Medial Meniscus Root Tear in the Middle Aged Patient: A Case Based Review
Biomechanical studies have shown that medial meniscal root tears result in meniscal extrusion and increased tibiofemoral joint contact pressures, which can accelerate the progression of arthritis. Repair is generally recommended for acute injuries in the young, active patient population. The far mor...
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Veröffentlicht in: | The Iowa orthopaedic journal 2017, Vol.37, p.123-132 |
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description | Biomechanical studies have shown that medial meniscal root tears result in meniscal extrusion and increased tibiofemoral joint contact pressures, which can accelerate the progression of arthritis. Repair is generally recommended for acute injuries in the young, active patient population. The far more common presentation however, is a subacute root tear with medial meniscal extrusion in a middle aged patient. Coexisting arthritis is common in this population and complicates decision making. Treatment should be based on the severity of the underlying arthritis. In cases of early or minimal arthritis, root repair is ideal to improve symptoms and restore meniscal function. In patients with moderate or severe medial compartment arthritis, medial unloader bracing or injections can be tried initially. When non-operative treatment fails, high tibial osteotomy or arthroplasty is recommended. Long term clinical studies are needed to determine the natural history of medial meniscal root tears in middle aged patients and the best surgical option. |
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Repair is generally recommended for acute injuries in the young, active patient population. The far more common presentation however, is a subacute root tear with medial meniscal extrusion in a middle aged patient. Coexisting arthritis is common in this population and complicates decision making. Treatment should be based on the severity of the underlying arthritis. In cases of early or minimal arthritis, root repair is ideal to improve symptoms and restore meniscal function. In patients with moderate or severe medial compartment arthritis, medial unloader bracing or injections can be tried initially. When non-operative treatment fails, high tibial osteotomy or arthroplasty is recommended. Long term clinical studies are needed to determine the natural history of medial meniscal root tears in middle aged patients and the best surgical option.</description><identifier>ISSN: 1541-5457</identifier><identifier>EISSN: 1555-1377</identifier><identifier>PMID: 28852346</identifier><language>eng</language><publisher>United States: The University of Iowa</publisher><subject>Arthritis - diagnostic imaging ; Arthritis - surgery ; Arthroscopy ; Female ; Humans ; Knee Joint - diagnostic imaging ; Knee Joint - surgery ; Magnetic Resonance Imaging ; Male ; Menisci, Tibial - diagnostic imaging ; Menisci, Tibial - surgery ; Middle Aged ; Radiography ; Sports Medicine ; Tibial Meniscus Injuries - diagnostic imaging ; Tibial Meniscus Injuries - surgery ; Treatment Outcome</subject><ispartof>The Iowa orthopaedic journal, 2017, Vol.37, p.123-132</ispartof><rights>Copyright © The Iowa Orthopaedic Journal 2017 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508273/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508273/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,4022,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28852346$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carreau, Joseph H</creatorcontrib><creatorcontrib>Sitton, Sean E</creatorcontrib><creatorcontrib>Bollier, Matthew</creatorcontrib><title>Medial Meniscus Root Tear in the Middle Aged Patient: A Case Based Review</title><title>The Iowa orthopaedic journal</title><addtitle>Iowa Orthop J</addtitle><description>Biomechanical studies have shown that medial meniscal root tears result in meniscal extrusion and increased tibiofemoral joint contact pressures, which can accelerate the progression of arthritis. Repair is generally recommended for acute injuries in the young, active patient population. The far more common presentation however, is a subacute root tear with medial meniscal extrusion in a middle aged patient. Coexisting arthritis is common in this population and complicates decision making. Treatment should be based on the severity of the underlying arthritis. In cases of early or minimal arthritis, root repair is ideal to improve symptoms and restore meniscal function. In patients with moderate or severe medial compartment arthritis, medial unloader bracing or injections can be tried initially. When non-operative treatment fails, high tibial osteotomy or arthroplasty is recommended. Long term clinical studies are needed to determine the natural history of medial meniscal root tears in middle aged patients and the best surgical option.</description><subject>Arthritis - diagnostic imaging</subject><subject>Arthritis - surgery</subject><subject>Arthroscopy</subject><subject>Female</subject><subject>Humans</subject><subject>Knee Joint - diagnostic imaging</subject><subject>Knee Joint - surgery</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Menisci, Tibial - diagnostic imaging</subject><subject>Menisci, Tibial - surgery</subject><subject>Middle Aged</subject><subject>Radiography</subject><subject>Sports Medicine</subject><subject>Tibial Meniscus Injuries - diagnostic imaging</subject><subject>Tibial Meniscus Injuries - surgery</subject><subject>Treatment Outcome</subject><issn>1541-5457</issn><issn>1555-1377</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkE9Lw0AQxRdRbK1-Bdmjl0D2_64HoRarhRal1HPY7E7alTSp2aTitzfFKnqZNzDD772ZEzQkQoiEMKVODz0nieBCDdBFjG9pypTU8hwNqNaCMi6HaLYAH2yJF1CF6LqIl3Xd4hXYBocKtxvAi-B9CXi8Bo9fbBugam_xGE9sBHzfF4-XsA_wcYnOCltGuDrqCL1OH1aTp2T-_DibjOfJjmjSJl5RbqWgliqntEvzvOCGSiMLRUTBHTd5KkUOjjsw1GnJjNMpoaowqdQ0ZyN0983ddfkWvOvzNLbMdk3Y2uYzq23I_k-qsMnW9T4TItVUsR5wcwQ09XsHsc22_elQlraCuosZMYwZzrg-rF7_9fo1-fkf-wJb52vs</recordid><startdate>2017</startdate><enddate>2017</enddate><creator>Carreau, Joseph H</creator><creator>Sitton, Sean E</creator><creator>Bollier, Matthew</creator><general>The University of Iowa</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>2017</creationdate><title>Medial Meniscus Root Tear in the Middle Aged Patient: A Case Based Review</title><author>Carreau, Joseph H ; Sitton, Sean E ; Bollier, Matthew</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p181t-d724a652a27c78c0bbf492696f715f4c49b065bec4ce92c8639c80127f90682b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Arthritis - diagnostic imaging</topic><topic>Arthritis - surgery</topic><topic>Arthroscopy</topic><topic>Female</topic><topic>Humans</topic><topic>Knee Joint - diagnostic imaging</topic><topic>Knee Joint - surgery</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Menisci, Tibial - diagnostic imaging</topic><topic>Menisci, Tibial - surgery</topic><topic>Middle Aged</topic><topic>Radiography</topic><topic>Sports Medicine</topic><topic>Tibial Meniscus Injuries - diagnostic imaging</topic><topic>Tibial Meniscus Injuries - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carreau, Joseph H</creatorcontrib><creatorcontrib>Sitton, Sean E</creatorcontrib><creatorcontrib>Bollier, Matthew</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Iowa orthopaedic journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Carreau, Joseph H</au><au>Sitton, Sean E</au><au>Bollier, Matthew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Medial Meniscus Root Tear in the Middle Aged Patient: A Case Based Review</atitle><jtitle>The Iowa orthopaedic journal</jtitle><addtitle>Iowa Orthop J</addtitle><date>2017</date><risdate>2017</risdate><volume>37</volume><spage>123</spage><epage>132</epage><pages>123-132</pages><issn>1541-5457</issn><eissn>1555-1377</eissn><abstract>Biomechanical studies have shown that medial meniscal root tears result in meniscal extrusion and increased tibiofemoral joint contact pressures, which can accelerate the progression of arthritis. Repair is generally recommended for acute injuries in the young, active patient population. The far more common presentation however, is a subacute root tear with medial meniscal extrusion in a middle aged patient. Coexisting arthritis is common in this population and complicates decision making. Treatment should be based on the severity of the underlying arthritis. In cases of early or minimal arthritis, root repair is ideal to improve symptoms and restore meniscal function. In patients with moderate or severe medial compartment arthritis, medial unloader bracing or injections can be tried initially. When non-operative treatment fails, high tibial osteotomy or arthroplasty is recommended. Long term clinical studies are needed to determine the natural history of medial meniscal root tears in middle aged patients and the best surgical option.</abstract><cop>United States</cop><pub>The University of Iowa</pub><pmid>28852346</pmid><tpages>10</tpages></addata></record> |
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subjects | Arthritis - diagnostic imaging Arthritis - surgery Arthroscopy Female Humans Knee Joint - diagnostic imaging Knee Joint - surgery Magnetic Resonance Imaging Male Menisci, Tibial - diagnostic imaging Menisci, Tibial - surgery Middle Aged Radiography Sports Medicine Tibial Meniscus Injuries - diagnostic imaging Tibial Meniscus Injuries - surgery Treatment Outcome |
title | Medial Meniscus Root Tear in the Middle Aged Patient: A Case Based Review |
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