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Knee Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
The function of the meniscus is to protect the knee joint from the stresses and shocks placed on it from walking, running, climbing, bending, and the body’s weight. The mechanism behind the functions sorbing ab weight loads is the ability of the meniscus to expand under compressive forces so that it increases the contact area and decreases the loads, stresses, and shocks to its elastic cartilage about 50–70%. It increases the contact area instead of a point to transmit the loads. In knee extension, the medial meniscus transmits up to 50% of a load applied to the medial side of the knee and the lateral meniscus transmits up to 70% of load applied to the lateral side of the knee of their compartmental loads. In knee flexion, their compartmental loads increase up to 85% and 90%, respectively. But the forces can increase to two to four times bodyweight when shifting from one meniscus to the other during activities such as walking, and the forces on the knee can increase up to six to eight times bodyweight while running or even 24 times bodyweight when landing from a jump (The Steadman Clinic 2020).
Regenerative Medicine in Pain Management
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Sharon McQuillan, Rafael Gonzalez
Vangness et al. performed a randomized, double-blinded study to determine the safety of intra-articular injections of cultured allogeneic bone marrow-derived MSCs for knee OA, the ability of MSCs to promote meniscus regeneration, and the effects of MSCs on OA changes in the knee in 55 patients. The subjects underwent partial medial meniscectomy followed by an injection of either low-dose allogeneic MSC, high-dose allogeneic MSCs, or sodium hyaluronate vehicle control within 7 to 10 days post-procedure. Patients were evaluated at baseline and through 2 years to determine safety, meniscus regeneration, and pain. Results showed significantly increased meniscal volume in both cell groups. Those receiving cell treatment also experienced a significant reduction in pain according to VAS assessment at 12 months.80
Soft Tissue Surgery of the Knee
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Stephen Key, Jonathan Miles, Richard Carrington
The anterolateral portal is created 1 cm above the lateral joint line and 1 cm lateral to the lateral border of the patellar tendon. This corresponds to a level just below the inferior pole of the patella. It can be palpated by pushing a thumb against the angle between the lateral border of the patella and the anterolateral border of the upper tibia. If the thumb is left on the upper tibial border, the incision can be made just above the thumb to guide the surgeon to the correct position. It is best done with a pointed, rather than curved, blade, with the blade facing away from the patella tendon. A vertical incision or horizontal incision is acceptable. If using a horizontal incision, once the skin is breached the blade is turned to face vertically upwards to perform the capsulotomy. This reduces the risk of damaging the lateral meniscus.
Knee meniscal retears after repair: A systematic review comparing diagnostic imaging modalities
Published in Libyan Journal of Medicine, 2022
Saad Syed, Mohammed Nagdi Zaki, Jeyaseelan Lakshmanan, Rik Kundra
The meniscus is a relatively avascular fibrocartilaginous structure that provides a key role in shock absorption and load transmission. However, accurate diagnosis of meniscal retear can present a clinical challenge [1]. Although knee arthroscopy is the gold standard for diagnosing meniscal tears, before subjecting the patient to surgical risks of arthroscopy the preferred modality to diagnose and characterize meniscal tears is Magnetic Resonance Imaging (MRI) [2–5]. Proper identification of a retear is the key for treating the knee, which might prove challenging by the conventional MRI, due to the distorted anatomy of the meniscus postoperatively [6–9]. Therefore, the purpose of this study was to conduct a systematic review on the available literature, which compare the sensitivities, specificities, and accuracies of different diagnostic modalities of diagnosing knee meniscal retears in patients who have undergone previous meniscal repair, such as MRI, Magnetic Resonance Arthrography with intraarticular contrast (direct MRA), and a combination of MRI and direct MRA.
Association between dry eye disease, self-perceived health status, and self-reported psychological stress burden
Published in Clinical and Experimental Optometry, 2021
Michael TM Wang, Alex Muntz, James S Wolffsohn, Jennifer P Craig
Tear meniscus height, non-invasive tear film breakup time, and tear film lipid layer grade were assessed using the Keratograph 5M (Oculus Optikgeräte GmbH, Wetzlar, Germany). The lower tear meniscus height was evaluated using high magnification pre-calibrated digital imaging, and three readings near the centre of the lower meniscus were averaged. Non-invasive tear film breakup time was measured using automated detection of first breakup, while the subject maintained fixation and was requested to refrain from blinking. Three breakup time readings were averaged in each case.24 Tear film lipid layer interferometry was evaluated according to the modified Guillon-Keeler system: grade 1, open meshwork; grade 2, closed meshwork; grade 3, wave or flow; grade 4, amorphous; grade 5, coloured fringes; grade 0, non-continuous layer (non-visible or abnormal coloured fringes).26,27
Biomechanical study of medial meniscus after posterior horn injury: a finite element analysis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Peishi Jiang, Juncheng Cui, Zhiwei Chen, Zhu Dai, Yangchun Zhang, Guoliang Yi
Knee meniscus is a type of fibrous cartilage tissue that protects articular cartilage, absorbs concussion, increases joint contact surface and transmits load (Verdonk et al. 2016). Meniscus protects articular cartilage by distributing load and reducing pressure peak on cartilage surface, and has an important role in mechanical environment of knee joint (Wang et al. 2015). When subject to sudden and repeated stress, the meniscus is frequently torn apart (Kim et al. 2011). The axial load of meniscus depends to a large extent on the integrity of tissue (Dong et al. 2014). When the body of meniscus is completely torn or the root of meniscus isbreaks, meniscus loses the function of converting axial load into hoop stress (LaPrade et al. 2014; Padalecki et al. 2014). Meniscus fissure can cause joint pain, swelling, joint instability, and increase the risk of contracting osteoarthritis (Cinque et al. 2018). Improvements in the treatment and prevention of meniscus injury require an understanding of the mechanisms by which meniscal fissures occur and expand.