OPERATIVE RECOVERY OF MENISICAL INJURIES AND POSTOPERATIVE REHABILITATION OF PATIENTS

(LITERATURE REVIEW)

Authors

  • Yu. О. Hrubar I. Horbachevsky Ternopil National Medical University
  • A. Ya. Nestorovych I. Horbachevsky Ternopil National Medical University
  • М. Yu. Grubar Municipal nonprofit enterprise «Ternopil regional clinical hospital», Ternopil regional Rada
  • I. Ya. Hrubar V. Hnatiuk Ternopil National Pedagogical University

DOI:

https://doi.org/10.11603/1811-2471.2024.v.i2.14712

Keywords:

analysis of literary sources, damage to the meniscus, meniscus suture, knee joint, rehabilitation

Abstract

SUMMARY. The menisci play a key role in cushioning, lubrication, proprioception and load distribution in the knee joint. Under various types of multiaxial loads, they are often damaged. The frequency of meniscal injuries is more than 30 % of the total number of acute knee injuries. In the last century, meniscectomy was the gold standard for the treatment of meniscal tears. The negative consequences of such surgical interventions were stressful changes in the cartilage and the progressive development of osteoarthritis. For the treatment of meniscal tears, the following methods of suturing them were implemented, namely "outside-in", "inside-out", "all-inside". The implementation of modern methods of their restoration poses new challenges in the rehabilitation of patients who have undergone such an operation.

The aim – to analyze current literature data on operative treatment of meniscal tears and their rehabilitation programs.

Material and Methods. The search for scientific information was carried out in electronic databases Article, CAS, PubMed, Google Scholar.

Results. This literature review presents surgical methods for the treatment of meniscal tears, which are based on the use of modern minimally invasive technologies under arthroscopic control. Close communication between the surgical team, the rehabilitation team and the patient, explaining the goals of rehabilitation, monitoring progress, and treating potential complications appropriately is the key to successful recovery and rehabilitation.

Conclusions. The surgical procedure of menisci restoration requires a clear definition of indications, a correctly chosen technique, taking into account its advantages in each specific case. The ultimate goal of any rehabilitation process should be complete individual functional recovery while minimizing the risk of re-injury to the meniscus.

References

Alentorn-Geli, E., Cuscó, X., Navarro, J., Seijas, R., Barastegui, D., Samitier, G., ... & Cugat, R. (2020). Circumferential-surrounding (“sandwich”) meniscal repair: a salvage technique to save the meniscus. Arthroscopy Techniques, 9(10), e1467-e1473. DOI: 10.1016/j.eats.2020.06.008. DOI: https://doi.org/10.1016/j.eats.2020.06.008

Allen, C. R., Wong, E. K., Livesay, G. A., Sakane, M., Fu, F. H., & Woo, S. L. Y. (2000). Importance of the medial meniscus in the anterior cruciate ligament-deficient knee. Journal of Orthopaedic Research, 18(1), 109-115. DOI: https://doi.org/10.1002/jor.1100180116

Avila, A., Rao, N., Buzin, S., Shankar, D. S., Davidson, P., & Strauss, E. J. (2023). Arthroscopic meniscus repair using an all-inside, all-suture, knotless device. Arthroscopy Techniques, 12(5), e615-e619. DOI: https://doi.org/10.1016/j.eats.2022.12.017

Balazs, G. C., Greditzer IV, H. G., Wang, D., Marom, N., Potter, H. G., Marx, R. G., ... & Williams III, R. J. (2019). Ramp lesions of the medial meniscus in patients undergoing primary and revision ACL reconstruction: prevalence and risk factors. Orthopaedic journal of sports medicine, 7(5), 2325967119843509. DOI: https://doi.org/10.1177/2325967119843509

Bansal, S., Floyd, E. R., A Kowalski, M., Aikman, E., Elrod, P., Burkey, K., ... & Patel, J. M. (2021). Meniscal repair: the current state and recent advances in augmentation. Journal of Orthopaedic Research®, 39(7), 1368-1382. DOI: https://doi.org/10.1002/jor.25021

Başar, B., Başar, G., Aybar, A., Kurtan, A., & Başar, H. (2020). The effects of partial meniscectomy and meniscal repair on the knee proprioception and function. Journal of Orthopaedic Surgery, 28(1), 2309499019894915. DOI: https://doi.org/10.1177/2309499019894915

Bedrin, M. D., Kartalias, K., Yow, B. G., & Dickens, J.F. (2021). Degenerative joint disease after meniscectomy. Sports medicine and arthroscopy review, 29(3), e44-e50. DOI: https://doi.org/10.1097/JSA.0000000000000301

Cavanaugh, J. T. (2014). Rehabilitation of meniscal injury and surgery. The journal of knee surgery, 27(06), 459-478. DOI: https://doi.org/10.1055/s-0034-1394299

Chahla, J., Knapik, D. M., Jawanda, H., Allende, F., Rivarola, H., McCormick, J. R., ... & Jackson, G. R. (2024). Meniscal radial tears: a classification system based on tear morphology. Arthroscopy Techniques, 102888. DOI: https://doi.org/10.1016/j.eats.2023.11.016

Della Villa, S., Della Villa, F., Ricci, M., & Tsapralis, K. (2016). Rehabilitation and return to sport. In Surgery of the Meniscus (pp. 279-285). Berlin, Heidelberg: Springer Berlin Heidelberg. DOI: https://doi.org/10.1007/978-3-662-49188-1_27

DePhillipo, N. N., Moatshe, G., Brady, A., Chahla, J., Aman, Z. S., Dornan, G. J., ... & LaPrade, R. F. (2018). Effect of meniscocapsular and meniscotibial lesions in ACL-deficient and ACL-reconstructed knees: a biomechanical study. The American journal of sports medicine, 46(10), 2422-2431. DOI: https://doi.org/10.1177/0363546518774315

Doig, T., Fagan, P., Frush, T., Lovse, L., Chen, C., & Lemos, S. (2020). The all-inside all-suture technique demonstrated better biomechanical behaviors in meniscus radial tear repair. Knee Surgery, Sports Traumatology, Arthroscopy, 28, 3606-3612. DOI: https://doi.org/10.1007/s00167-020-06078-2

Favreau, H., Maroteau, G., Praz, C., Ehlinger, M., Carnesecchi, O., Benad, K., ... & SFA, F. A. S. (2023). Rehabilitation protocol after suturing the medial meniscus of a stable knee, a retrospective series of the Francophone Arthroscopy Society. Orthopaedics & Traumatology: Surgery & Research, 109(8), 103651. DOI: https://doi.org/10.1016/j.otsr.2023.103651

Fox, A. J., Bedi, A., & Rodeo, S. A. (2012). The basic science of human knee menisci: structure, composition, and function. Sports health, 4(4), 340-351. DOI: https://doi.org/10.1177/1941738111429419

Goto, K., Duthon, V., & Menetrey, J. (2020). An isolated Posterolateral corner injury with rotational instability and hypermobile lateral meniscus: a novel entity. Journal of Experimental Orthopaedics, 7, 1-6. DOI: https://doi.org/10.1186/s40634-020-00313-y

Gupta, H., Ghasi, R. G., Kataria, H., Jain, V., Shankar, V., Daripa, R. K., & Upadhyay, A. D. (2019). Popliteal neurovascular bundle is safe during inside-out repair of medial meniscus without a safety incision. Knee Surgery, Sports Traumatology, Arthroscopy, 27(1), 153-165. DOI: https://doi.org/10.1007/s00167-018-5060-x

Hantes, M.E., Zachos, V. C., Varitimidis, S.E., Dailiana, Z.H., Karachalios, T., & Malizos, K.N. (2006). Arthroscopic meniscal repair: a comparative study between three different surgical techniques. Knee surgery, sports traumatology, arthroscopy, 14, 1232-1237. DOI: https://doi.org/10.1007/s00167-006-0094-x

Harput, G., Guney-Deniz, H., Nyland, J., & Kocabey, Y. (2020). Postoperative rehabilitation and outcomes following arthroscopic isolated meniscus repairs: a systematic review. Physical Therapy in Sport, 45, 76-85. DOI: https://doi.org/10.1016/j.ptsp.2020.06.011

Jarraya, M., Roemer, F.W., Englund, M., Crema, M. D., Gale, H.I., Hayashi, D., ... & Guermazi, A. (2017). Meniscus morphology: does tear type matter? A narrative review with focus on relevance for osteoarthritis research. In Seminars in arthritis and rheumatism (Vol. 46, No. 5, pp. 552-561). DOI: https://doi.org/10.1016/j.semarthrit.2016.11.005

LaPrade, R.F., Floyd, E.R., Carlson, G.B., Moatshe, G., Chahla, J., & Monson, J. K. (2021). Meniscal root tears: Solving the silent epidemic. Journal of Arthroscopic Surgery and Sports Medicine, 2(1), 47-57. DOI: https://doi.org/10.25259/JASSM_55_2020

LaPrade, R. F., Ho, C. P., James, E., Crespo, B., LaPrade, C.M., & Matheny, L.M. (2015). Diagnostic accuracy of 3.0 T magnetic resonance imaging for the detection of meniscus posterior root pathology. Knee Surgery, Sports Traumatology, Arthroscopy, 23, 152-157. DOI: https://doi.org/10.1007/s00167-014-3395-5

Lecas, L.K., Helms, C.A., Kosarek, F.J., & Garret, W.E. (2000). Inferiorly displaced flap tears of the medial meniscus: MR appearance and clinical significance. American Journal of Roentgenology, 174(1), 161-164. DOI: https://doi.org/10.2214/ajr.174.1.1740161

Lee, Y.S., Lee, O.S., & Lee, S.H. (2019). Return to sports after athletes undergo meniscal surgery: a systematic review. Clinical Journal of Sport Medicine, 29(1), 29-36. DOI: https://doi.org/10.1097/JSM.0000000000000500

Lozano, J., Ma, C.B., & Cannon, W.D. (2007). All-inside meniscus repair: a systematic review. Clinical Orthopaedics and Related Research (1976-2007), 455, 134-141. DOI: https://doi.org/10.1097/BLO.0b013e31802ff806

Makris, E.A., Hadidi, P., & Athanasiou, K.A. (2011). The knee meniscus: structure–function, pathophysiology, current repair techniques, and prospects for regeneration. Biomaterials, 32(30), 7411-7431. DOI: https://doi.org/10.1016/j.biomaterials.2011.06.037

Matheny, L.M., Ockuly, A.C., Steadman, J.R., & LaPrade, R. F. (2015). Posterior meniscus root tears: associated pathologies to assist as diagnostic tools. Knee Surgery, Sports Traumatology, Arthroscopy, 23, 3127-3131. DOI: https://doi.org/10.1007/s00167-014-3073-7

Migliorini, F., Cuozzo, F., Cipollaro, L., Oliva, F., Hildebrand, F., & Maffulli, N. (2022). Platelet-rich plasma (PRP) augmentation does not result in more favourable outcomes in arthroscopic meniscal repair: a meta-analysis. Journal of Orthopaedics and Traumatology, 23(1), 8. DOI: 10.1186/s10195-022-00630-1. DOI: https://doi.org/10.1186/s10195-022-00630-1

Migliorini, F., Pilone, M., Bell, A., Celik, M., Konrads, C., & Maffulli, N. (2023). Outside-in repair technique is effective in traumatic tears of the meniscus in active adults: a systematic review. Knee Surgery, Sports Traumatology, Arthroscopy, 31(10), 4257-4264. DOI: https://doi.org/10.1007/s00167-023-07475-z

Migliorini, F., Schäfer, L., Bell, A., Weber, C. D., Vecchio, G., & Maffulli, N. (2023). Meniscectomy is associated with a higher rate of osteoarthritis compared to meniscal repair following acute tears: a meta-analysis. Knee Surgery, Sports Traumatology, Arthroscopy, 31(12), 5485-5495. DOI: https://doi.org/10.1007/s00167-023-07600-y

Milliron, E.M., Magnussen, R.A., Cavendish, P.A., Quinn, J.P., DiBartola, A.C., & Flanigan, D.C. (2021). Repair of radial meniscus tears results in improved patient-reported outcome scores: A systematic review. Arthroscopy, Sports Medicine, and Rehabilitation, 3(3), e967-e980. DOI: https://doi.org/10.1016/j.asmr.2021.03.002

Ohori, T., Mae, T., Shino, K., Fujie, H., Hirose, T., Tachibana, Y., ... & Nakata, K. (2021). Different effects of the lateral meniscus complete radial tear on the load distribution and transmission functions depending on the tear site. Knee Surgery, Sports Traumatology, Arthroscopy, 29, 342-351.. DOI: https://doi.org/10.1007/s00167-020-05915-8

Oosten, J., Yoder, R., DiBartola, A., Bowler, J., Sparks, A., Duerr, R., ... & Flanigan, D. (2022). Several techniques exist with favorable biomechanical outcomes in radial meniscus tear repair – A systematic review. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 38(8), 2557-2578. DOI: https://doi.org/10.1016/j.arthro.2022.02.010

Petersen, W., & Zantop, T. (2006). Arthroscopic meniscal suture. Operative Orthopädie und Traumatologie, 18, 393-410. DOI: https://doi.org/10.1007/s00064-006-1185-2

Rai, M.F., Brophy, R.H., & Rosen, V. (2020). Molecular biology of meniscus pathology: lessons learned from translational studies and mouse models. Journal of Orthopaedic Research®, 38(9), 1895-1904. DOI: https://doi.org/10.1002/jor.24630

Sayegh, E.T., & Matzkin, E. (2022). Classifications in brief: the international society of arthroscopy, knee surgery, and orthopaedic sports medicine classification of meniscal tears. Clinical Orthopaedics and Related Research®, 480(1), 39-44.. DOI: https://doi.org/10.1097/CORR.0000000000001948

Sherman, S.L., DiPaolo, Z.J., Ray, T.E., Sachs, B.M., & Oladeji, L.O. (2020). Meniscus injuries: a review of rehabilitation and return to play. Clinics in sports medicine, 39(1), 165-183. DOI: https://doi.org/10.1016/j.csm.2019.08.004

Simonetta, R., Russo, A., Palco, M., Costa, G.G., & Mariani, P.P. (2023). Meniscus tears treatment: The good, the bad and the ugly-patterns classification and practical guide. World Journal of Orthopedics, 14(4), 171. DOI: https://doi.org/10.5312/wjo.v14.i4.171

Steineman, B.D., LaPrade, R.F., & Donahue, T.L.H. (2019). Loosening of transtibial pullout meniscal root repairs due to simulated rehabilitation is unrecoverable: A biomechanical study. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 35(4), 1232-1239. DOI: https://doi.org/10.1016/j.arthro.2018.11.041

Sukopp, M., Frey, J., Schwer, J., Kalbitz, M., Ignatius, A., & Seitz, A.M. (2024). Radial and longitudinal meniscus tears show different gapping patterns under stance phase conditions. Journal of Orthopaedic Research®, 42(5), 1134-1144. DOI: https://doi.org/10.1002/jor.25743

Wang, M., & Lee, Y.H.D. (2022). Repair Technique for Displaced Meniscal Flap Tears Indicated by MRI Comma Sign. Arthroscopy Techniques, 11(1), e79-e87. DOI: https://doi.org/10.1016/j.eats.2021.09.004

Miller JR, D.B. (1988). Arthroscopic meniscus repair. The American journal of sports medicine, 16(4), 315-320. DOI: https://doi.org/10.1177/036354658801600401

Wright, R.W., Huston, L.J., & Haas, A.K. (2023). Ten-Year Outcomes of Second-Generation, All-Inside Meniscal Repair in the Setting of ACL Reconstruction. JBJS, 105(12), 908-914. DOI: https://doi.org/10.2106/JBJS.22.01196

Wu, J., Huang, J.M., Zhao, B., Cao, J.G., & Chen, X. (2016). Risk factors comparison for radial and horizontal tears. The journal of knee surgery, 679-683. DOI: https://doi.org/10.1055/s-0036-1572415

Yamakawa, S., Mae, T., Ogasawara, I., Hirose, T., Konda, S., & Nakata, K. (2021). Placement of sutures for inside-out meniscal repair: both sutures through meniscal tissue reduces displacement on cyclical loading. Journal of Experimental Orthopaedics, 8, 1-6. DOI: https://doi.org/10.1186/s40634-021-00417-z

Published

2024-07-09

How to Cite

Hrubar Y. О., Nestorovych, A. Y., Grubar М. Y., & Hrubar, I. Y. (2024). OPERATIVE RECOVERY OF MENISICAL INJURIES AND POSTOPERATIVE REHABILITATION OF PATIENTS: (LITERATURE REVIEW). Achievements of Clinical and Experimental Medicine, (2), 6–12. https://doi.org/10.11603/1811-2471.2024.v.i2.14712

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Section

Literature reviews