It is a very common injury, especially among people who play sports. The aim is to strengthen the muscles surrounding the knee, such as the front thigh muscles, known as the quadriceps. Work up slowly to more intense exercise activity. Orthop J Sports Med 8(7):2325967120936672, Koga H, Muneta T, Watanabe T, Mochizuki T, Horie M, Nakamura T et al (2016) Two-year outcomes after arthroscopic lateral meniscus centralization. Without surgery, recovery will take about 6 to 8 weeks, though this can vary. In general, Ayurvedic treatment considers the whole state of the person, not just the specific location of the pain. (2012). And finally, the proper anatomical placement of the allograft is essential. Am J Sports Med 45(1):4249, Krych AJ, Bernard CD, Leland DP, Camp CL, Johnson AC, Finnoff JT et al (2020) Isolated meniscus extrusion associated with meniscotibial ligament abnormality. Clinical significance and management of meniscal extrusion in different knee pathologies: a comprehensive review of the literature and treatment algorithm, https://doi.org/10.1186/s43019-022-00163-1, Anterior cruciate ligament reconstruction (ACLR), https://doi.org/10.1007/s00167-020-06363-0, https://link.springer.com/article/10.1007%2Fs00402-020-03683-1, https://doi.org/10.1186/s43019-019-0019-x, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. We avoid using tertiary references. Semin Arthritis Rheum 45(3):257267, Liu Y, Joseph GB, Foreman SC, Li X, Lane NE, Nevitt MC et al (2020) Determining a threshold of medial meniscal extrusion for prediction of knee pain and cartilage damage progression over 4 years: data from the osteoarthritis initiative. Semin Arthritis Rheum 46(5):552561, LaPrade RF, LaPrade CM, James EW (2015) Recent advances in posterior meniscal root repair techniques. A tear that gives you a lot of pain or impairs use of your knee may require surgery to remove or repair the torn part of the meniscus. https://doi.org/10.1177/2325967120961368, Paletta GA, Crane DM, Konicek J, Piepenbrink M, Higgins LD, Milner JD et al (2020) Surgical treatment of meniscal extrusion: a biomechanical study on the role of the medial meniscotibial ligaments with early clinical validation. Zheng J, Zhai W, Li Q, Jia Q, Lin D. A Special Tear Pattern of Anterior Horn of the Lateral Meniscus: Macerated Tear. Osteoarthritis Cartilage 26(7):912919, Roubille C, Martel-Pelletier J, Abram F, Dorais M, Delorme P, Raynauld JP et al (2015) Impact of disease treatments on the progression of knee osteoarthritis structural changes related to meniscal extrusion: data from the OAI progression cohort. Your doctor may also recommend conservative measures as a first step if the tear is caused by injury to the knee. What is the usual treatment for a meniscal tear? Symptomatic meniscal tears are usually treated surgically. If the tear is in an area of the meniscus that has good blood supply, then it will generally be repaired with sutures. The concurrent ACLR with repair of the menisci has shown good clinical and functional results and less risk of reoperation during the follow-up periods [83, 87]. It is often used with chronic degenerative conditions although some authors also propose this term in the setting of a tear (macerated tear)2. Whilst APM is one of the most commonly performed orthopaedic procedures [], meniscal repair is the treatment of choice for the young athlete with an acute meniscal tear [].Meniscal repair is most commonly performed in younger populations aged under 35 years [10, 2127] and aims to preserve the entire meniscus, without excision.The Surgical versus conservative interventions for treating meniscal tears of the knee in adults. Webinferior leaet of the meniscus tear. Knee arthroscopy, a minimally invasive procedure, is often used to treat meniscal tears. At the time the article was created Yuranga Weerakkody had no recorded disclosures. Although meniscal allografts that are secured with the suture-only technique tend to show a greater degree of extrusion than the bony-fixation techniques, bony-fixation techniques still show high extrusion rates (2550%). Although there is still controversy in the literature in respect of the optimal cutoff value, a threshold of 3mm is considered significant. Arthroscopy 27(7):914922, Kim JH, Lee S, Ha DH, Lee SM, Jung K, Choi W (2018) The effects of graft shrinkage and extrusion on early clinical outcomes after meniscal allograft transplantation. CARTILAGE 21:1947603520934525, Lee DH, Lee BS, Kim JM, Yang KS, Cha EJ, Park JH et al (2011) Predictors of degenerative medial meniscus extrusion: radial component and knee osteoarthritis. The tear frequently occurs while playing sports. They will test your range of motion. Therefore, ultrasound (U/S) was recently introduced as a reliable alternative to MRI for the evaluation of ME, which also offers the possibility for dynamically assessing ME in various positions, as well as in a weight-bearing state, in an inexpensive and feasible manner [20,21,22]. Here's what you need to know as well as a chart. Osteoarthritis Cartilage 20(12):15071513, Bevers K, Bijlsma JW, Vriezekolk JE, van den Ende CH, den Broeder AA (2014) Ultrasonographic features in symptomatic osteoarthritis of the knee and relation with pain. Straighten the opposite knee using the muscles on the front of the thigh. Arthritis Care Res 68(10):15601566, Article It is associated with either rapidly progressive knee osteoarthritis or early onset of knee osteoarthritis and increased morbidity. Some clinical studies on its effectiveness exist, but more research is needed. Knee Surg Sports Traumatol Arthrosc 27(2):361368, Jacob G, An S, Kumar G, Varghese J (2020) Percutaneous arthroscopic assisted knee medial collateral ligament repair. People who tear a meniscus often feel like something has popped in their knee at the time of the injury. Sonographic evaluation of lateral meniscal extrusion: implementation and validation|SpringerLink [Internet]. Get useful, helpful and relevant health + wellness information, 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.merckmanuals.com/home/injuries-and-poisoning/sprains-and-other-soft-tissue-injuries/knee-sprains-and-related-injuries), (https://www.niams.nih.gov/health-topics/knee-problems#tab-overview), (https://orthoinfo.aaos.org/en/treatment/knee-arthroscopy/), (https://orthoinfo.aaos.org/en/diseases--conditions/meniscus-tears/), (https://www.physio-pedia.com/Meniscal_Repair). Knee Surg Sports Traumatol Arthrosc 27(8):26172623, Astur DC, Novaretti JV, Gomes ML, Rodrigues AG, Kaleka CC, Cavalcante ELB et al (2020) Medial opening wedge high tibial osteotomy decreases medial meniscal extrusion and improves clinical outcomes and return to activity. Your doctor will bend your knee, then straighten and rotate it. Cite this article. A narrative review with focus on relevance for osteoarthritis research. PubMed All rights reserved. Post-ACLR ME is also a concern and should be prevented by repairing concurrent meniscal tears and centralizing the meniscus along with the ACLR. In this review, we delineate the clinical significance of ME in various knee pathologies, as well as when, why and how it should be managed. Knee Surg Sports Traumatol Arthrosc 19(2):222229, Oo WM, Linklater JM, Bennell KL, Pryke D, Yu S, Fu K et al (2021) Are OMERACT knee osteoarthritis ultrasound scores associated with pain severity, other symptoms, and radiographic and magnetic resonance imaging findings? If the tear is too big to repair, your surgeon may remove all or part of the meniscus. Arthroscopy 35(6):16581666, Jiang D, Ao YF, Gong X, Wang YJ, Zheng ZZ, Yu JK (2014) Comparative study on immediate versus delayed meniscus allograft transplantation: 4- to 6-year follow-up. J Orthop Surg Hong Kong 28(1):2309499020906745, McCormack DJ, Puttock D, Godsiff SP (2021) Medial compartment osteoarthritis of the knee: a review of surgical options. WebYour doctor will remove a piece of the torn meniscus so your knee can function normally. It permits immediate weight bearing following surgery and provides a full range of motion soon afterward. Several preoperative and intraoperative factors (Table 3) are associated with the absolute value of allograft extrusion [16, 102, 106, 109, 120]. Am J Roentgenol 216(5):13181328, Teichtahl AJ, Cicuttini FM, Abram F, Wang Y, Pelletier JP, Dodin P et al (2017) Meniscal extrusion and bone marrow lesions are associated with incident and progressive knee osteoarthritis. Labral Makiev, K.G., Vasios, I.S., Georgoulas, P. et al. Knee Surg Sports Traumatol Arthrosc 28(11):35993605, Krych AJ, LaPrade MD, Hevesi M, Rhodes NG, Johnson AC, Camp CL et al (2020) Investigating the chronology of meniscus root tears: do medial meniscus posterior root tears cause extrusion or the other way around? Recovery after a meniscectomy takes 36 weeks, and recovery after a meniscus repair takes 36 months. This value is identified as the optimal cutoff point for a complete PRT of the LM and has 100% sensitivity and 83% specificity [92]. Treatment usually starts with the RICE method: Rest. Do I need surgery to repair or remove the torn meniscus? The inner two-thirds of the meniscus, however, lacks a blood supply. Those that are caused by an injury are often the ones that can be, A meniscectomy is a procedure that repairs a torn meniscus. All rights reserved. 2a), and found that postoperative ME was significantly reduced. Sometimes, degeneration from arthritis causes a tear, even without a knee injury. Am J Sports Med 45(4):900908, Yoon JR, Kim TS, Lee YM, Jang HW, Kim YC, Yang JH (2011) Transpatellar approach in lateral meniscal allograft transplantation using the keyhole method: can we prevent graft extrusion? Note that meniscectomy may cause osteoarthritis in the long term. Am J Sports Med 40(7):15911596, Lee BS, Kim JM, Kim JM, Kim KA, Bin SI (2015) Patient-related risk factors for the extrusion of lateral meniscal allograft transplants. (2017). Exercise programs start with an initial routine and then progress to intermediate and advanced routines. Magnetic resonance imaging (MRI) mid-coronal view of the right knee, where the tibial eminences are most prominent. J Orthop Res 38(11):24952504, Roemer FW, Kwoh CK, Hannon MJ, Green SM, Jakicic JM, Boudreau R et al (2012) Risk factors for magnetic resonance imagingdetected patellofemoral and tibiofemoral cartilage loss during a six-month period: the Joints On Glucosamine study. Am J Sports Med 47(12):28882894, Delinc P, Ghafil D (2012) Anterior cruciate ligament tears: conservative or surgical treatment? Winkler et al. It should be highlighted that the clinical significance of meniscal allograft extrusion has not yet been clearly elucidated, since it is difficult to draw firm conclusions. Torn shoulder labrum: Causes, symptoms, and treatment According to the American Academy of Orthopaedic Surgeons, treatment of a meniscus tear depends on the location of the injury, alongside other factors, including a persons: Below, we outline some potential treatment options. [39,40,41]. Wear athletic shoes that are appropriate for the sport youre doing. Arthritis Care Res. Osteoarthritis Cartilage 27(11):15781589, Primorac D, Molnar V, Matii V, Hudetz D, Jele , Rod E et al (2021) Comprehensive review of knee osteoarthritis pharmacological treatment and the latest professional societies guidelines. Knee Surg Sports Traumatol Arthrosc 27(10):33113317, Costa CR, Morrison WB, Carrino JA (2004) Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear?
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