Search Results (25)

Objectives: Arthroscopic meniscal surgery (AMS) is one of the most common orthopedic procedures worldwide, and its prevalence has been steadily increasing. In this study, we aimed to compare the short-term clinical outcomes (STCOs) and patient-reported outcome measures (PROMs) with anxiety and satisfaction in Mongolian patients. Methods: A prospective cohort study involved 103 patients who underwent arthroscopic knee surgery at The National Trauma Orthopedic Research Center and Grandmed Hospital in Mongolia between 2020 and 2023. STCO and PROM were calculated for the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscores, the visual analog scale was assessed for pain (VAS), and Knee Range of Motion (ROM), Measures of Anxiety State-Trait Anxiety Inventory (STAI), and The Surgical Satisfaction Questionnaire (SSQ-8) were also used. Results: Out of 103 patients (69 for partial meniscectomy and 34 for meniscal repair), KOOSs improved significantly from pre-operative to post-operative levels. The Koos subscores for pain were 57.93 ± 12.58 pre-operatively and 80.93 ± 5.70 post-operatively; Koos subscores for Symptoms (KOOS Sx) were 54.13 ± 12.73, 80.27 ± 6.22; Koos subscores for Activities of Daily Living (KOOS ADL) were 61.28 ± 13.19, 79.61 ± 4.91; Koos subscores for Sports/Recreation (KOOS SR) were 42.28 ± 13.21, 72.04 ± 6.88; and Koos subscores for Quality of Life (KOOS QOL) were 45.08 ± 12.46, 77.85 ± 7.96. On the other hand, the pre-operative and post-operative results of the STAI were not significant (46.03 ± 8.2 vs. 39.59 ± 7.13, p = 0.781). Conclusions: In the present study, we elucidated patient- and injury-specific factors that may guide personalized surgical decision-making in Mongolian patients. Our findings suggest that AMS is a viable option for alleviating pain and enhancing function in the short term for patients with meniscal tears. The high PROMs and satisfaction scores reflect good-to-excellent results, and meniscal repair was associated with better outcome scores. While pre-operative anxiety levels were high, they decreased after surgery, although they did not entirely disappear. Full article

Meniscal injuries are common and often lead to chronic pain, joint instability, and an increased risk of osteoarthritis. Traditional treatments, such as partial meniscectomy, may accelerate joint degeneration. In recent years, biologically active therapies, including platelet-rich plasma (PRP), mesenchymal stem cells (MSCs), hyaluronic acid (HA), bone marrow aspirate concentrate (BMAC), collagen, growth factors (GFs), and silk fibroin (SF), have emerged as promising strategies to enhance meniscal healing. This review evaluates the efficiency of these biological agents in promoting meniscal repair, with a particular focus on their potential integration into injectable hydrogel systems for targeted, minimally invasive delivery. Recent literature from 2015 to 2025 has provided growing insights into the role of biologically active agents and biomaterials in meniscal repair. Among the agents studied, PRP, MSCs, and HA have shown particular promise in modulating inflammation and supporting tissue regeneration. While biological therapies alone may not replace surgery for complex tears, they offer promising, less invasive alternatives that support tissue preservation. However, variability in study design, agent quality, and treatment protocols remains challenging. Further long-term research will be essential to confirm clinical benefits and optimize hydrogel-based delivery methods. Full article

Introduction: Meniscus injuries are common among endurance athletes, requiring structured rehabilitation to restore function and facilitate a safe return to sport. Traditional in-person rehabilitation may not always be accessible or feasible for high-performance athletes. Telerehabilitation, incorporating virtual reality, motion tracking, and telemonitoring, offers an innovative approach to guided recovery. However, evidence supporting its effectiveness in elite athletes remains limited. Case presentation: This case report explores the application of an innovative telerehabilitation program for a 49-year-old triathlete recovering from partial meniscectomy following a medial meniscus tear. The program was structured into three progressive phases over 12 weeks, focusing on restoring range of motion (ROM), muscle strength, and functional stability while gradually reintroducing sports-specific activities. Results: By the end of the rehabilitation, the patient achieved full ROM and muscle strength (scoring 5/5 on the Medical Research Council scale for the vastus medialis), along with a pain-free state in both static and dynamic conditions. The integration of telemonitoring devices facilitated detailed monitoring and feedback, enabling personalized adjustments to the rehabilitation protocol. Key milestones included a return to swimming and cycling in Phase 2, reintroduction of running in Phase 3, and a full resumption of triathlon training by week 12. Conclusions: Despite the positive results, the study highlights the need for further research to validate these findings across larger cohorts and establish standardized telerehabilitation protocols for athletes. This case underscores the potential of digital health technologies in enhancing recovery trajectories for high-demand athletes post-meniscus surgery, paving the way for supervised, accelerated, and effective sports reintegration. Full article

Background: Knee osteoarthritis (OA) is a common and debilitating disorder marked by joint degradation, inflammation, and persistent pain. This study examined the possible therapeutic effects of curcumin and vitamin D on OA progression and pain in a rat knee OA model by anterior cruciate ligament transection and meniscectomy (ACLT + MMx). Methods: Male Wistar rats were categorized into five groups: control, curcumin-treated (100 mg/kg/day), vitamin D-treated (25 µg/kg/day), a combination of vitamin D and curcumin, and sham-operated. All supplements were administered orally on a daily basis for 12 weeks. Pain behaviors were assessed, serum biomarkers were measured, and knee histology was examined. Results: Both curcumin and vitamin D independently reduced pain, while the combined group exhibited better analgesic effects. Serum inflammatory cytokines demonstrated a decrease in pro-inflammatory cytokines and an elevation in anti-inflammatory cytokine interleukin-10 (IL-10) in the supplement groups. The antioxidative markers were partially recovered by curcumin and vitamin D supplement. However, the oxidative stress marker Cartilage Oligomeric Matrix Protein (COMP) was significantly reduced. Histology analysis revealed a preservation of joint architecture and cartilage integrity and decreased synovium inflammation in the groups treated with curcumin and vitamin D. Conclusions: Our findings indicate a dual mechanism that encompasses the role of anti-inflammation and antioxidation on knee OA progression and pain reduction, underscoring the potential of these natural chemicals as therapeutic agents for knee OA; curcumin and vitamin D supplement may be added in delaying knee OA progression and associated pain management in clinical patient care. Full article

Introduction: Popliteal cysts (PCs) are occasionally accompanied by knee osteoarthritis (OA) and varus malalignment. However, whether concomitant arthroscopic excision of PCs with medial open-wedge high tibial osteotomy (MOWHTO) improves the osteoarthritic environment remains unclear. Therefore, this study assessed serial changes in C-size, medial meniscus extrusion (MME), and cartilage status for up to 2 years following an MOWHTO. Methods: This study retrospectively used serial magnetic resonance imaging (MRI) evaluations to assess 26 consecutive patients who underwent MOWHTO. Of the 26 patients, six with preoperative PCs were included. Based on the arthroscopic findings at the time of the MOWHTO, concomitant meniscal and chondral lesions, and whether or not partial meniscectomy was performed, were evaluated. All patients underwent second-look arthroscopy with plate removal 2 years postoperatively. The PC size, MME, and cartilage sub-scores in the medial compartment of the whole-organ MRI score (WORMS) were assessed by serial MRI preoperatively and at 3, 6, 18, and 24 months postoperatively. The recurrence of PCs and clinical outcomes, including the Rauschning–Lindgren grade, were also evaluated when serial MRI was performed. Moreover, changes in cartilage status were assessed using two-stage arthroscopy. Results: All patients underwent concomitant partial meniscectomy for medial meniscal tears in the posterior horn. A significant decrease in the mean size of preoperative PCs (27.4 ± 22.3 mm) was noted from 3 months postoperatively (8.7 ± 7.6 mm, p = 0.018), and thereafter. The mean size of PCs further decreased with time until 2 years (1.5 ± 4.0 mm, p = 0.018) following an MOWHTO with partial meniscectomy. Moreover, significant improvements in the MME and WORMS values were noted from 3 to 24 months postoperatively. Meanwhile, no PC recurrence occurred during the follow-up period and the preoperative Rauschning–Lindgren grade improved significantly with time after MOWHTO (p = 0.026). Furthermore, the two-stage arthroscopic assessments showed significant improvements in ICRS grade in the medial femoral condyle (p = 0.038). Conclusions: After an MOWHTO with partial meniscectomy, PCs decreased with time up to 2 years postoperatively; no recurrence occurred during the follow-up period, although cyst excision was not concomitantly performed. Furthermore, the reduction in PCs corresponded with improvements in MME and chondral lesions in the knee joint following the MOWHTO. Full article

The anterior cruciate ligament (ACL) is a major ligament in the knee joint, and its function is crucial for both the movement and stability of the knee. Our research takes a novel approach by investigating the effect of meniscus tears on the ACL, how such tears will impact the stress on the ACL, and its overall compensation in response to the changes in the meniscus. Hypothesis/Purpose: This study aims to investigate how the ACL compensates for the change in knee joint stability and contact pressures due to partial horizontal cleavage tears (HCTs) in the meniscus, such as partial meniscectomy and partial transplantation on knee joint stability and contact pressures. We hypothesize that HCTs will increase contact pressures and decrease joint stability, thereby inducing compensatory stress on the anterior cruciate ligament (ACL). Method: Seven freshly frozen human cadaveric knees were used in a study to investigate the effects of different meniscal conditions and surgical interventions on the meniscus itself. Four testing scenarios were established: intact knees, knees with partial horizontal cleavage tears (HCTs) of the meniscus, knees with partial meniscectomy, and knees with partial transplantation. Axial loading was applied, and the medial meniscus contact pressures were measured at 0° and 30° of flexion. Additionally, a mathematical 3D finite element model was created to evaluate the behavior of the ACL under different meniscus scenarios, which could not have been measured experimentally. Results: ACL contact pressure and stress analysis across various meniscal conditions demonstrated substantial variability. Horizontal cleavage tears (HCTs) resulted in heightened contact pressures and diminished joint stability, as evidenced by increased ACL stress attributed to compensatory mechanisms in the presence of meniscal tears. Conversely, transplantation procedures exhibited a mitigating effect, maintaining joint mechanics closer to intact conditions and minimizing alterations in ACL forces. These trends persisted at 30 degrees of knee flexion, where significant increases in ACL forces were observed in partial and complete HCT conditions. Conclusions: This study uncovers the biomechanical impacts of meniscal injuries, demonstrating how the ACL compensates for various meniscus conditions. In contrast, transplantation and repair conditions only slightly increase the stress on the ACL, putting much less strain on the ACL and supporting structures of the knee joint than an unrepaired tear. Full article

Objectives: There remains considerable debate regarding the optimal management of anterior cruciate ligament (ACL) injuries in skeletally immature patients. This study aims to evaluate the clinical outcomes of transphyseal ACL reconstruction in patients with open growth plates. Methods: This retrospective study included skeletally immature patients with full-thickness ACL tears and confirmed open physis. ACL reconstructions were performed using a four-strand semitendinosus autograft, with an additional gracilis tendon graft if needed. The surgical technique emphasized tibial and femoral physeal-sparing tunnel placement to minimize disruption of the growth plates. Clinical assessment included measurements for limb length discrepancy, knee stability, and growth disturbances. Functional outcomes were evaluated using IKDC 2000, Lysholm, and KOOS scores, while ligament stability was assessed with KT-1000 arthrometer measurements at routine follow-up. Results: A total of 31 consecutive patients (15 females, 16 males; mean age 13.6 ± 1.8 years, range 9–16 years) were included. Mean follow-up was 49 ± 26 months (range 18–93 months). The mean time to return to sports was 8.8 ± 4.4 months. Eight patients (26%) experienced ACL graft rupture and underwent revision ACL reconstruction. One additional patient required partial meniscectomy. The overall revision rate was 29%. The mean subjective IKDC score was 91.8 ± 7.2, with Lysholm and KOOS scores of 96.6 ± 7.9 and 94.2 ± 5.3, respectively. No significant growth disturbances were noted. The mean side-to-side difference in KT-1000 testing was 2.2 ± 1.5 mm. Patients who underwent revision ACL reconstruction showed significantly greater length growth compared with those with intact ACL reconstruction (p = 0.02). Spearman correlation revealed a significant association between length growth and anterior tibial translation (p = 0.02, r = 0.46). Conclusions: Transphyseal ACL reconstruction in skeletally immature patients provides favorable clinical and radiological outcomes, with minimal risk of growth disturbance. Most patients returned to pre-injury levels of athletic activity. However, the high revision rate emphasizes the complexity of managing ACL injuries in this population. Full article

Appropriate suture tension is a key factor in successful meniscal repair. This study aimed to clarify the appropriate value of meniscal stabilization with suture repair based on a probing procedure for healthy porcine menisci and a novel meniscal scaffold. After evaluating the reliability of the probing sensor, meniscal vertical tear and partial meniscectomy models were developed, in which suture repair and meniscal scaffold implantation were performed at suture intervals ranging between 20 and 2.5 mm. The residence forces at each interval were evaluated using a probing sensor. Moreover, a tensile test was conducted to evaluate the displacement and presence or absence of gaps. We found that normal and meniscal scaffolds should be fixed within 5 mm of suture interval. The probing residence forces required were at least 1.0 N for vertical tears and 3.0 N for meniscal scaffolds. These findings may be taken into consideration to reduce suture failure following meniscal tear repair and stabilizing meniscal scaffold fixation. Full article

Background: Our purpose was to evaluate whether the time of intervention and the type of meniscus surgery (repair vs. partial meniscectomy) play a role in managing anterior cruciate ligament (ACL) reconstructions with concurrent meniscus pathologies. Methods: We performed a prospective cohort study which differentiated between early and late ACL reconstructions with a cut-off at 3 months. Patients were re-evaluated after 2 years. Results: Thirty-nine patients received an operation between 2–12 weeks after the injury, and thirty patients received the surgery between 13–28 weeks after trauma. The strongest negative predictive factor of the International Knee Documentation Committee subjective knee form in a hierarchical regression model was older age (ß = −0.49 per year; 95% CI [−0.91; −0.07]; p = 0.022; partial R² = 0.08)). The strongest positive predictive factor was a higher preoperative Tegner score (ß = 3.6; 95% CI [0.13; 7.1]; p = 0.042; partial R² = 0.07) and an interaction between meniscus repair surgery and the time of intervention (ß = 27; 95% CI [1.6; 52]; p = 0.037; partial R² = 0.07), revealing a clinical meaningful difference as to whether meniscus repairs were performed within 12 weeks after trauma or were delayed. There was no difference whether partial meniscectomy was performed early or delayed. Conclusions: Surgical timing plays a crucial role when surgeons opt for a meniscus repair rather than for a meniscectomy. Full article

(1) Background: The anterior cruciate ligament (ACL) is a crucial ligament in the knee joint. This study compares the differences in knee range of motion (ROM), knee proprioception error, balance, function, and quality of life (QOL) among participants with and without meniscus repair or partial meniscectomy nine months post ACL reconstruction. (2) Methods: In this cross-sectional study, 57 male participants were selected through convenience sampling from a tertiary care hospital. Knee flexion and extension ROM were assessed using a digital goniometer; a digital inclinometer was used to assess knee proprioception error; the Y balance test was used to evaluate balance; the lower extremity functional scale (LEFS) was used to assess activity; and QOL was assessed using the ACLQOL questionnaire. (3) Results: There were no significant differences in outcomes except balance. The YB composite score had a moderate negative correlation with knee proprioception error with an R-value of −0.372 **. (4) Conclusions: Nine to 12 months post ACL reconstruction, the isolated ACL reconstruction participants had better lower-quarter single-leg balance than those who underwent ACL reconstruction and meniscal repair or partial meniscectomy. The remaining parameters, like knee ROM, knee proprioception error, LEFS score, and ACLQOL scores, were similar between these two groups. Full article

Numerous studies have assessed the performance of magnetic resonance imaging (MRI) in detecting tears of the knee menisci using arthroscopy results as the gold standard, but few have concentrated on the nature of discordant findings. The purpose of this study was to analyze the discordances between 3T MRI and arthroscopic evaluation of the knee meniscus. Medical records of 112 patients who underwent 3T MRI and subsequent arthroscopy of the knee were retrospectively analyzed to determine the accuracy of diagnoses of meniscal tear. Compared with arthroscopy, there were 22 false-negative and 14 false-positive MR interpretations of meniscal tear occurring in 32 patients. Images with errors in diagnosis were retrospectively reviewed by two musculoskeletal radiologists in consensus and all errors were categorized as either unavoidable, equivocal or as interpretation error. Of 36 MR diagnostic errors, there were 16 (44%) unavoidable, 5 (14%) interpretation errors and 15 (42%) equivocal for meniscal tear. The largest categories of errors were unavoidable false-positive MRI diagnoses (71%) and equivocal false-negative MRI diagnoses (50%). All meniscal tears missed by MRI were treated with partial meniscectomy (n = 14) or meniscal repair (n = 8). Discordant findings between 3T MRI and arthroscopic evaluation of the knee meniscus remain a concern and primarily occur due to unavoidable and equivocal errors. Clinicians involved in the diagnosis and treatment of patients with meniscal tears should understand why and how the findings seen on knee MRI and arthroscopy may sometimes differ. Full article

Meniscal injuries are one of the most common intra-articular knee injuries. Different treatments are presented depending on the symptoms and duration of meniscus tears, such as arthroscopic partial meniscectomy, physiotherapy, or even pharmacological treatment. The purpose was to investigate the effect of a concentric isokinetic knee muscle strengthening program on strength, joint range of motion, physical performance, quality of life and pain tolerance in overweight/obese women with chronic meniscal lesions. Twenty-four overweight/obese women were randomized into two groups. A control group (CG) performed a usual rehabilitation program plus isokinetic muscle strengthening (IMS) in the continuous passive motion mode and measured with an isokinetic dynamometer. An experimental group (EG) performed the same program in combination with IMS in the isokinetic active mode. The peak torque of the knee extensors (PTE) and flexors (PTF), sit-to-stand test, stair climb test, joint amplitude, heel-to-buttock distance, Thessaly test, KOOS questionnaire of pain and quality of life were measured pre- and post-protocol. After the intervention, the sit–stand number for both groups was significantly higher (p < 0.001) and the time to climb stairs was significantly reduced for the EG (p < 0.001). A significant improvement in joint range of motion, life quality (p < 0.001), relief in knee pain (p < 0.001) and in the post-program evaluation at the EG (p < 0.05) was noted. There was no significant difference in PTE and PTF between groups at 60°/s and 180°/s. The IMS in the active mode could be an effective therapeutic modality in managing middle-aged patients suffering from a degenerative meniscal tear. Full article

Meniscal lesions in skeletally immature patients can lead to joint degradation and knee instability. Meniscal allograft transplant (MAT) surgery is a solution to maintain knee stability. There is a lack of consensus on MAT surgery outcomes in pediatric patients. A systematic review was conducted according to the PRISMA guidelines. PubMed, Scopus and EMBASE databases were searched from 1965 to June 2022. Studies were evaluated using the Newcastle–Ottawa Scale (NOS). Three studies were selected, and 58 patients were included (mean age 15.9 years) in total. The lateral meniscus was involved in 82.8% of all MAT surgeries. Post-meniscectomy syndrome and discoid meniscus were the main indications for MAT surgery. All studies reported improved subjective clinical scores and levels of sport after the surgery. The complication rate was 27.5%. Partial meniscectomy, meniscus knot removal, chondral defect treatment and lysis of adhesions were the most frequent procedures performed during reoperation. MAT surgery can improve clinical outcomes in pediatric patients with strictly selected indications. MAT surgery is safe when there are no limb asymmetries or malalignments, but it remains a challenging procedure with a high complication rate. Long-term follow-up is needed for definitive statements on the use of MAT in skeletally immature patients. Full article

The extent to which resection of unstable leaf should be performed in horizontal cleavage meniscus tear has not yet been elucidated. The purpose of this study was to compare the clinical outcomes of partial meniscectomy for horizontal cleavage tear of medial meniscus between complete resection of inferior leaf including the periphery up to the joint capsule and partial resection leaving stable peripheral torn meniscal tissue. A total of 126 patients who underwent partial meniscectomy for horizontal cleavage tear of medial meniscus were divided into two groups: group C (n = 34), treated with the complete resection of the inferior leaf; and group P (n = 92), treated with partial resection of the inferior leaf. The minimum follow-up duration was 3 years. Functional outcomes were evaluated using the Lysholm knee scoring scale, International Knee Documentation Committee (IKDC) subjective knee evaluation form, and knee injury and osteoarthritis outcome score (KOOS). Radiologic assessments were performed using the IKDC radiographic assessment scale and measurement of the height of the joint space in the medial compartment of the tibiofemoral joint. The functional outcomes including the Lysholm knee, IKDC subjective score, activities of daily living and sport and recreation subscale of KOOS were worse in group C than in group P (p < 0.001). The radiologic outcomes including postoperative IKDC radiographic scale (p = 0.003) and the postoperative joint space on the affected side (p < 0.001) were also worse in group C than in group P. In the horizontal cleavage tear of medial meniscus, complete resection of the inferior leaf including the periphery up to the joint capsule showed inferior clinical outcomes compared with partial resection leaving stable peripheral rim of torn meniscus at minimum 3-year follow-up. If the peripheral part of the inferior leaf is stable in horizontal cleavage tear of medial meniscus, partial resection of the inferior leaf preserving peripheral rim can be recommended. Full article

(1) Background: The medial meniscus horizontal tear (MMHT) is known as a lesion that can be treated nonoperatively. However, some patients show persistent pain despite conservative treatments. In arthroscopic surgery for MMHT, surgeons often encounter unexpected unstable flaps, which can explain the intractable pain. This study aimed to determine whether preoperative factors could predict the hidden unstable flaps in MMHT. (2) Materials and Methods: Medical records of 65 patients who underwent arthroscopic partial meniscectomy (APM) for isolated MMHT during 2016–2020 were retrospectively reviewed. APM was indicated when there was no severe chondral degeneration and intractable localized knee pain in the medial compartment did not resolve despite conservative treatments. Unstable flap was confirmed based on arthroscopic images and operation notes. Each of the following preoperative factors were investigated using logistic regression analyses to determine whether they can predict an unstable flap: age, sex, body mass index, lower limb alignment, trauma history, mechanical symptoms, symptom duration, visual analogue scale (VAS), Lysholm score, cartilage wear of the medial compartment, and subchondral bone marrow lesion (BML). (3) Results: Hidden unstable flaps were noted in 45 (69.2%) patients. Based on univariate analyses for each preoperative factor, age, symptom duration, cartilage wear (of the femoral condyle and the tibial plateau), and subchondral BML were included in the multivariate logistic regression analysis. The results showed that symptom duration (p = 0.026, odds ratio = 0.99) and high-grade cartilage wear of the medial femoral condyle (p = 0.017, odds ratio = 0.06) were negatively associated with unstable flaps. A receiver operating characteristic curve was used to calculate the symptom duration at which the prediction of unstable flaps was maximized, and the cutoff point was 14.0 months. (4) Conclusions: More than two thirds of patients suffering intractable pain from MMHT had hidden unstable flaps. However, APM should not be considered when the symptom duration is more than 14 months or high-grade cartilage wear of the medial femoral condyle is noted. Full article