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Wolf Petersen - One of the best experts on this subject based on the ideXlab platform.
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no dynamic extrusion of the medial Meniscus in ultrasound examination in patients with confirmed root tear lesion
Knee Surgery Sports Traumatology Arthroscopy, 2019Co-Authors: Katrin Karpinski, Andreas B Imhoff, Theresa Diermeier, Lukas Willinger, Andrea Achtnich, Wolf PetersenAbstract:Purpose Extrusion of the medial Meniscus evaluated on magnetic resonance imaging (MRI) has been described as indirect radiological sign for Meniscus root tears. However, ultrasound detectable dynamic extrusion is observed in normal physiological settings. The aim of the present study was to analyze the dynamic meniscal extrusion using ultrasound (US) examination in patients with MRI-confirmed meniscal root tears. The hypothesis was that dynamic Meniscus extrusion is reduced in patients with medial root tear but not in the healthy Meniscus.
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the biomechanical effect of a lateral Meniscus posterior root tear with and without damage to the meniscofemoral ligament efficacy of different repair techniques
Arthroscopy, 2014Co-Authors: Philipp Forkel, Mirco Herbort, Frederike Sprenker, Sebastian Metzlaff, Michael J Raschke, Wolf PetersenAbstract:Purpose: To evaluate the effect of the meniscofemoral ligament (MFL) in maintaining lateral-compartment contact pressures after injury to the posterior root of the lateral Meniscus, and to measure the ability to restore intra-articular loads to normal by repairing the posterior root to the tibia after transection of the posterior root and the MFL. Methods: Ten human cadaveric knee joints were axially loaded to 100 N. A digital pressure sensor measured the contact pressure in the lateral compartment. Five different conditions were tested: intact, after release of the posterior root of the lateral Meniscus, after transection of the MFL along with release of the posterior root, refixation of the posterior root of the lateral Meniscus to the tibia using an anatomic transosseous tunnel, and refixation of the root of the lateral Meniscus using a tibial anterior cruciate ligament (ACL) tunnel. Results: After transection of the posterior lateral Meniscus root, the contact pressure did not increase significantly. The additional transection of the MFL led to a significant increase in the contact pressure. Anatomic fixation of the Meniscus posterior horn reduced the femorotibial pressure to nearly pre-sectioning values. The reattachment of the Meniscus posterior horn through a tibial ACL tunnel was equivalent to an anatomic fixation. Conclusions: In the case of a root tear of the lateral Meniscus, the MFL maintains Meniscus function and stabilizes the pressure in the lateral compartment. A complete detachment of the posterior Meniscus horn (MFL and root tear) leads to an increase in the intra-articular pressure. A root repair normalizes the pressure down to normal values. The tibial ACL tunnel is suitable to perform the repair and to lead out the suture. Clinical Relevance: In the case of a complete detachment of the Meniscus posterior horn, fixation of the posterior root is necessary to restore the Meniscus function and to guarantee an equal pressure distribution in the lateral compartment. It can be combined with an ACL reconstruction.
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A new rigid biodegradable anchor for Meniscus refixation: biomechanical evaluation
Knee Surgery Sports Traumatology Arthroscopy, 2004Co-Authors: Thore Zantop, Anne Kathleen Eggers, Volker Musahl, Andre Weimann, Joachim Hassenpflug, Wolf PetersenAbstract:All-inside repair devices have been developed to overcome the disadvantages of conventional suture techniques (such as vein and nerve damage and increased OR time). The Contour Meniscus Arrow is a second generation of the first biodegradable all-inside implant, the Meniscus Arrow. The aim of this study was to compare the biomechanical properties of the Contour Meniscus Arrow to the first-generation Meniscus Arrow and vertical or horizontal suture techniques. In fresh frozen bovine menisci, initial fixation strength, stiffness and failure mode of four different Meniscus refixation techniques (Meniscus Arrow, Contour Meniscus Arrow, vertical and horizontal 2–0 Ethibond suture techniques) were evaluated in a computer-based material-testing machine at a rate of 12.5 mm/s. Vertical Meniscus sutures showed the highest initial fixation strength, followed by the horizontal suture technique and the Contour Arrow. The Meniscus Arrow showed inferior pull-out strength. Subjecting the different refixation techniques to cyclic testing decreased the fixation strength in all groups. The modified Meniscus Anchor (Contour Arrow) provides biomechanical properties that are superior (pull-out strength) or similar (stiffness) compared to the first biodegradable all-inside implant, the Meniscus Arrow. The pull-out strength of the Contour Arrow was comparable to the pull-out strength reported for horizontal Meniscus sutures in the literature. These biomechanical characteristics of this new implant justify clinical use.
Toshifumi Ozaki - One of the best experts on this subject based on the ideXlab platform.
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meniscal repair concurrent with anterior cruciate ligament reconstruction restores posterior shift of the medial Meniscus in the knee flexed position
Knee Surgery Sports Traumatology Arthroscopy, 2019Co-Authors: Yoshiki Okazaki, Takayuki Furumatsu, Shin Masuda, Yusuke Kamatsuki, Yuya Kodama, Shinichi Miyazawa, Tomohito Hino, Toshifumi OzakiAbstract:PURPOSE: The purpose of this study was to evaluate the shape and shift of the medial Meniscus before and after meniscal repair concurrent with anterior cruciate ligament (ACL) reconstruction using magnetic resonance imaging (MRI) at 90° of knee flexion. METHODS: This study included 18 patients with ACL-deficient knees without Meniscus tears (group A), 11 patients with medial Meniscus tears alone (group M), and 15 patients with ACL-deficient knees complicated with medial Meniscus tears (group AM). The posterior segment shape was evaluated using open MRI at 90° of knee flexion preoperatively and at 3 months postoperatively. The length, height, width, and posterior extrusion of the medial Meniscus and posterior tibiofemoral distance were measured. These measurements were compared between the three groups. RESULTS: On preoperative MRI, a significant difference was observed in the posterior extrusion of the medial Meniscus (group A, 1.2 ± 0.5 mm; group M, 1.7 ± 0.3 mm; group AM, 4.1 ± 1.5 mm, p CONCLUSIONS: This study demonstrated that the medial Meniscus shifted posteriorly at 90° of knee flexion in ACL-deficient knees complicated with medial Meniscus tears. Medial meniscal repair concurrent with ACL reconstruction improved the deformed morphology and posterior extrusion. MRI measurements of the posterior extrusion at the knee-flexed position may be clinically useful to assess the functional improvement of the medial Meniscus following meniscal repair combined with ACL reconstruction.
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meniscal repair concurrent with anterior cruciate ligament reconstruction restores posterior shift of the medial Meniscus in the knee flexed position
Knee Surgery Sports Traumatology Arthroscopy, 2019Co-Authors: Yoshiki Okazaki, Takayuki Furumatsu, Shin Masuda, Yusuke Kamatsuki, Yuya Kodama, Shinichi Miyazawa, Tomohito Hino, Toshifumi OzakiAbstract:The purpose of this study was to evaluate the shape and shift of the medial Meniscus before and after meniscal repair concurrent with anterior cruciate ligament (ACL) reconstruction using magnetic resonance imaging (MRI) at 90° of knee flexion. This study included 18 patients with ACL-deficient knees without Meniscus tears (group A), 11 patients with medial Meniscus tears alone (group M), and 15 patients with ACL-deficient knees complicated with medial Meniscus tears (group AM). The posterior segment shape was evaluated using open MRI at 90° of knee flexion preoperatively and at 3 months postoperatively. The length, height, width, and posterior extrusion of the medial Meniscus and posterior tibiofemoral distance were measured. These measurements were compared between the three groups. On preoperative MRI, a significant difference was observed in the posterior extrusion of the medial Meniscus (group A, 1.2 ± 0.5 mm; group M, 1.7 ± 0.3 mm; group AM, 4.1 ± 1.5 mm, p < 0.001). All parameters did not differ between the three groups on postoperative MRI. In addition, the posterior width and extrusion of the medial Meniscus were decreased significantly after meniscal repair concurrent with ACL reconstruction. This study demonstrated that the medial Meniscus shifted posteriorly at 90° of knee flexion in ACL-deficient knees complicated with medial Meniscus tears. Medial meniscal repair concurrent with ACL reconstruction improved the deformed morphology and posterior extrusion. MRI measurements of the posterior extrusion at the knee-flexed position may be clinically useful to assess the functional improvement of the medial Meniscus following meniscal repair combined with ACL reconstruction. III.
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chondromodulin i derived from the inner Meniscus prevents endothelial cell proliferation
Journal of Orthopaedic Research, 2013Co-Authors: Masataka Fujii, Tomoko Kanazawa, Yuya Kajiki, Yusuke Yokoyama, Takayuki Furumatsu, Toshifumi OzakiAbstract:The Meniscus is a fibrocartilaginous tissue that plays an important role in controlling complex biomechanics of the knee. A perimeniscal capillary plexus supplies the outer Meniscus, whereas the inner Meniscus is composed of avascular tissue. Anti-angiogenic molecules, such as chondromodulin-I (ChM-I) and endostatin, have pivotal roles in preserving the avascularity of cartilage. However, the anti-angiogenic role of ChM-I is unclear in the Meniscus. We hypothesized that the inner Meniscus might maintain its avascular feature by expressing ChM-I. Immunohistochemical analyses revealed that ChM-I was mainly detected in the inner and superficial zones of the Meniscus. On the other hand, endostatin distribution was similar between the inner and outer Meniscus. In Western blot, ChM-I was detected only in the inner Meniscus, whereas endostatin was equally observed in both inner and outer menisci. In addition, ChM-I concentration of the inner Meniscus-derived conditioned medium was higher than that of the outer Meniscus-derived medium. ChM-I removal from the inner Meniscus-derived medium and functional blocking of ChM-I significantly increased endothelial cell proliferation. In this study, we demonstrated that the inner Meniscus contained larger amounts of ChM-I, and that the inner Meniscus-derived ChM-I inhibited endothelial cell proliferation. Our results suggest that ChM-I may be a key anti-angiogenic factor for maintaining the avascularity of the inner Meniscus. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31: 538–543, 2013
Hideyuki Koga - One of the best experts on this subject based on the ideXlab platform.
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Does practice of Meniscus surgery change over time? A report of the 2021 ‘THE Meniscus’ Webinar
'Springer Science and Business Media LLC', 2021Co-Authors: Christophe Jacquet, Hideyuki Koga, Caroline Mouton, Roland Becker, Matthieu Ollivier, Peter Verdonk, Philippe Beaufils, Romain SeilAbstract:Abstract Purpose The aim of this paper was to report the results presented in the session “Does practice of Meniscus surgery change over time?” of the 2021 Meniscus webinar held online on January 30th 2021. Method During the 2021 Meniscus webinar, an evaluation of Meniscus surgery practices was performed by analyzing: (1) The presentation of the results of a survey conducted among ESSKA members and assessing their current practices in the field of Meniscus surgery, (2) Four reports by national experts analyzing the trends in Arthroscopic Partial Meniscectomy (APM) and Meniscus repair procedures in their respective countries (France, Belgium, Germany and Japan). Results (1) ESSKA Survey: Among the 461 respondents, 75% of surgeons claimed to perform more Meniscus repairs and 85% less APM than 5 years ago. In ACL-associated Meniscus injuries, a majority of surgeons (60%) indicated to perform a meniscal resection in less than 25% of cases. 25% declared to perform Meniscus repair in ACL-associated Meniscus injuries in less than 25% of cases and 37% in more than 50% of cases. Half of the respondents repair medial or lateral root tears in less than 25% of cases. Less than 20% of respondents were not familiar with the ESSKA consensus. (2) National trends: In France, between 2005 and 2017, the APM rate decreased by 21.4%, while the repair rate increased by 320%. In Belgium, between 2007 and 2017, the APM rate decreased by 28.6%. In Germany, between 2010 and 2017 the number of APM decreased by 30%, while the number of repair procedures increased by 55%. Finally, in Japan, between 2011 and 2016, the APM ratio (APM/Meniscus procedures) decreased by 16% from 91 to 75% while the repair ratio increased from 9 to 25%. Conclusion The 2021 ESSKA members' survey as well as statistics from 4 specifically examined countries (Belgium, France, Germany and Japan) suggest there has been a significant shift over the last years in the surgical management of meniscal lesions towards less APM and more conservative treatments
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arthroscopic centralization restores residual knee laxity in acl reconstructed knee with a lateral Meniscus defect
Knee Surgery Sports Traumatology Arthroscopy, 2019Co-Authors: Takeshi Muneta, Hideyuki Koga, Tomomasa Nakamura, Monica A Linde, Brandon Marshall, Patrick SmolinskiAbstract:The aim of this study was to evaluate the effects of knee biomechanics with an irreparable lateral Meniscus defect using the centralization capsular Meniscus support procedure in the setting of the ACL-reconstructed knee in a porcine model. The hypothesis is the arthroscopic centralization will decrease the laxity and rotation of the ACL-reconstructed knee. Twelve fresh-frozen porcine knees were tested using a robotic testing system under the following loading conditions: (a) an 89.0 N anterior tibial load; (b) 4.0 N m internal and external rotational torques. Anatomic single-bundle ACL reconstruction with a 7 mm-diameter bovine extensor tendon graft was performed. A massive, middle segment, lateral Meniscus defect was created via arthroscopy, and arthroscopic centralization was performed with a 1.4 mm anchor with a #2 suture. The LM states with ACL reconstruction evaluated were: intact, massive middle segment defect and with the lateral Meniscus centralization procedure. The rotation of the ACL reconstructed knee with the lateral Meniscus defect was significantly higher than with the centralized lateral Meniscus under an external rotational torque at 30° of knee flexion, and under an internal rotational torque at 30° and 45° of knee flexion. There were no systematic and consistent effects of LM centralization under anterior tibial translation. In this porcine model, the capsular support of middle segment of the lateral Meniscus using arthroscopic centralization improved the residual rotational laxity of the ACL-reconstructed knee accompanied with lateral Meniscus dysfunction due to massive Meniscus defect. This study quantifies the benefit to knee kinematics of arthroscopic centralization by restoring the lateral meniscal function.
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bilateral hypoplasia of both medial and lateral menisci partially fused with the cartilage surface of the tibial plateau
Orthopedics, 2018Co-Authors: Shoichi Hasegawa, Takeshi Muneta, Masafumi Horie, Hiroki Katagiri, Kunikazu Tsuji, Hideyuki KogaAbstract:Hypoplastic Meniscus is an extremely rare abnormality. The authors present the first case of meniscal hypoplasia with a partial fusion of Meniscus and tibial cartilage. A 22-year-old man underwent surgery for a chronic patellar dislocation. Preoperative magnetic resonance imaging and arthroscopy incidentally revealed hypoplasia of both medial and lateral menisci. Moreover, the posterior horn of the medial Meniscus and middle body of the lateral Meniscus were fused with the cartilage surface of the tibia. Magnetic resonance imaging of the contralateral knee showed similar meniscal anomalies. This case presents an interesting and extremely rare abnormality of the Meniscus. [Orthopedics. 2018; 41(6):e884-e887.].
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trends in isolated Meniscus repair and meniscectomy in japan 2011 2016
Journal of Orthopaedic Science, 2018Co-Authors: Hisako Katano, Nobutake Ozeki, Takeshi Muneta, Hideyuki Koga, Koji Otabe, Mitsuru Mizuno, Makoto Tomita, Ichiro SekiyaAbstract:Abstract Background Meniscus surgery is the most commonly performed orthopedic surgery, and despite recent emphasis on saving the Meniscus, the current status of Meniscus surgeries is little known in many countries, including Japan. The National Database of Health Insurance Claims and Specific Health Checkups of Japan and the Statistics of Medical Care Activities in Public Health Insurance track Meniscus surgeries through health insurance claims. The National Database provides the numbers for 2014 and 2015, and the Statistics of Medical Care Activities provides the numbers from June 2011 to June 2016. Our aim was to analyze isolated Meniscus surgery numbers and Meniscus repair ratios by age group based on the National Database and evaluate trends of Meniscus repair ratios for the latest six years from the Statistics of Medical Care Activities. Methods Meniscus surgeries by age group were counted from the National Database for 2014–2015, and Meniscus repair ratios (Meniscus repairs/Meniscus surgeries) were calculated. The numbers were also counted from the Statistics of Medical Care Activities in 2011–2016. For statistical analysis of annual trends of Meniscus repair ratios, the Cochran–Armitage trend test was used. Meniscus surgeries with concomitant knee ligament surgeries were excluded. Results According to the National Database, isolated Meniscus surgeries totaled 34,966 in 2015, with peak ages of patients in their late teens and 60s. The Meniscus repair ratio was 19% in 2014 and 24% in 2015. According to the Statistics of Medical Care Activities, the Meniscus repair ratio was 9% in 2011 and significantly increased to 25% in 2016 (p = 0.0008). The ratio also increased significantly in each age group between the early 20s and late 70s. Conclusions Approximately 35,000 Meniscus surgeries are performed in Japan annually, with peak ages in the late teens and 60s. The number of Meniscus repairs has increased over the past six years.
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homeostasis and disorder of musculoskeletal system transplantation of synovial mesenchymal stem cells for cartilage and Meniscus regeneration
Clinical calcium, 2018Co-Authors: Nobutake Ozeki, Hideyuki Koga, Ichiro SekiyaAbstract:Cartilage injury remains one of the common clinical problems due to its limited regeneration capacities. Meniscectomy commonly performed for Meniscus injury leads to osteoarthritis, but the indication of Meniscus repair is limited. We have identified that synovial mesenchymal stem cells(MSCs)are superior to MSCs derived from other tissues in proliferation capacity and in vitro/in vivo chondrogenic potentials. When suspension of synovial MSCs was placed on the cartilage defect for 10 minutes, 60% of the cells attached to the defect site. Based on these basic researches, we started a clinical study for cartilage regeneration by arthroscopic transplantation of synovial MSCs. Additionally, we transplanted synovial MSCs for Meniscus injury after Meniscus repair. We obtained good clinical results of cartilage regeneration and Meniscus healing without any serious side effects. Transplantation of synovial MSCs will be useful for cartilage or Meniscus injuries.
Brice J Weinberg - One of the best experts on this subject based on the ideXlab platform.
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blood in the joint effects of hemarthrosis on Meniscus health and repair techniques
Osteoarthritis and Cartilage, 2020Co-Authors: Lucas P Lyons, Brice J Weinberg, Jocelyn Wittstein, Amy L McnultyAbstract:Injury to the Meniscus is common and frequently leads to the development of post-traumatic osteoarthritis (PTOA). Many times Meniscus injuries occur coincident with anterior cruciate ligament (ACL) injuries and lead to a bloody joint effusion. Hemarthrosis, or bleeding into the joint, has been implicated in degeneration of joint tissues. The goal of this review paper is to understand the pathophysiology of blood-induced joint damage, the possible effects of blood on Meniscus tissue, and the implications for current Meniscus repair techniques that involve the introduction of blood-derived products into the joint. In this review, we illustrate the similarities in the pathophysiology of joint damage due to hemophilic arthropathy (HA) and osteoarthritis (OA). Although numerous studies have revealed the harmful effects of blood on cartilage and synovium, there is currently a gap in knowledge regarding the effects of hemarthrosis on Meniscus tissue homeostasis, healing, and the development of PTOA following Meniscus injury. Given that many Meniscus repair techniques utilize blood-derived and marrow-derived products, it is essential to understand the effects of these factors on Meniscus tissue and the whole joint organ to develop improved strategies to promote Meniscus tissue repair and prevent PTOA development.
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Meniscus derived matrix bioscaffolds effects of concentration and cross linking on Meniscus cellular responses and tissue repair
International Journal of Molecular Sciences, 2019Co-Authors: Lucas P Lyons, Sofia Hidalgo Perea, Brice J Weinberg, Jocelyn Wittstein, Amy L McnultyAbstract:Meniscal injuries, particularly in the avascular zone, have a low propensity for healing and are associated with the development of osteoarthritis. Current meniscal repair techniques are limited to specific tear types and have significant risk for failure. In previous work, we demonstrated the ability of Meniscus-derived matrix (MDM) scaffolds to augment the integration and repair of an in vitro Meniscus defect. The objective of this study was to determine the effects of percent composition and dehydrothermal (DHT) or genipin cross-linking of MDM bioscaffolds on primary Meniscus cellular responses and integrative Meniscus repair. In all scaffolds, the porous microenvironment allowed for exogenous cell infiltration and proliferation, as well as endogenous Meniscus cell migration. The genipin cross-linked scaffolds promoted extracellular matrix (ECM) deposition and/or retention. The shear strength of integrative Meniscus repair was improved with increasing percentages of MDM and genipin cross-linking. Overall, the 16% genipin cross-linked scaffolds were most effective at enhancing integrative Meniscus repair. The ability of the genipin cross-linked scaffolds to attract endogenous Meniscus cells, promote glycosaminoglycan and collagen deposition, and enhance integrative Meniscus repair reveals that these MDM scaffolds are promising tools to augment Meniscus healing.
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Meniscus derived matrix scaffolds promote the integrative repair of meniscal defects
Scientific Reports, 2019Co-Authors: Jacob C Ruprecht, Louis E Defrate, Taylor D Waanders, Christopher R Rowland, James F Nishimuta, Katherine A Glass, Jennifer Stencel, Farshid Guilak, Brice J WeinbergAbstract:Meniscal tears have a poor healing capacity, and damage to the Meniscus is associated with significant pain, disability, and progressive degenerative changes in the knee joint that lead to osteoarthritis. Therefore, strategies to promote Meniscus repair and improve Meniscus function are needed. The objective of this study was to generate porcine Meniscus-derived matrix (MDM) scaffolds and test their effectiveness in promoting Meniscus repair via migration of endogenous Meniscus cells from the surrounding Meniscus or exogenously seeded human bone marrow-derived mesenchymal stem cells (MSCs). Both endogenous meniscal cells and MSCs infiltrated the MDM scaffolds. In the absence of exogenous cells, the 8% MDM scaffolds promoted the integrative repair of an in vitro meniscal defect. Dehydrothermal crosslinking and concentration of the MDM influenced the biochemical content and shear strength of repair, demonstrating that the MDM can be tailored to promote tissue repair. These findings indicate that native Meniscus cells can enhance Meniscus healing if a scaffold is provided that promotes cellular infiltration and tissue growth. The high affinity of cells for the MDM and the ability to remodel the scaffold reveals the potential of MDM to integrate with native meniscal tissue to promote long-term repair without necessarily requiring exogenous cells.
Ichiro Sekiya - One of the best experts on this subject based on the ideXlab platform.
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trends in isolated Meniscus repair and meniscectomy in japan 2011 2016
Journal of Orthopaedic Science, 2018Co-Authors: Hisako Katano, Nobutake Ozeki, Takeshi Muneta, Hideyuki Koga, Koji Otabe, Mitsuru Mizuno, Makoto Tomita, Ichiro SekiyaAbstract:Abstract Background Meniscus surgery is the most commonly performed orthopedic surgery, and despite recent emphasis on saving the Meniscus, the current status of Meniscus surgeries is little known in many countries, including Japan. The National Database of Health Insurance Claims and Specific Health Checkups of Japan and the Statistics of Medical Care Activities in Public Health Insurance track Meniscus surgeries through health insurance claims. The National Database provides the numbers for 2014 and 2015, and the Statistics of Medical Care Activities provides the numbers from June 2011 to June 2016. Our aim was to analyze isolated Meniscus surgery numbers and Meniscus repair ratios by age group based on the National Database and evaluate trends of Meniscus repair ratios for the latest six years from the Statistics of Medical Care Activities. Methods Meniscus surgeries by age group were counted from the National Database for 2014–2015, and Meniscus repair ratios (Meniscus repairs/Meniscus surgeries) were calculated. The numbers were also counted from the Statistics of Medical Care Activities in 2011–2016. For statistical analysis of annual trends of Meniscus repair ratios, the Cochran–Armitage trend test was used. Meniscus surgeries with concomitant knee ligament surgeries were excluded. Results According to the National Database, isolated Meniscus surgeries totaled 34,966 in 2015, with peak ages of patients in their late teens and 60s. The Meniscus repair ratio was 19% in 2014 and 24% in 2015. According to the Statistics of Medical Care Activities, the Meniscus repair ratio was 9% in 2011 and significantly increased to 25% in 2016 (p = 0.0008). The ratio also increased significantly in each age group between the early 20s and late 70s. Conclusions Approximately 35,000 Meniscus surgeries are performed in Japan annually, with peak ages in the late teens and 60s. The number of Meniscus repairs has increased over the past six years.
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homeostasis and disorder of musculoskeletal system transplantation of synovial mesenchymal stem cells for cartilage and Meniscus regeneration
Clinical calcium, 2018Co-Authors: Nobutake Ozeki, Hideyuki Koga, Ichiro SekiyaAbstract:Cartilage injury remains one of the common clinical problems due to its limited regeneration capacities. Meniscectomy commonly performed for Meniscus injury leads to osteoarthritis, but the indication of Meniscus repair is limited. We have identified that synovial mesenchymal stem cells(MSCs)are superior to MSCs derived from other tissues in proliferation capacity and in vitro/in vivo chondrogenic potentials. When suspension of synovial MSCs was placed on the cartilage defect for 10 minutes, 60% of the cells attached to the defect site. Based on these basic researches, we started a clinical study for cartilage regeneration by arthroscopic transplantation of synovial MSCs. Additionally, we transplanted synovial MSCs for Meniscus injury after Meniscus repair. We obtained good clinical results of cartilage regeneration and Meniscus healing without any serious side effects. Transplantation of synovial MSCs will be useful for cartilage or Meniscus injuries.
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osteochondral lesion of lateral tibial plateau with extrusion of lateral Meniscus treated with retrograde osteochondral autograft transplantation and arthroscopic centralisation
Asia-Pacific Journal of Sports Medicine Arthroscopy Rehabilitation and Technology, 2017Co-Authors: Takeshi Muneta, Tomoyuki Mochizuki, Tomomasa Nakamura, Ichiro Sekiya, Toshifumi Watanabe, Masafumi Horie, Koji Otabe, Hideyuki KogaAbstract:Abstract Background Extrusion of the Meniscus has been reported to be correlated with progression of osteoarthritis. In cases with osteochondral lesions after extrusion of the Meniscus, meniscal transplantation was the only surgical intervention. Recently, a novel procedure called arthroscopic centralisation has been developed to restore the Meniscus function by centralising the midbody of the extruded Meniscus onto the rim of the tibial plateau using suture anchors. Case report A combination of novel techniques—retrograde osteochondral autograft transplantation to retain hyaline articular cartilage and arthroscopic centralisation to restore residual meniscal function—was used to repair an osteochondral lesion of the lateral tibial plateau possibly caused by extrusion of the lateral Meniscus. Good clinical and radiographic outcomes were achieved at the 2-year follow-up. Conclusion A combination of retrograde osteochondral autograft transplantation and arthroscopic centralisation can be a good option to treat the osteochondral lesion of the tibial plateau caused by extrusion of the Meniscus.
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arthroscopic centralization of an extruded lateral Meniscus
Arthroscopy techniques, 2012Co-Authors: Hideyuki Koga, Takeshi Muneta, Tomoyuki Mochizuki, Tomomasa Nakamura, Toshifumi Watanabe, Masafumi Horie, Kazuyoshi Yagishita, Atsushi Okawa, Ichiro SekiyaAbstract:Extrusion of the lateral Meniscus has been reported after posterior root tear or radial tear, partial meniscectomy, and meniscoplasty of discoid Meniscus. It has also been shown to be associated with the development of osteoarthritis. This technical note describes a new arthroscopic technique to centralize and stabilize the mid body of the lateral Meniscus to restore and maintain the lateral Meniscus function by repairing/preventing extrusion of the Meniscus. A JuggerKnot Soft Anchor (Biomet, Warsaw, IN), loaded with a MaxBraid suture (Biomet), was placed on the lateral edge of the lateral tibial plateau, just anterior to the popliteal hiatus, through a midlateral portal. A Micro Suture Lasso Small Curve with Nitinol Wire Loop (Arthrex, Naples, FL) was used to pass 2 limbs of the MaxBraid suture through the Meniscus at the margin between the Meniscus and the capsule. Another anchor was inserted on the lateral edge of the lateral tibial plateau, 1 cm anterior to the first anchor, and the same procedure was repeated. The sutures were then tied by use of a self-locking sliding knot, achieving centralization and secure stabilization of the lateral Meniscus.
