Meniscus Injury Flashcards
indications for meniscal transplant
young patient with near-total meniscectomy
contraindications for meniscal transplant:
- inflammatory OA
- instability
- obesity
- grade IV chondrosis
- malalignment
- diffuse OA
when can you expect reutrn to sport after meniscal transplant?
6-9 months
post-operative management of meniscectomy:
early active ROM
- prolonged immobilization is detrimental to healing in a dog model
gold standard for meniscus repair?
inside-out technique
medial approach to the capsule for meniscal repair:
- incise the sartorius fascia
- retract the pes tendons/semi-M
- develop plane between the medial gastroc and the capsule
lateral approach to the capsule for meniscal repair
develop plane between the IT band and the biceps
- retract the lateral head of the gastroc posteriorly
strongest sutures for meniscal repair?
vertical mattress sutures
what’s the most common long-term complication after meniscal transplantation?
tearing related to the graft’s acellularity
- 36% rate over 8 years
what’s the only factor that predicts outcome after partial medial meniscectomy?
the modified outerbridge degree of cartilage injury
- location and size of tear seem not to have an influence on outcome
fixing a meniscus, should you use horizontal or vertical mattress suture technique?
vertical mattress is stronger
the most imporant factor in success of meniscal repair is:
width of the meniscal rim
- smaller rim is better (more likely red-red)
success of meniscal repair with concomitant ACL recon
Barber’s study showed 92% successful healing with concomitant ACL recon.
- only 67% rate of healing with meniscus repairs done in isolation
What structures are supplied by middle genicular artery?
- posterior capsule
- ACL
- PCL
- posterior meniscal horns
Anatomy of medial and lateral inferior geniculate arteries:
- anastomose anteriorly
- form capillary network to the fat pad, synovial cavity, patellar tendon
