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Knee medial compartment osteoarthritis is effectively treated by a medial open-wedge high tibial osteotomy (MOWHTO). The feasibility and safety of MOWHTO for mild lateral meniscal tears are unknown. This study examined the feasibility and safety of knee joint weight-bearing line ratio (WBLr) adjustment during MOWHTO with lateral meniscal injuries. We used a healthy adult male's lower extremities computed tomography scans and knee joint magnetic resonance imaging images to create a normal fine element (FE) model. Based on this model, we generated nine FE models for the MOWHTO operation (WBLr: 40–80%) and 15 models for various lateral meniscal injuries. A compressive load of 650N was applied to all cases to calculate the von Mises stress (VMS), and the intact lateral meniscus' maximal VMS at 77.5% WBLr was accepted as the corrective upper limit stress. Our experimental results show that mild lateral meniscal tears can withstand MOWHTO, while severe tears cannot. Our findings expand the use of MOWHTO and provide a theoretical direction for practical decisions in patients with lateral meniscal injuries.

OBJECTIVE: To compare the effect of early meniscal surgery versus exercise and education with the option of later surgery on pain, function, and quality of life in young patients with a meniscal tear, taking symptom onset into account. DESIGN: Randomized controlled trial. METHODS: In a randomized controlled trial (the "Danish RCT on Exercise versus Arthroscopic Meniscal surgery for young adults" [DREAM] trial), 121 patients aged 18-40 years with a magnetic resonance imaging--verified meniscal tear were randomized to surgery or 12 weeks of supervised exercise and patient education. For this exploratory study, the analyses were stratified by symptom onset (traumatic/nontraumatic). The main outcome was the difference in change after 12 months in the mean score of 4 Knee injury and Osteoarthritis Outcome Score subscales (KOOS4) covering pain, symptoms, function in sport and recreation, and quality of life. RESULTS: Forty-two patients (69%) in the exercise therapy group and 47 (78%) in the surgery group were categorized as having a traumatic tear. We observed no difference in change in the KOOS4 after 12 months between the 2 treatment groups for either traumatic tears (18.8 versus 16.0 in the surgery versus exercise therapy groups; adjusted mean difference, 4.8 [95% confidence interval, -1.7 to 11.2]) or nontraumatic tears (20.6 versus 17.3 in the surgery versus exercise therapy groups; adjusted mean difference, 7.0 [95% confidence interval, -3.7 to 17.7]). CONCLUSION: In patients with traumatic and nontraumatic meniscus tears, early meniscal surgery did not appear superior to exercise and education in improving pain, function, and quality of life after 12 months. Further research is needed to confirm the clinical applicability of these findings. [ABSTRACT FROM AUTHOR]

Purpose: Degenerative meniscus tears can cause discomfort in some patients, and when medical treatments fail to provide relief, arthroscopy may be considered before resorting to knee prosthesis. However, the benefits of arthroscopy over nonsurgical treatments in patients over 60 years old are limited, and the evidence regarding its overall efficiency and drawbacks remains scarce. Furthermore, there has been no investigation into whether those patients treated with partial meniscectomy, undergo the knee operation at an earlier stage of osteoarthritis. Methods: This study focused on data from a single Belgian hospital, involving patients over 60 years old with internal meniscal tears. The participants were categorized into two groups based on the treatment they received: arthroscopic partial meniscectomy (APM) or conservative management. The primary outcome assessed was the occurrence of knee arthroplasty within a five year period. Secondary outcomes included evaluating the ICRS cartilage grade and the time taken until total knee arthroplasty (TKA). Results: A total of 194 patients with internal meniscal tears were included in the study. At the 5-year mark, the overall rate of knee arthroplasty was found to be 16.5%, with 11.9% of cases occurring within two years. After the 5-year follow-up, it was observed that 19.2% (24 patients) of the APM group and 11.6% (8 patients) of the conservative management group underwent knee arthroplasty. Notably, patients over 70 years old who underwent APM had a higher risk of eventually requiring TKA compared to those who received conservative management. Additionally, patients who underwent meniscectomy and later underwent TKA showed less wear in the internal compartment of the knee compared to patients in the conservative treatment group who underwent TKA. Conclusion: The study suggests that patients who underwent arthroscopy faced a similar risk of knee arthroplasty compared to those who underwent conservative management, excepted for patients over 70 years old. Despite this similar risk of arthroplasty for the whole population, they exhibited lower osteoarthritis severity when compared to the conservative group. [ABSTRACT FROM AUTHOR]

Background: Extracorporeal shock wave therapy (ESWT) promotes tissue healing by modulating inflammation, which has implications for meniscal tear healing in the avascular zone. Purpose: To evaluate the effects of a single dose of radial ESWT on the healing process and inflammation of the meniscus and knee joints after meniscal tears in the avascular zone. Study Design: Controlled laboratory study. Methods: Avascular tears were induced in the medial meniscus (MM) of 72 Sprague-Dawley rats. One week postoperatively, the rats received a single session of radial ESWT with a Power+ handpiece (ESWT group; n = 36) or with a fake handpiece (sham-ESWT group; n = 36). The rats were then euthanized at 2, 4, or 8 weeks postoperatively. The MMs were harvested for analysis of healing (hematoxylin-eosin, safranin O–Fast Green, and collagen type 2 staining) and inflammation (interleukin [IL]-1β and IL-6 staining). Lateral menisci and synovia were obtained to evaluate knee joint inflammation (enzyme-linked immunosorbent assay of IL-1β and IL-6). Cartilage degeneration was assessed in the femurs and tibial plateaus using safranin O–Fast Green staining. Results: The ESWT group showed significantly better meniscal healing scores than the sham-ESWT group at 4 (P =.0066) and 8 (P =.0050) weeks postoperatively. The IL-1β level was significantly higher in the sham-ESWT group than in the ESWT group at 2 (MM: P =.0009; knee joint: P =.0160) and 8 (MM: P =.0399; knee joint: P =.0001) weeks. The IL-6 level was significantly lower in the sham-ESWT group than in the ESWT group at 2 (knee joint: P =.0184) and 4 (knee joint: P =.0247) weeks but higher at 8 weeks (MM: P =.0169; knee joint: P =.0038). The sham group had significantly higher osteoarthritis scores than the ESWT group at 4 (tibial plateau: P =.0157) and 8 (femur: P =.0048; tibial plateau: P =.0359) weeks. Conclusion: A single dose of radial ESWT promoted meniscal tear healing in the avascular zone, modulated inflammatory factors in the menisci and knee joints in rats, and alleviated cartilage degeneration. Clinical Relevance: Radial ESWT can be considered a potential option for improving meniscal tear healing in the avascular zone because of its ability to modulate inflammation. [ABSTRACT FROM AUTHOR]

Meniscal tears in the inner avascular area have been reported as a common cause of disability in dogs that associated with failure of healing process due to their limited vascularity. In spite of various sterategies were reported for treatment of such tears, their clinical use was limited. Therefore, different biomaterials have been assessed to stimulate regeneration of avascular meniscal tears. Currently, silver nanoparticles (AgNPs) enormously involved in biomedicine including tissue regeneration, drug delivary, and antibacterial applications. Thus, AgNPs was fabricated in the present study to investigate its potential to induce and support meniscal healing process in an avascular meniscal tear model. The nanomaterial was synthesized and characterized using transmission electron microscope (TEM). Next, a full thickness longitudinal meniscal tear was created in the avascular zone and either left empty or treated with AgNPs. Animals were monitored clinically at weeks 3, 6, 9, and 12 weeks after surgery for lameness parameters including lameness during walking, pain on manipulation, range of motion, and functional disability. Additionally, the harvested menisci were examined macroscopically and histologically at 4, 8, and 12 weeks. The designed material revealed improved clinical outcomes compared to control group. The gross and histological observations proved that the meniscal healing was stimulated in the AgNPs-treated group in comparison to control one, where the AgNPs-treated tear sites were filled with reparative tissue. In conclusion, AgNPs nanomaterial has a promoting effect on the process of meniscal tissue healing in the avascular region, proving that AgNPs is a promising material for meniscal tissue regeneration. [ABSTRACT FROM AUTHOR]

IntroductionTo investigate the epidemiological features and prevalence of cruciate ligament injuries (CLI) in children and adolescents, and to examine the potential risk factors associated with concomitant meniscal tear (MT) among this population.MethodsThe demographic data and injury details of children and adolescents with CLI from Southeast China were analyzed to describe their distribution characteristics, alongside an analysis of the prevalence of MTs, the most frequent complication. In addition, binary logistic analysis was employed to ascertain the risk factors linked to MT in individuals suffering from CLI.ResultsA total of 203 patients with CLI (n = 206) met the inclusion criteria, with a male-to-female ratio of 2.3:1. Notably, a higher proportion of females were aged ≤16 years old compared to males, who predominated in patients aged >16 years (P = 0.001). Among children and adolescents, anterior cruciate ligament (ACL) injuries were the primary type of CLI, accounting for 88.18% (179/203) of all cases. The majority of cases (132/203, 65.02%) were sustained during sports activities, and sprains were the predominant mechanism of injury (176/203, 86.7%). Additionally, the most common associated injury was an MT (157/203, 77.34%). The posterior horn is the most frequently affected site for both medial MT (62.93% out of 73 cases) and lateral MT (70.19% out of 73 cases). Moreover, vertical tears constituted the majority of medial MTs (59.48% out of 116 cases). Furthermore, patients with a higher BMI faced an increased risk of associated MT in comparison to non-overweight patients (88% vs. 73.86%; P = 0.038). Each increase in BMI unit was linked with a 14% higher probability of associated MT occurrence in children and adolescents with CLI (OR = 1.140; P = 0.036).DiscussionACL injuries are a common form of knee ligament injury among children and adolescents, especially those over the age of 16, and are often the result of a sprain. Meniscal posterior horn injury is the most commonly associated injury of youth with CLI. Additionally, overweight or obese people with CLI are at a greater risk of developing MT.

The article presents some of the injuries inherent in wrestling as a sport. It presents comparisons of injury between college and high school wrestlers. It discusses studies which reported surgical treatment of shoulder instability in competitive wrestlers, results of surgical treatment of recurrent patellar instability, and surgical treatment of isolated meniscal tears in wrestlers including anterior cruciate ligament reconstruction, bone-patellar tendon-bone and hamstring autografts.

Background: MRI knee is an expensive modality for diagnosis of meniscal injury. Ultrasound can be confidently used as a diagnostic tool. Objective: To compare the findings of high resolution dynamic ultrasonography of knee with MRI knee in evaluation of meniscal injuries. Study type,settings& duration:This cross sectional validation studywas carried out at Department of Diagnostic Radiology, Federal Government Polyclinic Hospital,Islamabad from January to June 2021. Methodology:In this study, 72 patients referred from Orthopedics’ department with clinical suspicion of meniscal injury were scanned, by using 12MHz linear probe in various knee positions. Their MRI knees were already done at outside diagnostic/health facilities which was used as reference standard. Findings of both were compared and analysed. Results:Ultrasound of 47 cases was positive for meniscal tear. Out of these, 37 cases (78.72 %) were positive on MRI thus regarded as true positive cases. 25 patients did not show tear on US. Out of these, 23 (92 %) were also negative on MRI, thus regarded as true negatives. Conclusion: High resolution ultrasound is an accurate and inexpensive imaging tool and gives results comparable to MRI and it can be used equally in all patients

BACKGROUND: The probability of meniscal tears is gradually increasing. However, the relationship between meniscal tears and the anatomical morphology of the tibial plateau has been poorly studied and controversial so far. OBJECTIVE: To measure the posterior tibial slope, medial tibial plateau depth, and lateral tibial plateau height in patients with meniscal tears and to investigate their association with meniscal tears. METHODS: From September 2019 to June 2022, 164 patients with meniscal tears and undergoing arthroscopic treatment were selected from Affiliated Hospital of Xuzhou Medical University. These patients were divided into medial meniscal tears group (n=92), lateral meniscal tears group (n=45) and medial and lateral meniscal tears group (n=27). Totally 78 patients with knee pain without meniscal tears during the same period were selected as the control group. The medial tibial slope, the lateral tibial slope, the medial tibial plateau depth and the lateral tibial plateau height in each group were carefully measured and compared. RESULTS AND CONCLUSION: (1) The medial tibial slope in the medial meniscal tears group was significantly steeper than that in the control group (P < 0.05), and the lateral tibial slope in the lateral meniscal tears group was steeper than that in the medial meniscal tears group and the control group (P < 0.05). The medial tibial slope of the medial meniscal tears group and the control group was significantly greater than their lateral tibial slope (P < 0.05). The medial tibial plateau depth in the medial meniscal tears group was significantly shallower than that in the lateral meniscal tears group and control group (P < 0.05), and the lateral tibial plateau height in the lateral meniscal tears group was higher than that in the medial meniscal tears group and control group (P < 0.05). (2) These results indicate that steep posterior tibial slope is a risk factor for meniscal tears. A shallow medial tibial plateau depth and a high lateral tibial plateau height have the potential to cause meniscal tears. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the risk factors for meniscal repair failure following concurrent primary anterior cruciate ligament (ACL) reconstruction. Methods: Prospective data recorded by the New Zealand ACL Registry and the Accident Compensation Corporation were reviewed. Meniscal repairs performed during concurrent primary ACL reconstruction were included. Repair failure was defined as a subsequent reoperation involving meniscectomy of the repaired meniscus. Multivariate survival analysis was performed to identify the risk factors for failure. Results: A total of 3,024 meniscal repairs were analysed with an overall failure rate of 6.6% (n = 201) at a mean follow-up of 2.9 years (SD 1.5). The risk of medial meniscal repair failure was higher with hamstring tendon autografts (adjusted HR [aHR] = 2.20, 95% CI 1.36–3.56, p = 0.001), patients aged 21–30 years (aHR = 1.60, 95% CI 1.30–2.48, p = 0.037) and in patients with cartilage injury in the medial compartment (aHR = 1.75, 95% CI 1.23–2.48, p = 0.002). The risk of lateral meniscal repair failure was higher in patients aged ≤ 20 years (aHR = 2.79, 95% CI 1.17–6.67, p = 0.021), when the procedure was performed by a low case volume surgeon (aHR = 1.84, 95% CI 1.08–3.13, p = 0.026) and when a transtibial technique was used to drill the femoral graft tunnel (aHR = 2.30, 95% CI 1.03–5.15, p = 0.042). Conclusion: The use of a hamstring tendon autograft, younger age and the presence of medial compartment cartilage injury are risk factors for medial meniscal repair failure, whereas younger age, low surgeon volume and a transtibial drilling technique are risk factors for lateral meniscal repair failure. Level of evidence: Level II. [ABSTRACT FROM AUTHOR]

Background: The identification of synovial fluid (SF) biomarkers that could anticipate the diagnosis of osteoarthritis (OA) is gaining increasing importance in orthopaedic clinical practice. This controlled trial aims to assess the differences between the SF proteome of patients affected by severe OA undergoing Total Knee Replacement (TKR) compared to control subjects (i.e., subjects younger than 35, undergoing knee arthroscopy for acute meniscus injury). Methods: The synovial samples were collected from patients with Kellgren Lawrence grade 3 and 4 knee osteoarthritis undergoing THR (study group) and young patients with meniscal tears and no OA signs undergoing arthroscopic surgery (control group). The samples were processed and analyzed following the protocol defined in our previous study. All of the patients underwent clinical evaluation using the International Knee Documentation Committee (IKDC) subjective knee evaluation (main outcome), Knee Society Clinical Rating System (KSS), Knee injury and Osteoarthritis Outcome Score (KOOS), and Visual Analogue Scale (VAS) for pain. The drugs' assumptions and comorbidities were recorded. All patients underwent preoperative serial blood tests, including complete blood count and C-Reactive Protein (CRP). Results: The synovial samples' analysis showed a significantly different fibrinogen beta chain (FBG) and alpha-enolase 1 (ENO1) concentration in OA compared to the control samples. A significant correlation between clinical scores, FBG, and ENO1 concentration was observed in osteoarthritic patients. Conclusions: Synovial fluid FBG and ENO1 concentrations are significantly different in patients affected by knee OA compared with non-OA subjects. [ABSTRACT FROM AUTHOR]

Background: MRI knee is an expensive modality for diagnosis of meniscal injury. Ultrasound can be confidently used as a diagnostic tool. Objective: To compare the findings of high resolution dynamic ultrasonography of knee with MRI knee in evaluation of meniscal injuries. Study type, settings & duration: This cross sectional validation study was carried out at Department of Diagnostic Radiology, Federal Government Polyclinic Hospital, Islamabad from January to June 2021. Methodology: In this study, 72 patients referred from Orthopedics' department with clinical suspicion of meniscal injury were scanned, by using 12MHz linear probe in various knee positions. Their MRI knees were already done at outside diagnostic/health facilities which was used as reference standard. Findings of both were compared and analysed. Results: Ultrasound of 47 cases was positive for meniscal tear. Out of these, 37 cases (78.72 %) were positive on MRI thus regarded as true positive cases. 25 patients did not show tear on US. Out of these, 23 (92 %) were also negative on MRI, thus regarded as true negatives. Conclusion: High resolution ultrasound is an accurate and inexpensive imaging tool and gives results comparable to MRI and it can be used equally in all patients. [ABSTRACT FROM AUTHOR]

Meniscal damage results in higher peak stress on the articular cartilage and leads to cartilage degeneration and osteoarthritis. Thus, in recent years there has been an increasing tendency to “save the meniscus” and to repair meniscal defects. However, this is not always possible and restoring meniscal function using scaffolds fulfills this gap. This approach requires the physical presence of an artificial meniscus to allow successful migration and colonization with precursor cells and vessels that lead to the development of organized meniscal tissue. Two meniscal scaffolds are currently available; 1 composed of aliphatic polyurethane named Actifit (Orteq Sports Medicine, Ltd.), and one based on collagen type I fibers called Collagen Meniscus Implant (Stryker Kalamazoo). Both provide an effective and safe solution to treat symptomatic patients with segmental meniscus mid-substance defects. Indeed, recent studies have demonstrated their ability to significantly improve patient satisfaction and clinical evaluation in the mid- to long-term. As such, these approaches hold great promise as a meniscus preservation option to facilitate long-term knee health.

ObjectivesTo investigate the association of weight change over 48 months with progression of meniscal intrasubstance degeneration (MID).MethodsWe studied 487 subjects with MID at baseline and after 48 months using 3-T MRI with the same protocol (FSE sequences with and without fat suppression). These participants lost weight (≥3%, n = 141), had moderate weight gain (3-10%, n = 77), substantial weight gain (>10%, n = 15) or maintained stable weight (n = 254). Progression of MID to a meniscal tear was assessed using the WORMS grading system and compared among weight change groups using logistic regression. ANOVA and chi-square tests were used to study the differences in subjects' characteristics.ResultsProgression of MID increased from weight loss to substantial weight gain (p < 0.001) and was significantly more likely with both moderate weight gain (odds ratio [OR], 4.9; 95% confidence interval [CI] 2.4-8.9) and substantial weight gain (OR, 9.5; 95% CI 3.2-28.5) compared to stable weight. Results were similar in both menisci for moderate weight gain (medial: OR, 6.8; 95% CI 3.5-11.3; lateral: OR, 2.6; 95% CI 1.1-6.6) and substantial weight gain (medial: OR, 21.0; 95% CI 5.1-80.7; lateral: OR, 9.7; 95% CI 0.95-100.2).ConclusionWeight gain is associated with an increased likelihood that meniscal intrasubstance degeneration will progress with the risk increasing with greater weight gain.Key points• Subjects who gained weight were more likely to develop meniscal tears. • Greater amount of weight gain was associated with an increasing likelihood of progression. • Prevention of weight gain has health benefits for the meniscus.

Ganglion cysts (GC) are an uncommon complication following arthroscopic knee surgery. Due to high rates of recurrence following GC resection, many symptomatic patients can experience pain and discomfort for years. The presence of a GC at the site of an arthroscopic knee portal has only been reported once before in the literature. This case report details the history, physical and treatment of an active-duty soldier who had undergone various aspirations and surgical resections with limited improvement until the most recent operative intervention. At 18 months postoperatively, the patient had not experienced recurrence and had returned to all activities. We believe this surgical technique yielded resolution of the GC because following resection, the joint was checked to exclude areas of fluid extravasation, the capsule closure was performed with non-absorbable barbed suture and the operative extremity was immobilised in extension for 2 weeks to promote soft tissue rest and healing., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Meniscal tears in the avascular region are thought to rarely heal and are a considerable challenge to treat. Although the therapeutic effects of a pulsed electromagnetic field (PEMF) have been extensively studied in a variety of orthopaedic disorders, the effect of a PEMF on meniscal healing has not been reported. Hypothesis: PEMF treatment would promote meniscal healing and prevent osteoarthritis progression. Study Design: Controlled laboratory study. Methods: A total of 72 twelve-week-old male Sprague-Dawley rats with full-thickness longitudinal medial meniscal tears in the avascular region were divided into 3 groups: control (Gcon), treatment with a classic signal PEMF (Gclassic), and treatment with a high–slew rate signal PEMF (GHSR). Macroscopic observation and histological analysis of the meniscus and articular cartilage were performed to evaluate the meniscal healing and progression of osteoarthritis. The synovium was harvested for histological and immunofluorescent analysis to evaluate the intra-articular inflammation. Meniscal healing, articular cartilage degeneration, and synovitis were quantitatively evaluated according to their scoring systems. Results: Dramatic degenerative changes of the meniscus and articular cartilage were noticed during gross observation and histological evaluation in Gcon at 8 weeks. However, the menisci in the 2 treatment groups were restored to normal morphology, with a smooth surface and shiny white color. Particularly, the HSR signal remarkably enhanced the fibrochondrogenesis and accelerated the remodeling process of the regenerated tissue. The meniscal healing scores of the PEMF treatment groups were significantly higher than those in Gcon at 8 weeks. Specifically, the HSR signal showed a significantly higher meniscal repair score than did the classic signal at week 8 (P <.01). Additionally, the HSR signal significantly downregulated the secretion levels of interleukin 1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α) in the meniscus and synovium as compared with the control group. When compared with the 2 treatment groups, Gcon had significantly higher degeneration scores (Gcon vs Gclassic, P <.0001; Gcon vs GHSR, P <.0001). The HSR signal also exhibited significantly lower synovitis scores compared with the other two groups (Gcon vs Gclassic, P <.0001; Gclassic vs GHSR, P =.0002). Conclusion: A PEMF promoted the healing of meniscal tears in the avascular region and restored the injured meniscus to its structural integrity in a rat model. As compared with the classic signal, the HSR signal showed increased capability to promote fibrocartilaginous tissue formation and modulate the inflammatory environment, therefore protecting the knee joint from posttraumatic osteoarthritis development. Clinical Relevance: Adjuvant PEMF therapy may offer a new approach for the treatment of meniscal tears attributed to the enhanced meniscal repair and ameliorated osteoarthritis progression. [ABSTRACT FROM AUTHOR]

Introduction: There has been an increase in research on the effectiveness of treatment options for the management of meniscal tears. However, there is very little evidence about the patient experiences of meniscal tears. Aim: To summarise the available qualitative evidence on patients' experiences and expectations of meniscal tears. Method: A search of EMBASE, Medline, Sociofile and Web of Science up to November 2020 was performed to identify studies reporting patient experiences of meniscal tears. Studies were critically appraised using the CASP (Critical Appraisal Skills Program) checklist, and a meta-synthesis was performed to generate third-order constructs (new themes). Results: Two studies reporting semi-structured interviews from 34 participants (24 male; 10 female) were included. The mean interview length ranged from 16 to 45 min. Five themes were generated: (1) the imaging (MRI) results are a key driver in the decision-making process, (2) surgery is perceived to be the definitive and quicker approach, (3) physiotherapy and exercise is a slower approach which brought success over time, (4) patient perceptions and preferences are important in the clinical decision-making process and, (5) the impact on patient lives is a huge driver in seeking care and treatment decisions. Conclusion: This is the first study to summarise the qualitative evidence on patient experiences with meniscal tears. The themes generated demonstrate the importance of patient perceptions of MRI findings and timing of treatment success as important factors in the decision-making process. This study demonstrates the need to strengthen our understanding of patients' experiences of meniscal tears. [ABSTRACT FROM AUTHOR]

Discoid menisci represent a range of morphological meniscal variants, most commonly involving the lateral meniscus. Clinical presentation ranges from an asymptomatic incidental finding to snapping, pain, swelling and reduced range of knee movement. Symptomatic presentation of discoid menisci is usually due to meniscal tears and instability resulting from abnormal meniscal morphology and ultrastructure, with absent peri-meniscal ligamentous and meniscocapsular attachments characteristic of the Wrisberg sub-type. This article reviews the current classification systems of discoid menisci, gross morphological characteristics of each sub-type and ultrastructure. Clinical presentation, arthroscopic findings and indirect radiological diagnostic criteria are described, as are the MRI findings of normal and pathological discoid menisci. Current concepts of surgical management and outcomes of the discoid meniscus are also briefly discussed. [ABSTRACT FROM AUTHOR]

Meniscal tears are a frequent orthopedic injury commonly managed by conservative strategies to avoid osteoarthritis development descending from altered biomechanics. Among cutting-edge approaches in tissue engineering, 3D printing technologies are extremely promising guaranteeing for complex biomimetic architectures mimicking native tissues. Considering the anisotropic characteristics of the menisci, and the ability of printing over structural control, it descends the intriguing potential of such vanguard techniques to meet individual joints' requirements within personalized medicine. This literature review provides a state-of-the-art on 3D printing for meniscus reconstruction. Experiences in printing materials/technologies, scaffold types, augmentation strategies, cellular conditioning have been compared/discussed; outcomes of pre-clinical studies allowed for further considerations. To date, translation to clinic of 3D printed meniscal devices is still a challenge: meniscus reconstruction is once again clear expression of how the integration of different expertise (e.g., anatomy, engineering, biomaterials science, cell biology, and medicine) is required to successfully address native tissues complexities. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Conservative and surgical treatments for meniscal lesions are various and this field of orthopedic surgery is in continuous development. Stem cells represent one of the current options to stimulate meniscal healing. The present systematic review aimed at summarizing the state of art in the application of stem cells for the treatment of meniscal damage both at pre-clinical and clinical level. MATERIALS AND METHODS: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to perform this systematic review. A systematic search was performed using the PubMed (MEDLINE), EMBASE and Cochrane Library databases. All the studies dealing with the application of stem cells as a treatment for meniscal tears were pooled, data were extracted and analyzed. The studies were divided into two groups (pre-clinical and clinical), and then, discussed independently. RESULTS: A total of 18 studies were included. Thirteen were classified as "pre-clinical" and five as "clinical". The most commonly used cells were mesenchymal stem cells (MSC), derived from bone marrow (BMMSC), synovial tissue (SMSC), or adipose tissue (ADSC). Follow-ups ranged from 2 to 16 weeks for the pre-clinical studies and from 3 to 24 months for the clinical studies. All studies documented good results in terms of laboratory markers/scores, clinical and radiologic evaluation. CONCLUSIONS: Based on the currently available data, it is not possible to establish the best cell source or delivery method for the treatment of meniscal injuries. Bone Marrow derived stem cells delivered through injection represent the most studied approach, with the most promising results. However, the full impact of these therapies through their different sub-type of stem cells and implantation techniques still needs to be critically analyzed through larger randomized controlled trials with longer follow-up. [ABSTRACT FROM AUTHOR]

Introduction: Numerous studies have been performed in the past for assessing diagnostic efficacy of Magnetic Resonance Imaging (MRI) against arthroscopy in evaluating meniscal and cruciate ligament injuries of knee joint and adequate correlation was observed. However, many of these studies have been performed on scanners of 1.5 T (Tesla) or lower field strengths. Aim: To assess the incidence and characterise the primary and secondary signs of intra-articular traumatic knee injuries and to assess the accuracy of 3T MRI by comparing the imaging findings with arthroscopy. Materials and Methods: A cross-sectional prospective study was conducted between November 2017 to March 2020. During this period, a total of 287 patients with clinical suspicion of traumatic cruciate ligament/meniscal injuries who were referred for MRI at ESIC Super Speciality Hospital, Sanath Nagar, Hyderabad, Telangana, India, were included in the study. Among those who underwent the procedure, operative findings of 60 patients who revisited the hospital were obtained and compared to preoperative 3T MRI findings. Correlation between 3T MRI and arthroscopy findings was obtained by calculating sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), accuracy, positive and negative likelihood ratios for Anterior Cruciate Ligament (ACL), Posterior Cruciate Ligament (PCL), Medial Meniscus (MM) and Lateral Meniscus (LM) tears individually. Results: Sensitivity, Specificity, PPV, NPV and Accuracy were calculated for respective categories. For ACL tears it was 95.45%, 81.25%, 93.3%, 86.6%, 91.6%; For PCL tears it was 100%, 96.3%, 97%, 100%, 98.33%; For MM tears it was 97.1%, 88%, 91.8%, 95.6%, 93.3%; and for LM tears it was 95.65 %, 94.59%, 91.6%, 97.22%, 95%. Conclusion: A 3T MRI improves the diagnostic accuracy of cruciate and meniscal injuries due to improved Signal-to-Noise Ratio (SNR), spatial resolution, better anatomical depiction of structures that are usually blind spots on arthroscopy (inferior surface and intrasubstance tears, posterolateral corner injuries, displaced small fragments into the recesses etc.).

Abstract Background Repair of a meniscal tear is indicated in certain conditions. Despite extensive research on the biomechanics of various repair methods, there has been minimal investigation of whether the suture material influences the meniscal-suture construct. The purpose of this study was to compare the biomechanical properties of nine different suture materials under cyclic and load-to-failure conditions. Methods Ninety porcine menisci were randomly allocated to simple suture placement using either Ultrabraid®, Ultratape®, Magnum Wire®, TigerWire®, TigerTape®, LabralTape®, Orthocord®, 0 FiberWire®, or 2-0 FiberWire®. Each suture-meniscus specimen underwent cyclic loading followed by load-to-failure testing. Elongation, maximum load to failure, stiffness, and mode of failure were recorded and compared between each suture type using non-parametric testing. Mean ± standard deviation was reported and the statistical significance was p

INTRODUCTION: Meniscus injuries are the most frequent problem of the knee. The aim of this study was to investigate the accuracy of the Thessaly test and comparing it with those of McMurray and Joint-line tenderness tests for diagnosing meniscal tears. MATERIALS AND METHODS: This study was designed as a prospective observational one done in an outpatient clinic at a university hospital. 106 patients with knee pain and 82 agematched control were included during study period (from February 2014 to January 2015). Each patient was clinically examined with McMurray, Thessaly, and joint line tenderness tests. Then, the findings were matched by MRI and arthroscopic findings. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated as main outcomes. RESULTS: Based on MRI, Thessaly was the most sensitive for medial meniscus tears (56.2%), while McMurray and jointline tenderness were more specific (89.1% and 88.0%, respectively). For lateral meniscus tears, McMurray was the most sensitive (56.2%) and all were specific (McMurray 89.6%, Thessaly 88.4%, joint-line tenderness 90.2%). With arthroscopy, Thessaly was the most sensitive for medial meniscus (76.6%), while McMurray and joint-line tenderness were more specific (81.0%, and 81.0%). Agreement with arthroscopy was the highest with McMurray (for medial meniscus kappa=0.40, p

Nanofibrous scaffolds fabricated via electrospinning have been proposed for meniscus tissue regeneration. However, the electrospinning process is slow, and can only generate scaffolds of limited thickness with densely packed fibers, which limits cell distribution within the scaffold. In this study, we explored whether pneumatospinning could produce thicker collagen type I fibrous scaffolds with higher porosity, that can support cell infiltration and neo-fibrocartilage tissue formation for meniscus tissue engineering. We pneumatospun scaffolds with solutions of collagen type I with thicknesses of approximately 1 mm in 2 h. Scanning electron microscopy revealed a mix of fiber sizes with diameters ranging from 1 to 30 µm. The collagen scaffold porosity was approximately 48% with pores ranging from 7.4 to 100.7 µm. The elastic modulus of glutaraldehyde crosslinked collagen scaffolds was approximately 45 MPa, when dry, which reduced after hydration to 0.1 MPa. Mesenchymal stem cells obtained from the infrapatellar fat pad were seeded in the scaffold with high viability (>70%). Scaffolds seeded with adipose-derived stem cells and cultured for 3 weeks exhibited a fibrocartilage meniscus-like phenotype (expressing COL1A1, COL2A1 and COMP). Ex vivo implantation in healthy bovine and arthritic human meniscal explants resulted in the development of fibrocartilage-like neotissues that integrated with the host tissue with deposition of glycosaminoglycans and collagens type I and II. Our proof-of-concept study indicates that pneumatospinning is a promising approach to produce thicker biomimetic scaffolds more efficiently that electrospinning, and with a porosity that supports cell growth and neo-tissue formation using a clinically relevant cell source.

Purpose: To perform a systematic review and meta-analysis of the existing literature on meniscal centralisation procedures, analysing its impact on meniscal extrusion, joint biomechanics and clinical and radiological outcome measures., Methods: The Cochrane Controlled Register of Trials, PubMed (MEDLINE) and Embase were used to perform a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Biomechanical studies on healthy animal or human cadaveric knee joints that assessed meniscal extrusion or tibiofemoral contact mechanics (contact area and pressure) following centralization for meniscal pathologies were included. For clinical studies, those that prospectively or retrospectively assessed patient-reported outcome measures (PROMs), postoperative knee motion, complications and radiological extrusion following centralization for meniscal pathologies were included., Results: Fifteen studies were included in the analysis, comprising eight biomechanical, six clinical and one both. There were 92 knee specimens for biomechanical testing, of which 40 were human cadaveric and 52 porcine models. Biomechanical data revealed centralization to be commonly performed for posterior meniscal root tears and significantly reduced extrusion and contact pressure whilst improving contact area following a tear (p < 0.00001). Centralization restored extrusion to that of the native knee at all flexion angles described (0-90°, p = 0.25) and, compared to the torn state, brought tibiofemoral contact mechanics 3.2-5.0 times closer to the native state. Clinical data showed that 158 patients underwent centralization for extrusion. It improved postoperative Knee Injury and Osteoarthritis Outcome score (KOOS) (p = 0.006) and Lysholm scores (p < 0.00001) at 25.0 months, maintained extrusion reduction at 17.1 months (p < 0.00001) and preserved knee motion., Conclusion: Centralisation for various meniscal injuries associated with extrusion can reduce meniscal extrusion and improve joint biomechanics, along with clinical and radiological outcomes. Existing evidence is still scarce and exhibits a notable amount of methodological heterogeneity., Level of Evidence: Systematic review of Level IV evidence., (© 2024 The Author(s). Knee Surgery, Sports Traumatology, Arthroscopy published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)

Purpose: The management of meniscal tears is a widely researched and evolving field. Previous studies reporting the incidence of meniscal tears are outdated and not representative of current practice. The aim of this study was to report the current incidence of MRI confirmed meniscal tears in patients with a symptomatic knee and the current intervention rate in a large NHS trust. Methods: Radiology reports from 13,358 consecutive magnetic resonance imaging scans between 2015 and 2017, performed at a large UK hospital serving a population of 470,000, were assessed to identify patients with meniscal tears. The hospital database was interrogated to explore the subsequent treatment undertaken by the patient. A linear regression model was used to identify if any factors predicted subsequent arthroscopy. Results: 1737 patients with isolated meniscal tears were identified in patients undergoing an MRI for knee pain, suggesting a rate of 222 MRI confirmed tears per 100,000 of the population aged 18 to 55 years old. 47% attended outpatient appointments and 22% underwent arthroscopy. Root tears [odds ratio (95% CI) 2.24 (1.0, 4.49); p = 0.049] and bucket handle tears were significantly associated with subsequent surgery, with no difference between the other types of tears. The presence of chondral changes did not significantly affect the rate of surgery [0.81 (0.60, 1.08); n.s]. Conclusion: Meniscal tears were found to be more common than previously described. However, less than half present to secondary care and only 22% undergo arthroscopy. These findings should inform future study design and recruitment strategies. In agreement with previous literature, bucket handle tears and root tears were significant predictors of subsequent surgery. Level of evidence: III. [ABSTRACT FROM AUTHOR]

Meniscal tears may be managed through conservative physical therapy and nonsteroidal anti-inflammatory medications or operative intervention. Meniscal repair is superior to partial meniscectomy with better functional outcomes and less severe degenerative changes over time. Surgical advances in operative techniques, modern instrumentation and biological enhancements collectively improve healing rates of meniscal repair. However, failed repair is not without consequences and can negative impact patient outcomes. Therefore, it is imperative for surgeons to have a thorough understanding of the vascular zones and biomechanical classifications of meniscal tears in order to best determine the most appropriate treatment. [ABSTRACT FROM AUTHOR]

Background: Anterior cruciate ligament (ACL) ruptures are common, but the ideal timing for ACL reconstruction after injury is unclear with regard to meniscal insult. Purpose: To determine whether there is a relationship between timing from ACL rupture to ACL reconstruction and development of meniscal tears within this period. Study Design: Systematic review and meta-analysis. Methods: A systematic literature search was undertaken independently by 2 reviewers using the Cochrane method for systematic reviews in 5 online databases. The reviewers performed independent data extraction and assessment of risk of bias and study quality. The search included any comparative study, including randomized controlled trials (RCTs), prospective and retrospective cohort studies, and case-control studies of an adult population, that assessed the relationship between timing of ACL reconstruction surgery and rates of meniscal tears. Results: After screening, 12 studies (No. of participants = 3042) out of 3390 records were included for analysis: 3 RCTs (n = 272), 2 prospective cohort studies (n = 307), and 7 retrospective cohort studies (n = 2463). In analysis of these studies, rates of reported meniscal tears were compared for ACL procedures performed at 3 and 6 months after injury. Meta-analysis of 5 studies (n = 2012) showed that ACL reconstruction performed >3 months after injury was associated with a higher rate of medial meniscal tears compared with ACL reconstruction performed within 3 months of injury (estimated OR, 2.235; 95% CI, 1.183-4.223; P =.013) but not with a higher rate of lateral meniscal tears. Similarly, meta-analysis of 4 studies (n = 990) showed that ACL reconstruction performed >6 months after injury was associated with a higher rate of medial meniscal tears compared with ACL reconstruction performed within 6 months of injury (estimated OR, 2.487; 95% CI, 1.241-4.984; P =.01) but not with a higher rate of lateral meniscal tears. Conclusion: Our results suggest that delay of ACL reconstruction surgery >3 months after injury is associated with a higher rate of medial meniscal tears within this prereconstruction time frame. Further high-quality prospective studies may help determine whether this is a causal effect. However, based on current evidence, in those patients for whom ACL reconstruction is indicated, ACL reconstruction within 3 months of injury may be recommended. Registration: CRD42016032846 (PROSPERO) [ABSTRACT FROM AUTHOR]

Objective: To determine the patient reported outcomes in individuals undergoing arthroscopic partial meniscectomy for chronic meniscal tears. Study Design: Cross sectional study. Place and Duration of Study: Orthopedic Surgery Department, Combined Military Hospital Rawalpindi, 06 months from Jun 2018 to Nov 2018. Methodology: A total of 41 patients of both genders between the ages of 15-50 years undergoing arthroscopic partial meniscectomy for chronic meniscal tears were included in the study. Patients with no meniscal tears on arthroscopy, patients having cruciate ligament injuries, infection of knee joint and history of previous surgery on the knee joint were excluded. Patient reported outcome measurement was done on the basis of knee injury and Osteoarthritis Outcomescore (KOOS) at the time of presentation and at 03 months after surgery. The patients’ satisfaction rate was also determined. Data were analyzed by SPSS version 23.0. Results: The mean age of patients was 28.32 ± 6.88 years with a range of 17-41 years. Out of total 41 patients, 35 patients (85.37%) were male and 6 patients (14.63%) were female. The difference in the preoperative KOOS and postoperative KOOS in patients undergoing arthroscopic partial meniscectomy after 03 months was found to be statistically significant (p

ObjectiveTo analyze knee trabecular bone structure and spatial cartilage T(1ρ) and T(2) relaxation times using 3-T magnetic resonance imaging (MRI) in subjects with and without tears of posterior horn of the medial meniscus (PHMM).Design3-T MRI from 59 subjects (>18 years), were used to evaluate PHMM tears based on modified Whole-Organ Magnetic Resonance Imaging Score (WORMS) scoring; and to calculate apparent trabecular bone-volume over total bone volume fraction (app. BV/TV), apparent trabecular number (app. Tb.N), apparent trabecular separation (app. Tb.Sp) and apparent trabecular thickness (app. Tb.Th) for overall femur/tibia and medial/lateral femur/tibia; and relaxation times for deep and superficial layers of articular cartilage. A repeated measures analysis using Generalized Estimating Equation (GEE) was performed to compare trabecular bone and cartilage relaxation time parameters between people with (n = 35) and without (n = 24) PHMM tears, while adjusting for age and knee OA presence.ResultsSubjects with PHMM tears had lower app. BV/TV and app. Tb.N, and greater app. Tb.Th, and app. Tb.Sp. They also had higher T(1ρ) times in the deep cartilage layer for lateral tibia and medial femur and higher T(2) relaxation times for the deep cartilage layer across all compartments.ConclusionsPHMM tears are associated with differences in underlying trabecular bone and deep layer of cartilage. Over-load of subchondral bone can lead to its sclerosis and stress shielding of trabecular bone leading to the resorptive changes observed in this study. The results underline the importance of interactions of trabecular bone and cartilage in the pathogenesis of knee OA in people with PHMM tears.

Background: Treatment of meniscal tears is necessary to maintain the long-term health of the knee joint. Morphological elements, particularly vascularity, that play an important role in meniscal healing are known to change during skeletal development. Purpose: To quantitatively evaluate meniscal vascularity, cellularity, collagen, and proteoglycan content by age and location during skeletal development. Study Design: Descriptive laboratory study. Methods: Medial and lateral menisci from 14 male and 7 female cadavers aged 1 month to 11 years were collected and evaluated. For each meniscus, histologic and immunohistologic techniques were used to establish the ratio of the area of proteoglycan (safranin O) positivity to the total area (proteoglycan ratio), collagen type I and type II immunostaining positivity, number of blood vessels, and cell density. These features were evaluated over the entire meniscus and also separately in 5 circumferential segments: anterior root, anterior horn, body, posterior horn, and posterior root. Additionally, cell density and number of blood vessels were examined in 3 radial regions: inner, middle, and periphery. Results: Age was associated with a decrease in meniscal vessel count and cell density, while the proteoglycan ratio increased with skeletal maturity. Differences in vessel counts, cellular density, and proteoglycan ratio in different anatomic segments as well as in the inner, middle, and peripheral regions of the developing menisci were also observed. Collagen immunostaining results were inconsistent and not analyzed. Conclusion: The cellularity and vascularity of the developing meniscus decrease with age and the proteoglycan content increases with age. All of these parameters are influenced by location within the meniscus. Clinical Relevance: Age and location differences in meniscal morphology, particularly in the number of blood vessels, are expected to influence meniscal healing. [ABSTRACT FROM AUTHOR]

Introduction: To investigate the epidemiological features and prevalence of cruciate ligament injuries (CLI) in children and adolescents, and to examine the potential risk factors associated with concomitant meniscal tear (MT) among this population., Methods: The demographic data and injury details of children and adolescents with CLI from Southeast China were analyzed to describe their distribution characteristics, alongside an analysis of the prevalence of MTs, the most frequent complication. In addition, binary logistic analysis was employed to ascertain the risk factors linked to MT in individuals suffering from CLI., Results: A total of 203 patients with CLI ( n  = 206) met the inclusion criteria, with a male-to-female ratio of 2.3:1. Notably, a higher proportion of females were aged ≤16 years old compared to males, who predominated in patients aged >16 years ( P  = 0.001). Among children and adolescents, anterior cruciate ligament (ACL) injuries were the primary type of CLI, accounting for 88.18% (179/203) of all cases. The majority of cases (132/203, 65.02%) were sustained during sports activities, and sprains were the predominant mechanism of injury (176/203, 86.7%). Additionally, the most common associated injury was an MT (157/203, 77.34%). The posterior horn is the most frequently affected site for both medial MT (62.93% out of 73 cases) and lateral MT (70.19% out of 73 cases). Moreover, vertical tears constituted the majority of medial MTs (59.48% out of 116 cases). Furthermore, patients with a higher BMI faced an increased risk of associated MT in comparison to non-overweight patients (88% vs. 73.86%; P  = 0.038). Each increase in BMI unit was linked with a 14% higher probability of associated MT occurrence in children and adolescents with CLI (OR = 1.140; P  = 0.036)., Discussion: ACL injuries are a common form of knee ligament injury among children and adolescents, especially those over the age of 16, and are often the result of a sprain. Meniscal posterior horn injury is the most commonly associated injury of youth with CLI. Additionally, overweight or obese people with CLI are at a greater risk of developing MT., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Zhi, Wen, Zhang, Lai, Ye, Wu, Li, Shao, Canavese, Zeng and Xu.)

Knee medial compartment osteoarthritis is effectively treated by a medial open-wedge high tibial osteotomy (MOWHTO). The feasibility and safety of MOWHTO for mild lateral meniscal tears are unknown. This study examined the feasibility and safety of knee joint weight-bearing line ratio (WBLr) adjustment during MOWHTO with lateral meniscal injuries. We used a healthy adult male's lower extremities computed tomography scans and knee joint magnetic resonance imaging images to create a normal fine element (FE) model. Based on this model, we generated nine FE models for the MOWHTO operation (WBLr: 40-80%) and 15 models for various lateral meniscal injuries. A compressive load of 650N was applied to all cases to calculate the von Mises stress (VMS), and the intact lateral meniscus' maximal VMS at 77.5% WBLr was accepted as the corrective upper limit stress. Our experimental results show that mild lateral meniscal tears can withstand MOWHTO, while severe tears cannot. Our findings expand the use of MOWHTO and provide a theoretical direction for practical decisions in patients with lateral meniscal injuries.

Background: Repair of a meniscal tear is indicated in certain conditions. Despite extensive research on the biomechanics of various repair methods, there has been minimal investigation of whether the suture material influences the meniscal-suture construct. The purpose of this study was to compare the biomechanical properties of nine different suture materials under cyclic and load-to-failure conditions. Methods: Ninety porcine menisci were randomly allocated to simple suture placement using either Ultrabraid®, Ultratape®, Magnum Wire®, TigerWire®, TigerTape®, LabralTape®, Orthocord®, 0 FiberWire®, or 2-0 FiberWire®. Each suture-meniscus specimen underwent cyclic loading followed by load-to-failure testing. Elongation, maximum load to failure, stiffness, and mode of failure were recorded and compared between each suture type using non-parametric testing. Mean ± standard deviation was reported and the statistical significance was p < 0.05. Results: Elongation during cyclic loading was lowest with 2-0 FiberWire (0.95 ± 0.17 mm); this value was statistically significantly different than the results for all other sutures except 0 FiberWire® (1.09 ± 0.17 mm, p = 0.79), TigerWire® (1.09 ± 0.29 mm, p = 0.85), TigerTape® (1.39 ± 0.29 mm, p = 0.08), and LabralTape® (1.20 ± 0.33 mm, p = 0.41). The highest elongation was seen with Ultrabraid® (1.91 ± 0.34 mm); this value was statistically significantly greater than the results for all other suture materials except Orthocord® (1.59 mm ± 0.31 mm, p = 0.46) and Magnum Wire® (1.43 ± 0.25 mm, p = 0.14). Load to failure was highest for TigerTape® (287.43 ± 41.15 N), and this result was statistically significantly different than the results for all other sutures except LabralTape® (271.34 ± 48.48 N, p = 0.99) and TigerWire® (251.03 ± 25.8 N, p = 0.51). Stiffness was highest for LabralTape® (195.77 ± 49.06 N/mm), and this result was statistically significantly different than the results for all other sutures except TigerWire® (186.49 ± 19.83 N/mm, p = 0.45) and TigerTape® (173.35 ± 15.60 N/mm, p = 0.19). The majority of sutures failed by pullout (n = 46, 51%) or tearing (n = 40, 45%). Conclusion: Suture design and material affect the biomechanical behavior of porcine meniscal-suture specimens. LabralTape®, TigerWire®, and TigerTape® demonstrated better overall combinations of low elongation, high maximum load to failure, and high stiffness. [ABSTRACT FROM AUTHOR]

The meniscus plays an important, complex role in maintaining the homeostasis and health of the knee. Meniscal tears are a risk factor for early chondral injury and eventually knee osteoarthritis. There is a growing body of evidence about the early biological changes associated with meniscal injury that likely start the process of joint degeneration. This review highlights the basic science, translational and clinical studies of the detrimental effects of meniscal injury and deficiency on the biology of the knee. [ABSTRACT FROM AUTHOR]

Discoid menisci represent a range of morphological meniscal variants, most commonly involving the lateral meniscus. Clinical presentation ranges from an asymptomatic incidental finding to snapping, pain, swelling and reduced range of knee movement. Symptomatic presentation of discoid menisci is usually due to meniscal tears and instability resulting from abnormal meniscal morphology and ultrastructure, with absent peri-meniscal ligamentous and meniscocapsular attachments characteristic of the Wrisberg sub-type. This article reviews the current classification systems of discoid menisci, gross morphological characteristics of each sub-type and ultrastructure. Clinical presentation, arthroscopic findings and indirect radiological diagnostic criteria are described, as are the MRI findings of normal and pathological discoid menisci. Current concepts of surgical management and outcomes of the discoid meniscus are also briefly discussed. [ABSTRACT FROM AUTHOR]

Meniscal tears are a common orthopedic injury. The management approaches for meniscal tears include both surgical and non-surgical procedures; however, the majority of the surgeons opt for various surgical interventions. This systematic review aimed to compare the outcomes of different surgical techniques for meniscal tears. The systemic search was carried out in various databases including PubMed, Web of Science, CINAHL, and Scopus. Studies that investigated surgical techniques for meniscal repair and published between 2010 to 2023 were included. Out of the 7,421 potential studies identified from databases and Google Scholar search, only 17 studies were included in our systemic review. The follow-up periods ranged from 6 weeks to 123 months. Adverse effects were reported in some studies, including joint line tenderness, swelling, and loss of flexion, while others reported no significant adverse events. Pull-out repair and refixation techniques demonstrated better clinical outcomes and slower arthritic progression than partial meniscectomy. Mason-Allen stitches and simple stitches yielded comparable results, and both inside-out and all-inside techniques had similar clinical and functional outcomes. This systematic review provides valuable insights into the outcomes of different surgical techniques for meniscal tears. Further studies with longer follow-up periods may help assess the long-term effectiveness of these surgical techniques., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alhelali et al.)