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Knee Disorders
Condition
Meniscal Injury
The meniscus is a flexible tissue within the knee which helps to distribute the pressures from the rounded end of the femur onto the relatively flat tibia. The meniscus can often tear due to trauma or in the setting of arthritis. In some cases, the entire meniscus can tear from its edge leading to the appearance of a bucket handle. The source of pain from meniscus tears is not definitely known however one of the theories is that the tear causes traction on the capsule of the joint which is highly innervated.
Additionally, a meniscus fragment can be lodged in the joint and can act as a foreign body leading to clicking and even locking the knee in a certain position with substantial pain. The healing potential of a tear of the meniscus depends on the presence of blood supply which can provide cells and chemical mediators to heal the tear. The blood supply is diminished in the central edge of the meniscus. This area is termed the “white zone”. Tears in this region are best treated with debridement and removal of the torn segment. In the event of a tear in the outer, more vascular region (“red zone”), the meniscus can be repaired using various techniques.
Prior to the advent of arthroscopy and our current knowledge of the importance of the meniscus, surgeons routinely removed the entire meniscus in the event of a tear. Currently, using arthroscopic instruments, most surgeons simply remove the injured region or attempt to repair the meniscus based on the location. If the entire meniscus is severely damaged and has to be removed, that portion of the knee is almost guaranteed to develop osteoarthritis. In such cases, the transplantation of a frozen meniscus cadaveric graft (allograft) is a recently available option. In this procedure, a frozen meniscus with bone plugs at the ends is transferred to the affected compartment. The bone plugs are placed in bone tunnels in the affected tibia and the soft tissue portion of the meniscus is sewn to the outer envelope of the joint (the capsule).
The goals of meniscal transplantation is to decrease pain in the knee, to preserve the joint cartilage by reducing high contact pressures exposed to it, and to help restore the stabilizing effect of the meniscus on the knee
Condition
Meniscal Injury
The meniscus is a flexible tissue within the knee which helps to distribute the pressures from the rounded end of the femur onto the relatively flat tibia. The meniscus can often tear due to trauma or in the setting of arthritis. In some cases, the entire meniscus can tear from its edge leading to the appearance of a bucket handle. The source of pain from meniscus tears is not definitely known however one of the theories is that the tear causes traction on the capsule of the joint which is highly innervated.
Additionally, a meniscus fragment can be lodged in the joint and can act as a foreign body leading to clicking and even locking the knee in a certain position with substantial pain. The healing potential of a tear of the meniscus depends on the presence of blood supply which can provide cells and chemical mediators to heal the tear. The blood supply is diminished in the central edge of the meniscus. This area is termed the “white zone”. Tears in this region are best treated with debridement and removal of the torn segment. In the event of a tear in the outer, more vascular region (“red zone”), the meniscus can be repaired using various techniques.
Prior to the advent of arthroscopy and our current knowledge of the importance of the meniscus, surgeons routinely removed the entire meniscus in the event of a tear. Currently, using arthroscopic instruments, most surgeons simply remove the injured region or attempt to repair the meniscus based on the location. If the entire meniscus is severely damaged and has to be removed, that portion of the knee is almost guaranteed to develop osteoarthritis. In such cases, the transplantation of a frozen meniscus cadaveric graft (allograft) is a recently available option. In this procedure, a frozen meniscus with bone plugs at the ends is transferred to the affected compartment. The bone plugs are placed in bone tunnels in the affected tibia and the soft tissue portion of the meniscus is sewn to the outer envelope of the joint (the capsule).
The goals of meniscal transplantation is to decrease pain in the knee, to preserve the joint cartilage by reducing high contact pressures exposed to it, and to help restore the stabilizing effect of the meniscus on the knee
