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1.
Artroscopia (En linea) ; 31(1): 1-5, 2024.
Article in Spanish | LILACS, BINACIS | ID: biblio-1555187

ABSTRACT

Introducción: la función del tejido meniscal es fundamental en la transmisión y distribución de cargas de la rodilla. En casos de lesión meniscal, la sutura es el tratamiento quirúrgico de elección, y pueden utilizarse diferentes materiales para realizarla. El objetivo del trabajo es analizar la aparición de quistes meniscales sintomáticos con el uso de sutura no reabsorbible del tipo monofilamento de polipropileno en un grupo de pacientes con lesiones en asa de balde y evaluar el material de sutura como causal de quiste.Materiales y métodos: se realizó un estudio retrospectivo de un grupo de pacientes con lesiones en asa de balde suturadas con material no reabsorbible del tipo monofilamento de polipropileno (MP) y sutura de alta resistencia de polietileno de ultra alto peso molecular UHMWPE (SAR) y se analizó la presencia de quiste meniscal sintomático como complicación. Los criterios de inclusión para este estudio fueron pacientes con lesiones en asa de balde a los cuales se les realizó sutura meniscal con técnicas combinadas con material de tipo no reabsorbible. Se excluyeron pacientes con lesiones que no fueran con patrón en asa de balde o a los cuales se les hizo sutura meniscal todo-adentro únicamente.Resultados: un total de veinticinco pacientes, quince de sexo masculino y diez de sexo femenino. La edad media del grupo evaluado fue de 27.8 años. El 72% fue suturado con sutura de alta resistencia (SAR) mientras que a un 28% se les realizó sutura con monofilamento de polipropileno (MP). El 92% de las lesiones se presentaron en el menisco interno. Se observaron tres pacientes con quistes meniscales sintomáticos asociados a la sutura MP, los cuales fueron tratados quirúrgicamente con buena evolución. Conclusión: identificamos en nuestra serie que la aparición de quistes sintomáticos se relaciona estrechamente con el uso de monofilamento de polipropileno (MP). Consideramos la utilización de hilos no reabsorbibles de alta resistencia (polietileno de ultra alto peso molecular UHMWPE) como la primera opción para realizar las suturas meniscales por la baja tasa de complicación y los buenos resultados. Nivel de Evidencia: IV


Introduction: The function of the meniscal tissue is fundamental in the transmission and distribution of knee loads. In cases of meniscal injury, suturing is the surgical treatment of choice, and different materials can be used to perform it. The aim of the work is to analyze the appearance of symptomatic meniscal cysts with the use of non-absorbable polypropylene monofilament suture in a group of patients with bucket handle injuries and to evaluate the suture material as a cause of the cyst. Materials and methods: a retrospective study was carried out on a group of patients with bucket-handle injuries sutured with non-absorbable polypropylene monofilament (MP) material and high-strength ultra-high molecular weight UHMWPE polyethylene (SAR) suture and the presence of a symptomatic meniscal cyst as a complication was analyzed. The inclusion criteria for this study were patients with bucket-handle injuries in whom meniscal suture was performed with combined techniques with non-resorbable material. Patients with injuries other than a bucket-handle pattern or who underwent all-in meniscal suturing only were excluded.Results: a total of twenty-five patients, fifteen males and ten females. The average age of the evaluated group was 27.8 years. 72% were sutured with high resistance suture (SAR) while 28% were sutured with polypropylene monofilament (MP). 92% of the injuries occurred in the medial meniscus. Three patients were observed with symptomatic meniscal cysts associated with the MP suture, which were treated surgically with good outcomes. Conclusion: we identified in our series that the appearance of symptomatic cysts is closely related to the use of polypropylene monofilament (MP). We consider the use of high-strength non-absorbable threads (ultra-high molecular weight polyethylene UHMWPE) as the first option to perform meniscal sutures due to the low complication rate and good results. Level of Evidence: IV


Subject(s)
Polypropylenes , Sutures , Bone Cysts , Meniscus , Knee Joint
2.
Artroscopia (En linea) ; 31(1): 6-11, 2024.
Article in Spanish | LILACS, BINACIS | ID: biblio-1555188

ABSTRACT

Introducción: Los meniscos son estructuras semilunares formadas por fibrocartílagos, localizadas entre el fémur y la tibia. El menisco externo es más móvil, debido a sus inserciones a través de los ligamentos meniscotibiales y poplíteomeniscales. El menisco interno tiene un desplazamiento de 2-3 mm comparado con un desplazamiento de 9-10 mm del menisco externo. Se ha descripto en la literatura mundial que la hipermovilidad meniscal es secundaria a lesión de ligamentos poplíteomeniscales (principales estabilizadores), sin embargo, se realizó un estudio cadavérico donde se evidenció que los ligamentos poplíteomeniscales desempeñan un papel secundario. El objetivo de este estudio es demostrar que la lesión de los ligamentos meniscotibiales es la causante de la hipermovilidad meniscal externa.Materiales y métodos: se realizó un estudio cadavérico en 2022 en Arthrex, Naples, Florida, Estados Unidos. Previo a la valoración artroscópica se efectuó la sección de ligamentos meniscotibiales en el tercio posterior del menisco externo, manteniendo los ligamentos poplíteomeniscales y la inserción de la raíz posterior. Posteriormente, se efectuó la valoración artroscópica en la que se vio traslación anterior y superior del tercio posterior del menisco externo y se realizó la fijación meniscal.Resultados: mediante la fijación del tercio posterior del menisco lateral con técnica transósea, en una falla o insuficiencia de los ligamentos meniscotibiales, se logra estabilidad completa del menisco.Conclusión: la estabilidad principal del tercio posterior del menisco lateral está dada por la inserción periférica de los ligamentos meniscotibiales, por lo que la hipermovilidad meniscal externa no se debe a lesión de los ligamentos poplíteomeniscales. Nivel de Evidencia: IV


Introduction: The menisci are semilunar structures formed by fibrocartilage, located between the femur and the tibia. The lateral meniscus is more mobile due to its insertions through the tibial meniscus and popliteal meniscal ligaments. The medial meniscus has a displacement of 2-3 mm compared to a displacement of 9-10 mm for the external meniscus. It has been described in the world literature that meniscal hypermobility is secondary to injury to the popliteal meniscal ligaments (main stabilizers), however a cadaveric study was carried out where it was shown that the meniscal popliteal ligaments play a secondary role. The objective of this study is to demonstrate that injury to the meniscotibial ligaments is the cause of external meniscal hypermobility.Materials and methods: the cadaveric study was carried out in 2022 at Arthrex, Naples, Florida, United States. Prior to the arthroscopic evaluation, section of the meniscotibial ligaments was performed in the posterior third of the lateral meniscus, maintaining the popliteal meniscal ligaments and the posterior root insertion. Subsequently, the arthroscopic assessment is performed, showing anterior and superior translation of the posterior third of the external meniscus, and meniscal fixation is performed.Results: by fixing the posterior third of the lateral meniscus with a transosseous technique, in a failure or insufficiency of the meniscotibial ligaments, complete stability of the meniscus is achieved. Conclusion: the main stability of the posterior third of the lateral meniscus is given by the peripheral insertion of the meniscotibial ligaments, so external meniscal hypermobility is not due to injury to the popliteal meniscal ligaments. Level of Evidence: IV


Subject(s)
Biomechanical Phenomena , Meniscus , Knee Joint , Ligaments, Articular
3.
Article in Chinese | WPRIM | ID: wpr-1009231

ABSTRACT

The discoid meniscus is a common congenital meniscal malformation that is prevalent mainly in Asians and often occurs in the lateral discoid meniscus. Patients with asymptomatic discoid meniscus are usually treated by conservative methods such as observation and injury avoidance, while patients with symptoms and tears need to be treated surgically. Arthroscopic saucerization combined with partial meniscectomy and meniscus repair is the most common surgical approach., and early to mid-term reports are good. The prognostic factors are the patient's age at surgery、follow-up time and type of surgery. Some patients experience complications such as prolonged postoperative knee pain, early osteoarthritis, retears and Osteochondritis dissecans. The incidence of prolonged postoperative knee pain was higher and the incidence of Osteochondritis dissecans was the lowest. Retears of the lateral meniscus is the main reason for reoperation.


Subject(s)
Child , Humans , Osteochondritis Dissecans , Treatment Outcome , Follow-Up Studies , Knee Joint/surgery , Menisci, Tibial/surgery , Joint Diseases/surgery , Prognosis , Cartilage Diseases/surgery , Meniscus , Pain, Postoperative , Arthroscopy/methods
4.
Rev. bras. ortop ; 58(5): 755-759, Sept.-Oct. 2023. graf
Article in English | LILACS | ID: biblio-1529955

ABSTRACT

Abstract Objective Considerable attention has been paid to meniscotibial ligaments (MTLs), also known as coronary ligaments, especially after the "Save the Meniscus" initiative gained importance among knee surgeons. Technically challenging, the diagnosis and treatment of ramp lesion show the importance of MTLs. These ligaments were discovered long ago, but their contribution to knee stability has only recently been studied and still lacks information. Thus, the aim of the present study was to describe step-by-step an dissection technique of the medial MTL, efficient, reproducible and that may lead to further research. Method Twenty fresh cadaver knees were used, with no preference for sex or age. The knees were dissected using the same technique standardized by our team. Each dissection step was recorded digitally. Results The medial MTL was found in all 20 knees studied using the aforementioned technique. In our sample, the medial MTL exhibited an average length of 70.0 ± 13.4 mm and width of 32.25 ± 3.09 mm, thickness of 35.3 ± 2.7 mm and weight of 0.672 ± 0.134 g. In all the cases, the medial MTL originated proximally and deeply to the deep MTL in the tibia. Conclusion We describe a simple effective and reproducible medial MTL dissection technique that makes it possible to identify the ligament over the entire medial extension of the knee.


Resumo Objetivo Considerável atenção tem sido dada aos ligamentos meniscotibiais (LMT), também conhecidos como ligamentos coronários, especialmente depois que a iniciativa "Salve o Menisco" ganhou importância entre os cirurgiões de joelho. Tecnicamente desafiadores, o diagnóstico e o tratamento da lesão em rampa são importantes nos LMTs. Esses ligamentos foram descobertos há muito tempo, mas sua contribuição para a estabilidade do joelho foi recentemente estudada e ainda carece de informações. Assim, o objetivo deste estudo foi descrever passo a passo uma técnica de dissecção medial do LMT que é eficiente, reprodutível e que possa levar a novas pesquisas. Métodos Foram utilizados 20 joelhos de cadáveres frescos, sem preferência por sexo ou idade. Os joelhos foram dissecados com a mesma técnica padronizada por nossa equipe. Cada etapa da dissecação foi gravada digitalmente. Resultados O LMT medial foi encontrado em todos os 20 joelhos estudados com a técnica supracitada. Em nossa amostra, o LMT medial apresentou comprimento médio de 70,0 ± 13,4 mm e largura de 32,25 ± 3,09 mm, além de espessura de 35,3 ± 2,7 mm e peso de 0,672 ± 0,134 g. Em todos os casos, a origem do LMT medial era proximal e profunda em relação ao LMT profundo na tíbia. Conclusão Descrevemos uma técnica de dissecção simples do LMT medial que é eficaz, reprodutível e permite a identificação do ligamento em toda a extensão medial do joelho.


Subject(s)
Meniscus/surgery , Ligaments
5.
Int. j. morphol ; 41(2): 471-476, abr. 2023. tab
Article in Spanish | LILACS | ID: biblio-1440332

ABSTRACT

Los términos disco y menisco se encuentran en Terminologia Anatomica. Sin embargo, ambos términos son utilizados como sinónimos para referirse al cartílago intraarticular presente en la articulación temporomandibular (ATM). Por este motivo, el objetivo de este estudio es exponer las raíces griegas de los términos disco y menisco para evaluar la coherencia entre su relación léxica y su relación morfológica. Ambos términos fueron consultados en el Programa Federativo Internacional de Terminología Anatómica y en diccionarios de idiomas griego, español e inglés. La búsqueda reportó que el término "disco" deriva del latín discus, y este a su vez del griego δίσκος [dískos] que significa "cuerpo cilíndrico cuya base es muy grande respecto a su altura". Por su parte "menisco" proviene del griego mēnískos μηνίσκος [mḗn μήν gr. μείς 'meis', 'luna creciente' + -iskos gr. Sufijo diminutivo 'pequeño'] que significa "luna creciente pequeña" y se define como "cartílago de forma semilunar y de espesor menguante de la periferia al centro; forma parte de la articulación de la rodilla". Por lo tanto, la definición anatómica de disco articular y menisco está determinada por su morfología según la etimología de la palabra. En la ATM se encuentra un disco articular entre los huesos articulares, según su morfología.


SUMMARY: The terms disc and meniscus are found in Terminologia Anatomica. However, both terms are used synonymously to refer to the intra-articular cartilage present in the temporomandibular joint (TMJ). For this reason, this study aims to expose the greek roots of the terms disc and meniscus to evaluate the coherence between their lexical and morphological relationships. Both terms were consulted in the International Federative Program of Anatomical Terminology and in Greek, Spanish and, English dictionaries. The search reported that the term "disc" derives from the Latin discus, and this in turn from the Greek δίσκος [dískos], which means "cylindrical body whose base is very large compared to its height". For its part, "meniscus" comes from the Greek mēnískos μηνίσκος [mḗn μήν gr. μείς 'meis', 'crescent moon' + -iskos Gr. Diminutive suffix 'small'] which means "small crescent moon" and, is defined as "cartilage with a semilunar shape and decreasing thickness from the periphery to the center; It is part of the knee joint. Therefore, the anatomical definition of articular disc and meniscus is determined by its morphology according to the etymology of the word. In the TMJ, an articular disc is found between the articular bones, depending on their morphology.


Subject(s)
Humans , Temporomandibular Joint Disc/anatomy & histology , Meniscus/anatomy & histology , Terminology as Topic
6.
Rev. bras. ortop ; 58(2): 206-210, Mar.-Apr. 2023. tab, graf
Article in English | LILACS | ID: biblio-1449791

ABSTRACT

Abstract Objectives To perform a systematic review of the literature on the anatomy of the medial meniscotibial ligaments (MTLs), and to present the most accepted findings, as well as the evolution of the anatomical knowledge on this structure. Materials and Methods An electronic search was conducted in the MEDLINE/PubMed, Google Scholar, EMBASE and Cochrane library databases with no date restrictions. The following index terms were used in the search: anatomy AND meniscotibial AND ligament AND medial. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We included anatomical studies of the knee were included, such as cadaver dissections, histological and/or biological investigations, and/or imaging of the medial MTL anatomy. Results Eight articles that met the inclusion criteria were selected. The first article was published in 1984 and the last, in 2020. The total sample in the 8 articles was of 96 patients. Most studies are purely descriptive in terms of the macroscopic morphological and microscopic histological findings. Two studies evaluated the biomechanical aspects of the MTL, and one, the anatomical correlation with the magnetic resonance imaging examination. Conclusion The main function of the medial MTL, a ligament that originates in the tibia and is inserted in the lower meniscus, is to stabilize and maintain the meniscus in its position on the tibial plateau. However, there is a limited amount of information regarding medial MTLs, primarily in terms of anatomy, especially vascularization and innervation.


Resumo Objetivos Fazer uma revisão sistemática da literatura sobre a anatomia dos ligamentos meniscotibiais (LMTs) mediais, e apresentar os achados mais aceitos e a evolução das informações anatômicas sobre essa estrutura. Materiais e Métodos A busca eletrônica foi realizada nos bancos de dados MEDLINE/PubMed, Google Scholar, EMBASE e Cochrane, sem restrições de data. Os seguintes termos de indexação foram utilizados: anatomy AND meniscotibial AND ligament AND medial. A revisão seguiu as recomendações da declaração de Principais Itens para Relatar Revisões Sistemáticas e Metanálises (Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA, em inglês). Foram incluídos estudos anatômicos do joelho, como dissecções de cadáveres, investigações histológicas e/ou biológicas, e/ou imagens da anatomia do LMT medial. Resultados Oito artigos atenderam aos critérios de inclusão e foram selecionados. O primeiro foi publicado em 1984, e o último, em 2020. A amostra total nos 8 artigos foi de 96 pacientes. A maioria dos estudos é puramente descritiva em relação aos achados morfológicos macroscópicos e histológicos microscópicos. Dois estudos avaliaram os aspectos biomecânicos do LMT, e um analisou a correlação anatômica com o exame de ressonância magnética. Conclusão A principal função do LMT medial, ligamento que se origina na tíbia e se insere no menisco inferior, é estabilizar e manter a posição do menisco no platô tibial.


Subject(s)
Humans , Tibia/anatomy & histology , Meniscus/anatomy & histology , Knee/anatomy & histology , Ligaments
7.
Rev. bras. ortop ; 58(1): 85-91, Jan.-Feb. 2023. tab, graf
Article in English | LILACS | ID: biblio-1441340

ABSTRACT

Abstract Objective To analyze the dimensions of the posterior cruciate ligament (PCL), anterior cruciate ligament (ACL), the presence of meniscus-femoral ligaments MFLs in human knees, and the correlation with the dimensions of the knee skeleton. Methods Anatomical study on 29 specimens of human knees in which we measured the length and width of the cruciate and meniscus-femoral ligaments and the dimensions of femoral and tibia condyles and the femoral notch. The ACL length was calculated with different degrees of knee flexion. The relationship between the ligaments and bone dimensions were analyzed. Results The length of the ACL and the PCL were similar. Posterior MFL was more frequent and longer than the anterior MFL. We found the posterior MFL in the 72.41% of the knees and anterior MFL in 20.69%. The ACL presented 30% of its maximum length up to 60°, approximately half of its length between 90° and 120°, reaching its maximum length at 170°. We found a strong correlation between the length of the ACL and that of the PCL (p= 0.001). However, the lengths of the ACL and PCL were not related with the bone dimensions. Conclusion We have found no correlations between the cruciate and MFLs and the anatomical dimensions of the intercondylar notch and the proximal tibia and distal femur. The presence of the posterior MFL was more frequent and longer than that of the anterior ligament.


Resumo Objetivo Analisar as dimensões do ligamento cruzado posterior (LCP), do ligamento cruzado anterior (LCA), a presença de ligamentos meniscofemorais (LMFs) em joelhos humanos e a correlação com as dimensões do esqueleto do joelho. Métodos Estudo anatômico em 29 espécimes de joelhos humanos nos quais medimos o comprimento e a largura dos ligamentos cruzado e meniscofemoral e as dimensões dos côndilos femorais e tibiais e do entalhe femoral. O comprimento do LCA foi calculado com diferentes graus de flexão do joelho. Analisou-se a relação entre os ligamentos e as dimensões ósseas. Resultados O comprimento do LCA e do LCP foram semelhantes, LMF posterior foi mais frequente e mais longo do que o LMF anterior. Foram encontradas LMF posterior em 72,41% dos joelhos e LMF anterior em 20,69%. O LCA apresentou 30% de seu comprimento máximo até 60°, aproximadamente metade de seu comprimento entre 90° e 120°, atingindo seu comprimento máximo com flexão de 170°. Encontramos uma forte correlação entre o comprimento do LCA e do LCP (p= 0,001). No entanto, os comprimentos do LCA e do LCP não estavam relacionados com as dimensões ósseas. Conclusão Não encontramos correlações entre os ligamentos cruzado e meniscofemoral e as dimensões anatômicas do entalhe intercondilar e da tíbia proximal e do fêmur distal. A presença do LMF posterior foi mais frequente e maior que a do ligamento anterior.


Subject(s)
Humans , Anterior Cruciate Ligament , Posterior Cruciate Ligament , Meniscus , Knee
8.
Article in Spanish | LILACS, BINACIS | ID: biblio-1437498

ABSTRACT

Introducción: La sutura meniscal es una técnica cada vez más utilizada en pacientes con lesiones meniscales, con buenos resultados en la población general. Sin embargo, los estudios realizados en pacientes deportistas son escasos. Se analizaron las fallas de la sutura meniscal y el retorno al deporte en pacientes deportistas, y se identificaron posibles factores asociados. Materiales y Métodos: Se evaluaron retrospectivamente 61 suturas meniscales en deportistas (puntaje de Tegner ≥6) con un seguimiento mínimo de 12 meses. Cuarenta y nueve eran lesiones aisladas y 12 se asociaban con plástica del ligamento cruzado anterior. El seguimiento promedio fue de 61 meses y los pacientes fueron evaluados con los puntajes de Tegner y de Lysholm. Resultados: Se constató la falla de la sutura meniscal en 12 (19,67%) pacientes; la falla ocurrió, en promedio, 14 meses poscirugía. Nueve fallas se produjeron en suturas aisladas y 3 se asociaron con plástica del ligamento cruzado anterior (p <0,05). El menisco que más falló fue el interno. El 75% corresponde a pacientes que practicaban un deporte de contacto y pivote (p <0,05). Los pacientes que no sufrieron falla pudieron continuar con la misma actividad deportiva que antes de la lesión y el puntaje de Lysholm había mejorado significativamente (p <0,05). Conclusiones: Las fallas fueron significativamente más frecuentes en meniscos internos, suturas aisladas, lesiones en asa de balde, y deportes de contacto y pivote. Consideramos que la sutura meniscal es una excelente opción quirúrgica para pacientes deportistas, ya que un alto porcentaje de ellos retorna al deporte. Nivel de Evidencia: IV


Introduction: Meniscal suturing is a technique increasingly used in patients with meniscal lesions, with good outcomes in the general population. However, research on athletes is limited. Meniscal suture failures and return to sport in athletes were analy-zed, and possible contributing factors were identified. Materials and Methods: Sixty-one meniscal sutures in athletes (Tegner score ≥6) with a minimum follow-up of 12 months were retrospectively evaluated. Forty-nine were isolated lesions and 12 were associated with anterior cruciate ligament reconstruction. The average follow-up was 61 months and patients were evaluated with Tegner and Lysholm scores. Results: Meniscal suture failure was noted in 12 (19.67%) patients; failure occurred, on average, 14 months post-surgery. Nine failures occurred in isolated sutures and 3 were associated with anterior cruciate ligament recons-truction (p<0.05). The meniscus that failed the most was the internal meniscus. Seventy-five percent corresponded to patients who practiced pivot-contact sports (p<0.05). Patients who did not suffer failure were able to continue with the same sporting activity as before the injury and the Lysholm score had significantly improved (p<0.05). Conclusions: Failures were significantly more frequent in internal menisci, isolated sutures, bucket-handle injuries, and pivot-contact sports. We believe that meniscal suture is an excellent surgical option for athletic patients because a high percentage of them return to sports. Level of Evidence: IV


Subject(s)
Athletic Injuries , Sutures , Return to Sport , Meniscus , Knee
9.
Article in Chinese | WPRIM | ID: wpr-1009169

ABSTRACT

OBJECTIVE@#To investigate the correlation between the medial meniscal indentation index (MDI) and medial tibiofemoral articular cartilage damage more than 3 degrees in patients aged 40 to 60 years old with suspected or complicated knee osteoarthritis at non-weight-bearing position, and to determine the predictive threshold.@*METHODS@#From June 2016 to June 2020, a total of 308 patients who underwent initial knee arthroscopic exploration for chronic knee pain were collected. The age ranged from 36 to 71 years old with an average of(56.40±1.82) years old, including 105 males and 203 females. And patients with extra-articular malformations (abnormal force lines), a history of trauma, inflammatory arthritis and other specific arthritis were excluded. Finally, 89 eligible cases were obtained, aged from 42 to 60 years old with an average of (59.50±0.71) years old, including 45 males and 44 females. The degree of cartilage damage in the medial compartment of the knee joint was recorded, which was divided into two groups(≥degree 3 and<degree 3) according to Outer-Bridge classification system. The possible risk factors were determined by univariate analysis in the age, gender, affected sides, body mass index (BMI), synovial thickening grade, meniscus injury and MDI of 2 groups. Then, the independent risk factors for cartilage injury of more than grade 3 were determined by further binary Logistic regression analysis. If MDI was taken as an independent risk factor, receiver operating characteristic (ROC) analysis was performed to confirm whether it had diagnostic value for cartilage damage of above degree 3 and calculate the critical value of MDI.@*RESULTS@#A total of 89 eligible patients were obtained. Univariate analysis showed age, BMI, MDI and meniscus injury may be the independent risk factors for cartilage damage of more than 3 degrees, further binary Logistic regression analysis confirmed that MDI[OR=1.66, 95%CI(1.64, 1.69), P=0.01]and BMI [OR=1.58, 95%CI(1.17, 2.15), P=0.03] were independent risk factors for cartilage injury of more than degree 3 in enrolled patients. ROC analysis showed that MDI had more diagnostic value than BMI, and the critical value was 0.355 with a sensitivity of 89.1% and a specificity of 88.2%.@*CONCLUSION@#In doubt or accompanied by 40 to 60 years old patients with knee osteoarthritis, the MDI measured by non-weight-bearing knee MRI has predictive value for cartilage injury of more than degree 3 in medial tibiofemoral joint, and the critical value for diagnosis of cartilage injury of more than degree 3 is 0.355.


Subject(s)
Male , Female , Humans , Adult , Middle Aged , Aged , Osteoarthritis, Knee/surgery , Cartilage, Articular/surgery , Knee Joint/surgery , Meniscus , Menisci, Tibial/surgery , Cartilage Diseases , Magnetic Resonance Imaging/adverse effects
10.
Article in Chinese | WPRIM | ID: wpr-1009064

ABSTRACT

OBJECTIVE@#To summarize the clinical features, surgical methods, and prognosis of bucket-handle meniscal tears (BHMTs), and provide guidance for clinical treatment.@*METHODS@#The clinical data of 91 BHMTs patients (91 knees), who met the selection criteria and were admitted between January 2015 and January 2021, was retrospectively analyzed. There were 68 males and 23 females. Age ranged from 16 to 58 years with an average of 34.4 years. The injury was caused by sports in 68 cases, traffic accident in 15 cases, and falls or sprains in 8 cases. There were 49 cases of left knee injury and 42 cases of right knee injury. The time from the onset of symptoms to the admission ranged from 1 day to 13 months (median, 18 days), including >1 month in 35 cases and ≤1 month in 56 cases. Medial BHMTs occurred in 52 cases and lateral BHMTs in 39 cases. There were 36 cases with ACL rupture and 12 cases with discoid meniscus. The knee extension was limited more than 10° in 55 cases. According to the condition of meniscus injury, the meniscus suture with Inside-out combined with All-inside techniques (54 cases) or meniscoplasty (37 cases) under arthroscopy were selected. ACL reconstruction was performed in all patients with ACL rupture with autogenous hamstring tendon. Postoperative complications were observed. International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score were used to evaluate knee function, and clinical failure was recorded.@*RESULTS@#Two patients developed intermuscular venous thrombosis, which improved after oral anticoagulant therapy. No vascular injury, postoperative infection, joint stiffness, or other complications occurred in all patients. All patients were followed up 24-95 months, with a median of 64 months. A total of 12 cases (13.19%) failed the operation and were re-operated or given oral anti-inflammatory analgesics and rehabilitation therapy. At last follow-up, IKDC score and Lysholm score of 91 patients significantly increased when compared with those before operation ( P<0.05), while Tegner score significantly decreased ( P<0.05). The above indexes of patients treated with meniscus suture and meniscoplasty were also significantly different from those before operation ( P<0.05).@*CONCLUSION@#BHMTs occurs mostly in young men and is one of the important reasons for the limitation of knee extension after trauma. Arthroscopic meniscus suture and meniscoplasty can obtain good effectiveness according to individual conditions of patients. But the latter can better preserve the shape and function of meniscus, and theoretically can obtain better long-term outcomes, which needs to be confirmed by further research with larger sample size.


Subject(s)
Male , Female , Humans , Adolescent , Young Adult , Adult , Middle Aged , Treatment Outcome , Retrospective Studies , Meniscus , Knee Joint/surgery , Menisci, Tibial/surgery , Knee Injuries/diagnosis , Rupture , Tibial Meniscus Injuries/surgery , Arthroscopy/methods , Anterior Cruciate Ligament Injuries/surgery
11.
Journal of Biomedical Engineering ; (6): 1185-1191, 2023.
Article in Chinese | WPRIM | ID: wpr-1008949

ABSTRACT

A novel structural dynamics test method and device were designed to test the biomechanical effects of dynamic axial loading on knee cartilage and meniscus. Firstly, the maximum acceleration signal-to-noise ratio of the experimental device was calculated by applying axial dynamic load to the experimental device under unloaded condition with different force hammers. Then the experimental samples were divided into non-specimen group (no specimen loaded), sham specimen group (loaded with polypropylene samples) and bovine knee joint specimen group (loaded with bovine knee joint samples) for testing. The test results show that the experimental device and method can provide stable axial dynamic load, and the experimental results have good repeatability. The final results confirm that the dynamic characteristics of experimental samples can be distinguished effectively by this device. The experimental method proposed in this study provides a new way to further study the biomechanical mechanism of knee joint structural response under axial dynamic load.


Subject(s)
Animals , Cattle , Biomechanical Phenomena , Knee Joint/physiology , Meniscus , Mechanical Phenomena , Weight-Bearing
12.
Rev. bras. ortop ; 57(6): 1014-1021, Nov.-Dec. 2022. tab, graf
Article in English | LILACS | ID: biblio-1423633

ABSTRACT

Abstract Objective The aim of the present study was to investigate the difference between clinician-completed and patient-completed outcome scores in detecting improvement following arthroscopic meniscectomy in patients with meniscal tears of the knee. Methods Thirty-four patients with meniscal tears were prospectively assessed using 9 clinical outcome measures. The five clinician-completed knee scores included the Tegner Activity Score, the Lysholm Knee Score, the Cincinnati Knee Score, the International Knee Documentation Committee (IKDC) Examination Knee Score, and the Tapper and Hoover Meniscal Grading Score. The four patient-completed knee scores included the IKDC Subjective Knee Score, the Knee Outcome Survey - Activities of Daily Living Scale (KOS-ADLS), the Short Form-12 Item Health Survey (SF-12), and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Twenty-nine of the 34 patients underwent an arthroscopic meniscectomy and were reassessed with all 9 outcome scores upon their follow-up review. Results A significant longitudinal improvement was observed in 4 of the 5 clinician-completed scores (Tegner [p< 0.001], Lysholm [p= 0.004], Cincinnati [p = 0.002] and Tapper and Hoover [p< 0.001], but not in the IKDC Examination [p= 0.332]. However, the IKDC Subjective score (p= 0.021) was the only patient-completed score to demonstrate significant improvement postoperatively. Conclusion Overall, clinician-completed scoring systems were found to be inconsistent with those of patient-completed instruments. The mode of administering outcome measures can have a significant influence on the outcome results both for research and for clinical practice. A combination of both a clinician-completed with a patient-completed instrument may be a more balanced approach to assessing and quantifying meniscus tears and the outcome following arthroscopic meniscectomy.


Resumo Objetivo O objetivo do presente estudo foi investigar a diferença entre instrumentos de desfechos preenchidos por médicos e pacientes na detecção de melhora após a meniscectomia artroscópica para tratamento de rupturas de menisco. Métodos Trinta e quatro pacientes com rupturas de menisco foram avaliados de forma prospectiva usando 9 medidas de desfechos clínicos. Os cinco instrumentos de avaliação de joelho respondidos por médicos foram o Escore de Atividade de Tegner, o Escore de Joelho de Lysholm, o Escore de Joelho de Cincinnati, o Escore de Exame do Joelho do International Knee Documentation Committee (IKDC, na sigla em inglês) e o Escore de Classificação do Menisco de Tapper e Hoover. Os quatro instrumentos de avaliação do joelho respondidos por pacientes foram o Escore Subjetivo do Joelho do IKDC, a Pesquisa de Desfecho de Joelho - Escala de Atividades de Vida Diária (KOS-ADLS, na sigla em inglês), o Formulário Curto de Pesquisa em Saúde de 12 Itens (SF-12, na sigla em inglês) e o Escore de Desfecho de Osteoartrite e Lesões no Joelho (KOOS, na sigla em inglês). Vinte e nove dos 34 pacientes foram submetidos a uma meniscectomia artroscópica e reavaliados com todos os 9 instrumentos na sua consulta de acompanhamento. Resultados Uma melhora longitudinal significativa foi observada em 4 dos 5 instrumentos respondidos por médicos (Tegner [p< 0,001], Lysholm [p= 0,004], Cincinnati [p= 0,002] e Tapper e Hoover [p< 0,001], mas não no IKDC [p= 0,332]). Por outro lado, o Escore Subjetivo do Joelho do IKDC (p= 0,021) foi o único instrumento respondido por pacientes a demonstrar melhora pós-operatória significativa. Conclusão De modo geral, os instrumentos respondidos por médicos foram considerados inconsistentes em relação àqueles respondidos por pacientes. O modo de administração dos instrumentos pode ter influência significativa nos resultados, tanto para fins de pesquisa quanto para a prática clínica. A combinação de um instrumento respondido pelo médico com um instrumento respondido pelo paciente pode ser uma abordagem mais equilibrada para a avaliação e a quantificação das rupturas do menisco e do desfecho após a meniscectomia artroscópica.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Outcome Assessment, Health Care , Lysholm Knee Score , Meniscus/surgery , Meniscectomy
13.
Artrosc. (B. Aires) ; 29(2): 75-80, 2022.
Article in Spanish | LILACS, BINACIS | ID: biblio-1380195

ABSTRACT

Introducción: La subluxación del menisco externo indemne, por desinserción meniscocapsular posterior, es una causa de dolor y bloqueo articular poco frecuente y con escasa bibliografía reportada hasta la fecha.Materiales y métodos: presentamos una serie de doce pacientes a los que se diagnosticó por clínica y examen físico: referían bloqueo articular y dolor recurrente. En todos los casos, la resonancia magnética fue informada como normal. En todos los casos, además, se realizó sutura meniscal con sistema todo-adentro asociado a puntos verticales de afuera-adentro.Resultados: el seguimiento promedio fue de cuatro años y dos meses (rango de 7 a 2 años). Al año de la cirugía los pacientes fueron citados para realizarles examen físico y completar las escalas de Lysholm y Tegner para la reinserción deportiva; todos los pacientes refirieron remisión de la sintomatología, sin complicaciones. El promedio de la escala de Lysholm fue de 97.5 puntos (mín. 90 ­ máx. 100) y el promedio en la escala de Tegner para reinserción deportiva fue de 7.6 (mín. 7 ­ máx. 9).Conclusión: se debe sospechar la desinserción meniscocapsular del menisco externo en pacientes que presentan antecedentes de bloqueos o pseudobloqueos de rodilla (meniscales), con resonancia informada como normal, o sin lesión meniscal cuantificada, y que no respondan al tratamiento médico. Ante la alta sospecha de esta patología, y como se observa en nuestra serie, su reparación, a corto plazo, muestra excelentes resultados. Nivel de Evidencia: IV


Introduction: Subluxation of a healthy lateral meniscus, due to posterior meniscal capsular disinsertion, is an uncommon cause of pain and locking knee. Literature reported so far is scarce.Materials and methods: we present a case series of twelve patients, in which the diagnosis was made by clinical presentation and physical examination: locking knee episodes and recurrent pain. In all cases, the MRI did not show any abnormalities. Meniscal fixation was made in all patients, using a combination of all-inside and vertical outside-in sutures, achieving a stable meniscus.Results: one year after surgery, patients were given an appointment to perform a physical examination, complete the Lysholm score and Tegner activity scale. Average follow-up was four years and two months (range 2 to 7 years). One year after surgery, all patients reported remission of symptoms without complications. Average of the Lysholm score was 97.5 points (min. 90 ­ max. 100) and Tegner activity scale for sports reintegration was 7.6 (min. 7 ­ max. 9).Conclusion: posterior capsular meniscal disinsertion of the lateral meniscus should be suspected in patients with a history of locking knee (meniscal), with MRI reported as normal or without quantified meniscal injury, and who do not respond to medical treatment. Given the high suspicion of this pathology and as observed in our series, in the short term, their repair shows excellent results. Level of Evidence: IV


Subject(s)
Child , Adolescent , Adult , Pain , Meniscus/injuries , Joint Instability , Knee Joint
14.
Article in English | WPRIM | ID: wpr-922353

ABSTRACT

PURPOSE@#To retrospectively analyze the clinical outcomes of meniscus repair with simultaneous anterior cruciate ligament (ACL) reconstruction and explore the causes of failure of meniscus repair.@*METHODS@#From May 2013 to July 2018, the clinical data of 165 patients who were treated with meniscus surgery and simultaneous ACL reconstruction, including 69 cases of meniscus repair (repair group) and 96 cases of partial meniscectomy (partial meniscectomy group) were retrospectively analyzed. The exclusion criteria were as follows: (1) ACL rupture associated with fracture, collateral ligament injury, or complex ligament injury; (2) a history of knee surgery; or (3) a significant degree of osteoarthritis. The 69 patients in the repair group were divided into the non-failure group (62 cases) and the failure group (7 cases) depending on the repair effect. Postoperative outcomes of the repair group and the partial meniscectomy group were compared. General conditions and postoperative outcomes of the failure group and the non-failure group were compared. During the median follow-up period of 28 months (range, 4 - 65 months) after the second arthroscopy, postoperative outcomes of seven patients in the failure group were summarized. SPSS 25.0 statistical software was used for statistical analysis. A p value less than 0.05 was considered statistically significant.@*RESULTS@#Seven patients in the failure group who underwent the second arthroscopy were followed up for (30 ± 17.4) months and their postoperative outcomes were summarized. Compared with the partial meniscectomy group, the International Knee Documentation Committee scores of patients in the repair group improved significantly (p = 0.031). Compared with the non-failure group, more patients in the failure group were younger than 24 years (p = 0.030). The median follow-up period was 39.5 months. All patients recovered well after subsequent partial meniscectomy and relieved clinical symptoms. Visual analog scale scores decreased significantly (p = 0.026), and the International Knee Documentation Committee and Lysholm scores improved significantly (p = 0.046 for both).@*CONCLUSION@#The failure rate of meniscus repair in this study was 10.1% (7/69), all of which were medial meniscus tears. However, the surgical outcomes of ACL reconstruction were not affected, and there might be a role for graft protection. Therefore, meniscus retears can be successful treated by performing subsequent partial meniscectomy in patients with repair failure.


Subject(s)
Humans , Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament Reconstruction , Menisci, Tibial/surgery , Meniscus , Retrospective Studies
15.
Rev. bras. ortop ; 56(2): 133-137, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1251352

ABSTRACT

Abstract Medial arthrosis of the knee is an evolutionary pathology that occurs due to progressive muscle imbalance. The muscles of the knee region have a large imbalance caused by the difference of power and lever arm. With the progression of life, this imbalance manifests itself more importantly, especially due to the loss of muscle strength due to aging. Pathological postures begin to occur and determine areas of support and pressure harmful to the joint. Meniscal injury is typical in the evolution of this pathology, as well as cartilage injury. The recognition of this pathology enables good results with less aggressive treatments, such as correction of muscle imbalance and consequent reeducation of joint support. Economic and partial meniscectomy brings good results in the early stages of the degenerative process. Progressive evolution leads to knee degeneration and the consequent need for broader surgeries.


Resumo A artrose medial do joelho é uma patologia evolutiva que ocorre em decorrência de desequilíbrio muscular progressivo. Os músculos da região do joelho têm um grande desequilíbrio, provocado pela diferença de potência e braço de alavanca. Com a progressão da vida, este desequilíbrio se manifesta de forma mais importante, especialmente em decorrência da perda de força muscular em função do envelhecimento. Posturas patológicas passam a ocorrer e determinar zonas de apoio e pressão lesivas para a articulação. A lesão meniscal é típica na evolução desta patologia, assim como a lesão da cartilagem. O reconhecimento desta patologia possibilita resultados bons com tratamentos menos agressivos, como a correção do desequilíbrio muscular e consequente reeducação do apoio da articulação. A meniscectomia econômica e parcial traz bons resultados nas fases iniciais do processo degenerativo. A evolução progressiva leva à degeneração do joelho e à consequente necessidade de cirurgias mais amplas.


Subject(s)
Osteoarthritis/diagnosis , Osteoarthritis/therapy , Osteonecrosis , Meniscus/injuries
16.
Int. j. morphol ; 39(1): 32-37, feb. 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1385300

ABSTRACT

RESUMEN: La población femenina de adultos mayores suele presentar daños de los discos o meniscos articulares de la rodilla (DAR) generalmente derivados de procesos degenerativos de cartílago ocurridos en osteoartritis. Conocer patrones morfológicos estándares de los DAR en una población demográfica específica permite tener claridad de las características autóctonas de dicha población. Una forma de caracterizar estos patrones es a través del diseño de Modelos de Elementos Finitos (MEF) que permiten predecir anormalidades clínicas y radiológicas. Hasta el momento es escasa la evidencia sobre las características morfométricas de los DAR en la población colombiana. Por esta razón, el objetivo del presente estudio fue describir la morfometría de DAR en imágenes por resonancia magnética (IRM) de mujeres colombianas saludables. En este estudio se tomaron 25 IRM de la rodilla de mujeres colombianas con normo-peso, sin antecedentes de patología de la rodilla, ni historia de trauma o cirugía de esta, y con edades entre los 18 y 60 años. El análisis del ancho del cuerno posterior del DAR medial (12,73 ± 2,42) comparado con el lateral (8,04 ± 1,52) arrojó diferencia estadísticamente significativa (p<0,05). Por otra parte, el DAR medial presentó un diámetro antero-posterior aumentado (38,52 ± 2,71) en comparación con el del DAR lateral (29,18 ± 2,75) cercano a la significancia estadística (p=0.051). De igual manera, la altura del cuerno anterior se encontró aumentada en el DAR medial (4,42 ± 0,79) en comparación con el lateral (3,66 ± 0,76), con tendencia a la significancia estadística (p=0,063). Anatómicamente se reconoce que los DAR medial y lateral se adaptan a la forma y tamaño de los cóndilos femorales, lo que concuerda con las medidas resultantes de la población estudiada, donde se evidencia un DAR medial más largo (diámetro antero-posterior) y menos alto que el lateral.


SUMMARY: The elderly female population usually presents damage to the articular discs or menisci of the knee (ADK), generally derived from degenerative cartilage processes that occur in osteoarthritis. Knowing the standard morphological patterns of ADKs in a specific demographic population allows clarity of the indigenous characteristics of that population. One way to characterize these patterns is through the design of Finite Element Models (FEM) that would enable predicting clinical and radiological abnormalities. So far, there is little evidence on the morphometric characteristics of ADKs in the Colombian population. Thus, the objective of the present study was to describe the morphometry of ADK in magnetic resonance imaging (MRI) of healthy Colombian women. In this study, 25 MRIs of the knee of Colombian women with normal weight were taken, with no history of knee pathology, trauma, or surgery, and with ages between 18 and 60 years. The analysis of the width of the posterior horn of the medial ADK (12.73 ± 2.42) compared to the lateral (8.04 ± 1.52) showed a statistically significant difference (p <0.05). On the other hand, the medial ADK presented an increased anteroposterior diameter (38.52 ± 2.71) compared to that of the lateral ADK (29.18 ± 2.75) close to statistical significance (p = 0.051). Similarly, the height of the anterior horn was found to be increased in the medial ADK (4.42 ± 0.79) compared to the lateral (3.66 ± 0.76), with a trend towards statistical significance (p = 0.063). Anatomically, it is recognized that the medial and lateral ADK adapt to the shape and size of the femoral condyles, which is in agreement with the results of the studied population where measurements show that medial ADK has a longer (anterior to posterior diameter) and a shorter height than the lateral ADK.


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Young Adult , Magnetic Resonance Imaging , Meniscus/diagnostic imaging , Knee Joint/diagnostic imaging , Cross-Sectional Studies , Colombia , Finite Element Analysis , Meniscus/anatomy & histology , Knee Joint/anatomy & histology
17.
Artrosc. (B. Aires) ; 28(3): 197-203, 2021.
Article in Spanish | LILACS, BINACIS | ID: biblio-1348315

ABSTRACT

Introducción: El objetivo del siguiente trabajo es mostrar los resultados de reparaciones meniscales en asa de balde con un seguimiento mínimo a dos años, describir la técnica quirúrgica utilizada y analizar los resultados funcionales, complicaciones y causas de falla. Materiales y métodos: evaluamos retrospectivamente pacientes intervenidos quirúrgicamente por nuestro equipo a los que se les realizó reparación de lesión en asa de balde meniscal, con cinco o más suturas, asociada, o no, a lesión del LCA. Se excluyeron los pacientes a los que se les realizaron cuatro o menos suturas y aquellos con cirugías previas y seguimiento menor a dos años. Resultados: cuarenta pacientes con edad promedio de veintiséis años (rango 8-60). Seguimiento promedio de cuarenta y ocho meses (rango 24-60). El promedio de suturas utilizadas fue de seis (rango 5-9 puntos). Cuatro pacientes presentaron fallas aisladas de la sutura meniscal por eventos traumáticos. Hasta la fecha, los pacientes con lesión asociada del LCA no presentaron fallas. Los scores de Lysholm, Tegner e IKDC mostraron gran mejoría en el postoperatorio. Conclusión: en la serie estudiada encontramos muy buenos resultados funcionales con la reparación meniscal, con un índice de falla del 10%. Es por esto que, para este tipo de lesiones, estimulamos al cirujano artroscopista a intentar la sutura meniscal por sobre la meniscectomía, aunque la primera sea, técnicamente, más demandante. Nivel de Evidencia: IV


Introduction: our aim is to show the results of bucket handle meniscal repairs with a minimum follow-up of two years, describing the surgical technique used and analyzing the functional results, complications and causes of failure. Materials and methods: we retrospectively reviewed those patients who were treated by our surgical team who experienced a bucket-handle meniscus tear that were isolated or with concomitant ACL injury. We excluded patients with four sutures or less, previous surgeries and follow up less than two years.Results: forty patients were included between 8 and 60 years old (average of 26 years). Average follow up of 48 months (range 24 to 60 months). The number of sutures varies from five up to nine (average: 6). Four patients (10%) were defined as failure, due to a new sport traumatic event. None of these had an ACL concomitant surgery. Lysholm, Tegner and IKDC post-operative score show promising results. Conclusions: we found encouraging outcomes and functional results with meniscal repair, with a failure rate of 10%. This is why, for this type of injury, we encourage the surgeon to always try meniscal repair over meniscectomy, although the former is technically more demanding. Level of Evidence: IV


Subject(s)
Arthroscopy/methods , Treatment Outcome , Meniscus/injuries , Knee Injuries
18.
Article in Chinese | WPRIM | ID: wpr-921910

ABSTRACT

OBJECTIVE@#To evaluate clinical efficacy of arthroscopic with platelet-rich plasma (PRP) in treating meniscus injury.@*METHODS@#From January 2015 to December 2019, clinical control study on repair meniscus injury by arthroscopic with PRP between arthroscopic were searched by PubMed, Science Direct, Cochrane library, Chinese Journal Full-text Database, Wanfang and VIP database. Literature screening, data extraction and quality evaluation according to inclusion and exclusion criteria. Visual analogue scale(VAS) of knee joint and Lysholm score at 1, 6 and 12 months after opertaion between two groups were compared, and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) at 3, 6 and 12 months after opertaion between twogroups were also compared.@*RESULTS@#Totally 9 literatures and 329 patients with meniscal injuries were screened, include 146 patients treated by arthroscopic with PRP and 183 patients treated by arthroscopic. There were no statistical differences in VAS between two groups at 1, 6 and 12 months after opertaion. There were differences in Lysholm score at 1 and 6 months after operation between two groups [@*CONCLUSION@#Arthroscopic with PRP for repair meniscus injury has short term efficacy of knee function and delay arthritis, while has similar effect in long term clinical efficacy and relieve pain.


Subject(s)
Humans , Arthroscopy , Knee Joint , Meniscus , Osteoarthritis, Knee , Platelet-Rich Plasma , Tibial Meniscus Injuries/surgery , Treatment Outcome
19.
Rev. bras. ortop ; 55(6): 778-782, Nov.-Dec. 2020. graf
Article in English | LILACS | ID: biblio-1156183

ABSTRACT

Abstract Objectives The present paper aims to evaluate and compare the histological features of fresh and frozen menisci stored in a tissue bank for 1 month and for 5 years. Methods The meniscal grafts were subjected to a histological study. A total of 10 menisci were evaluated; 2 were frozen for 5 years, 4 were frozen for 1 month, and 4 were fresh, recently harvested specimens. Histological properties were evaluated in sections stained with hematoxylin and eosin and Masson trichrome methods. Results The menisci frozen for 1 month showed partially preserved collagen fiber structure and no significant hydropic tissue degeneration. The menisci frozen for 5 years presented an evident dissociation of collagen fibers and multiple foci of hydropic degeneration. Discussion Degeneration was much more significant in menisci stored for 5 years, indicating that a long freezing period results in substantial progression of tissue deterioration. This may suggest that the 5-year period, considered the maximum time for graft storage before transplant, is too long. Conclusion Grafts stored for 1 month showed a slight degenerative change in collagen fibers, whereas menisci frozen for 5 years presented significant tissue degeneration.


Resumo Objetivos Avaliar e comparar as características histológicas de meniscos frescos e meniscos congelados armazenados em banco de tecidos por 1 mês e por 5 anos. Métodos Foi feito um estudo histológico com enxertos meniscais. Avaliamos 10 meniscos, sendo 2 que ficaram armazenados sob congelamento por 5 anos, 4 armazenados congelados por 1 mês, e 4 frescos, recém captados. Foram feitos cortes histológicos corados com hematoxilina e eosina e Tricrômico de Masson, para avaliação das propriedades histológicas. Resultados Os meniscos congelados por 1 mês apresentaram preservação parcial da estrutura das fibras colágenas, sem degeneração hidrópica significativa do tecido. Nos meniscos congelados por 5 anos, observamos dissociação evidente das fibras colágenas, com presença de múltiplos focos de degeneração hidrópica. Discussão Encontramos degeneração bem mais significativa nos meniscos armazenados por 5 anos, o que indica que o longo período de congelamento leva à progressão significativa da degeneração do tecido. Isto pode sugerir que o período de 5 anos, considerado período máximo que o enxerto pode permanecer armazenado antes de ser transplantado, é um período muito longo. Conclusão Nos enxertos armazenados por 1 mês, existiu apenas discreta alteração degenerativa das fibras colágenas, enquanto que nos meniscos com 5 anos de congelamento foi observada degeneração significativa do tecido. Tibiais


Subject(s)
Tissue Banks , Wounds, Penetrating , Collagen , Eosine Yellowish-(YS) , Transplants , Meniscus , Freezing , Goals , Hematoxylin
20.
Arq. bras. med. vet. zootec. (Online) ; 72(5): 1646-1652, Sept.-Oct. 2020. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1131575

ABSTRACT

The objective was to establish the reference standards for elastography of the main structures of the canine stifle joint. The medial meniscus, patellar and cruciate ligaments of thirty healthy beagles was evaluated by B-mode and ARFI elastography (n=60 joints). Analysis detected a positive correlation of the shear wave velocity (SWV) of structures according to age. Patellar ligament presented a gradual stiffness increase in relation to age, while medial meniscus and cruciate ligament were more rigid in puppies than in adults. However, greater stiffness of these structures was observed in elderly animals. Elasticity of each structure was evaluated according to gender and reproductive status. Females presented greater stiffness of all structures, with SWV differing 0.3 and 0.36m/s between genders. Only the medial meniscus was not stiffer in neutered animals when compared to intact animals, differing only 0.02m/s in menisci and 0.4 to 0.47m/s in ligaments between groups. These findings corroborate with literature data that states a higher prevalence of ligament insufficiency in elderly dogs, females and neutered animals. It was concluded that ARFI elastography of the canine stifle joint is feasible and its application can be potentially effective in early diagnosis of ligament and meniscal changes.(AU)


O objetivo foi estabelecer os padrões normais para elastografia das principais estruturas da articulação do joelho em cães. O menisco medial, ligamento patelar e cruzado de trinta beagles saudáveis foram avaliados pelo modo B e elastografia ARFI (n=60 articulações). A análise detectou uma correlação positiva da velocidade de cisalhamento (SWV) das estruturas com a idade. O ligamento patelar apresentou um aumento gradual da rigidez em relação à idade, enquanto o menisco medial e o ligamento cruzado foram mais rígidos em filhotes do que em adultos. Entretanto, observou-se maior rigidez dessas estruturas em idosos. A elasticidade de cada estrutura foi avaliada de acordo com o sexo e o estado reprodutivo. As fêmeas apresentaram maior rigidez em todas as estruturas, com SWV diferente de 0,3 e 0,36m/s entre os sexos. Somente o menisco medial não foi mais rígido nos animais castrados quando comparado não castrados, diferindo apenas 0,02m/s no menisco e 0,4 a 0,47m/s nos ligamentos entre os grupos. Esses achados corroboram com dados da literatura que afirmam maior prevalência de insuficiência ligamentar em cães idosos, fêmeas e animais castrados. Concluiu-se que a elastografia ARFI da articulação do joelho canino é viável e sua aplicação pode ser eficaz no diagnóstico precoce de alterações ligamentares e meniscais.(AU)


Subject(s)
Animals , Dogs , Patellofemoral Joint/diagnostic imaging , Meniscus/diagnostic imaging , Knee Joint/diagnostic imaging , Ultrasonography/veterinary , Elasticity Imaging Techniques/veterinary
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