubMed  Google Scholar 

  15. Hede A, Hempel-Poulsen S, Jensen JS (1990) Symptoms and level of sports activity in patients awaiting arthroscopy for meniscal lesions of the knee. J Bone Joint Surg Am 72A:550–552

    Google Scholar 

  16. Herrlin S, Hallander M, Wanger P, Weidenhielm L, Werner S (2007) Arthroscopic or conservative treatment of degenerative medial meniscal tears: a prospective randomised trial. Knee Surg Sports Traumatol Arthrosc 15:393–401

    Article  PubMed  Google Scholar 

  17. Horibe S, Shino K, Maeda A, Nakamura N, Matsumoto N, Ochi T (1996) Results of isolated meniscal repair evaluated by second-look arthroscopy. Arthroscopy 12:150–155

    Article  PubMed  CAS  Google Scholar 

  18. Kotsovolos ES, Hantes ME, Mastrokalos DS, Lorbach O, Paessler HH (2006) Results of all-inside meniscal repair with the FasT-Fix meniscal repair system. Arthroscopy 22:3–9

    Article  PubMed  Google Scholar 

  19. Koukoulias N, Papastergiou S, Kazakos K, Poulios G, Parisis K (2007) Clinical results of meniscus repair with the meniscus arrow: a 4- to 8-year follow-up study. Knee Surg Sports Traumatol Arthrosc 15:133–137

    Article  PubMed  Google Scholar 

  20. Lozano J, Ma CB, Cannon WD (2007) All-inside meniscus repair: a systematic review. Clin Orthop Relat Res 455:134–141

    Article  PubMed  Google Scholar 

  21. Majewski M, Stoll R, Widmer H, Muller W, Friederich NF (2006) Midterm and long-term results after arthroscopic suture repair of isolated, longitudinal, vertical meniscal tears in stable knees. Am J Sports Med 34:1072–1076

    Article  PubMed  Google Scholar 

  22. Moseley JB, O’Malley K, Petersen NJ, Menke TJ, Brody BA, Kuykendall DH et al (2002) A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med 347(2):81–88

    Article  PubMed  Google Scholar 

  23. Noble J, Erat K (1980) In defense of the meniscus. J Bone Joint Surg 62A:7–11

    Google Scholar 

  24. Pujol N, Panarella L, Ait Si Selmi T, Neyret P, Fithian D, Beaufils P (2008) Meniscal healing after meniscus repair: a CT arthrography assessment. Am J Sports Med 36:1489–1495

    Article  PubMed  Google Scholar 

  25. Pujol N, Beaufils P (2009) Healing results of meniscal tears left in situ during anterior cruciate ligament reconstruction: a review of clinical studies. Knee Surg Sports Traumatol Arthrosc 17:396–401

    Article  PubMed  Google Scholar 

  26. Pujol N (2010) Meniscus repair. In: Beaufils P, Verdonk R (eds) The meniscus. Springer, Berlin/New York, pp 229–234

    Chapter  Google Scholar 

  27. Pujol N, Barbier O, Boisrenoult P, Beaufils P (2011) Amount of meniscal resection after failed meniscal repair. Am J Sports Med 39:1648–1652

    Article  PubMed  Google Scholar 

  28. Pujol N, Bohu Y, Boisrenoult P, Makdes A, Beaufils P (2012) Clinical outcomes of open meniscal repair of horizontal meniscal tears in young patients. Knee Surg Sports Traumatol Arthrosc 2012 Jun 14 [Epub ahead of print]

    Google Scholar 

  29. Rockborn P, Gillquist J (2000) Results of open meniscus repair. Long-term follow-up study with a matched uninjured control group. J Bone Joint Surg Br 82:494–498

    Article  PubMed  CAS  Google Scholar 

  30. Rockborn P, Messner K (2000) Long-term results of meniscus repair and meniscectomy: a 13-year functional and radiographic follow-up study. Knee Surg Sports Traumatol Arthrosc 8:2–10

    Article  PubMed  CAS  Google Scholar 

  31. Shelbourne KD, Dersam MD (2004) Comparison of partial meniscectomy versus meniscus repair for bucket-handle lateral meniscus tears in anterior ­cruciate ligament reconstructed knees. Arthroscopy 20:581–585

    Article  PubMed  Google Scholar 

  32. Siebold R, Dehler C, Boes L, Ellermann A (2007) Arthroscopic all-inside repair using the meniscus arrow: long-term clinical follow-up of 113 patients. Arthroscopy 23:394–399

    Article  PubMed  Google Scholar 

  33. Siparsky P, Ryzewicz M, Peterson B, Bartz R (2007) Arthroscopic treatment of osteoarthritis of the knee: are there any evidence-based indications? Clin Orthop Relat Res 455:107–112

    Article  PubMed  Google Scholar 

  34. Smillie IS (1978) Injuries of the knee joint, 4ème edth edn. Churchill Livingstone, Edinburgh

    Google Scholar 

  35. Steenbrugge F, Van Nieuwenhuyse W, Verdonk R, Verstraete K (2005) Arthroscopic meniscus repair in the ACL-deficient knee. Int Orthop 29:109–112

    Article  PubMed  CAS  Google Scholar 

  36. Steenbrugge F, Verdonk R, Verstraete K (2002) Long-term assessment of arthroscopic meniscus repair: a 13-year follow-up study. Knee 9:181–187

    Article  PubMed  Google Scholar 

  37. Stein T, Mehling AP, Welsch F, von Eisenhart-Rothe R, Jäger A (2010) Long-term outcome after arthroscopic meniscal repair versus arthroscopic partial meniscectomy for traumatic meniscal tears. Am J Sports Med 38:1542–1548

    Article  PubMed  Google Scholar 

  38. Tuckman DV, Bravman JT, Lee SS, Rosen JE, Sherman OH (2006) Outcomes of meniscal repair: minimum of 2-year follow-up. Bull Hosp Jt Dis 63:100–104

    PubMed  Google Scholar 

  39. van Trommel MF, Simonian PT, Potter HG, Wickiewicz TL (1998) Different regional healing rates with the outside-in technique for meniscal repair. Am J Sports Med 26:446–452

    PubMed  Google Scholar 

  40. Venkatachalam S, Godsiff SP, Harding ML (2001) Review of the clinical results of arthroscopic meniscal repair. Knee 8:129–133

    Article  PubMed  CAS  Google Scholar 

  41. Vyas D, Harner CD (2012) Meniscus root repair. Sports Med Arthrosc 20:86–94

    Article  PubMed  Google Scholar 

  42. Weiss CB, Lundberg M, Hamberg P, DeHaven KE, Gillquist J (1989) Non-operative treatment of meniscal tears. J Bone Joint Surg Am 71A:811–822

    Google Scholar 

  43. Zanetti M, Pfirrmann CW, Schmid MR, Romero J, Seifert B, Hodler J (2003) Patients with suspected meniscal tears: prevalence of abnormalities seen on MRI of 100 symptomatic and 100 contralateral asymptomatic knees. Am J Roentgenol 181:635–641

    Article  Google Scholar 

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Correspondence to Philippe Beaufils .

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Beaufils, P., Pujol, N., Boisrenoult, P. (2013). Meniscal Lesions Today: Evidence for Treatment. In: Bentley, G. (eds) European Instructional Lectures. European Instructional Lectures, vol 13. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36149-4_19

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  • DOI: https://doi.org/10.1007/978-3-642-36149-4_19

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