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
Hauptverfasser: Carreau, Joseph H, Sitton, Sean E, Bollier, Matthew
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Bollier, Matthew
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. 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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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