Anatomic variants and pitfalls that can mimic a tear include discoid meniscus, meniscal flounce, a meniscal ossicle, and chondrocalcinosis. MRI scan considered most accurate and non-invasive method of diagnosis. Sagittal peripheral meniscal images demonstrate the normal anatomical 'bow-tie configuration' (the central meniscal body with the anterior and posterior horns as well circumscribed triangles. Although rarely taught and poorly utilised, recent validation demonstrated a sensitivity of 90%, and specificity of 98% in detecting meniscal injury.10, If clinically suspicious of meniscal injury, a trial of conservative measures may be considered or confirmation with magnetic resonance imaging (MRI). Bucket-hand tears can manifest as sensitive but not specific signs 1:. Bull NYU Hosp Jt Dis 2010;68:84–90. Arnoczky SP, Warren RF, Spivak JM. Dr Hideki Takeda would like to gratefully acknowledge Dr Lars Engebretsen and Dr Kevin R. Stone, previous contributors to this topic. Tears may lead to degenerative, arthritic changes if not already present. Br Med Bull 2011;2011:89–106. Figure 1. Solomon L, Warwick D, Nayagam S. Apley's Concise System of Orthopaedics and Fractures. Identifying and accurately describing the type of meniscal tear can help the surgeon in patient education and planning of the surgical procedure. Coronal proton weighted MRI of horizontal tear of lateral meniscus (white arrow) with complicating ganglion (black arrow) at the lateral margin of the meniscus. Your feedback has been submitted successfully. Herrlin S, Hallander M, Wange P, Weidenhielm L, Werner S. Arthroscopic or conservative treatment of degenerative medial meniscal tears: a prospective randomised trial. In brief: meniscal tears. To open a PDF file you will need compatible software such as Adobe Reader. Pain and/or clicking on compression suggest a meniscal lesion 1,32, Figure 3. The medial and lateral menisci are shock absorbers and force distributors located between the femur and the tibia. Radiology 2007;242:85–93. The unhappy triad, also known as a blown knee among other names, is an injury to the anterior cruciate ligament, medial collateral ligament, and meniscus.Analysis during the 1990s indicated that this 'classic' O'Donoghue triad is actually an unusual clinical entity among athletes with knee injuries. The past few decades have seen striking advances in our understanding of meniscal structure, function and the treatment of meniscal injuries. within, or mailed with, Australian Family Physician is not necessarily endorsed by the publisher. All rights reserved. With the foot as close to the hip as possible, the clinician holds the knee joint (with fingers along the joint line) with one hand, and the other hand rotates the tibia internally and externally while extending and flexing the knee. Dandy also described various non-bucket handle tears in his classification, which are not included in this discussion. The absent bow tie sign in bucket-handle tears of the menisci in the knee. The awards will be for the best papers published in JSES in the previous calendar year, as chosen by committee. This article outlines the aetiology, presentation, diagnosis (both clinical and radiographic) and management of these important injuries. New experimental surgical techniques
Early, clinical examination, appropriate investigation and treatment of meniscal injuries may prevent later degenerative disease and inappropriate surgical treatment that can predispose to later degenerative change. Lim HC, Bae JH, Wang JH, Seok CW, Kim MK. Magnetic resonance imaging can confirm clinical concern
Sekiya JK, West RV, Groff YJ, Irrgang JJ, Fu FH, Harner CD. Scuderi G, Tria A. Krych AJ, McIntosh AL, Voll AE, Stuart MJ, Dahm DL. When a meniscal tear is identified, accu-rate description and classification of the tear pattern can guide the referring clinician in patient education and surgical planning. Singapore: World scientific, 2010. Barrett GR, Field MH, Treacy SH, Ruff CG. can be assessed arthroscopically for stability and vascularity. These will have "DOC" in brackets along with the filesize of the download. Meniscal repair using an exogenous fibrin clot. On MRI, meniscal tears are evident as a linear signal intensity that extends through the meniscal substance to a free edge17 (Figure 4). Its investigation and treatment includes surgical techniques that are among the most commonly performed orthopaedic procedures worldwide. To view these documents you will need software that can read Microsoft Word format. Every care is Bernstein J. Knee Surg Sports Traumatol Arthrosc 2007;15:393–401. )Basics topics Delivering cancer care during the COVID-19 pandemic⦠The typical meniscal pain profile comprises well localised joint-line pain (with medial pain generally being indicative of a medial tear and vice-versa). Physiotherapy at two visits per week for at least 8 weeks is recommended.20 There is little evidence for strapping of meniscal injuries and this is not currently recommended. These are often 'bucket-handle tears', in which there is a vertical or oblique tear in the posterior horn running toward the anterior horn,5 forming a loose section which remains attached anteriorly and posteriorly.1 In older patients, tears are generally due to degeneration associated with ageing and tend to be horizontal tears. Conservative management is important in all patients with acute rest, intensive rehabilitation with physiotherapy and modification of activity. The role of preoperative MRI in knee arthroscopy: a retrospective analysis of 2,000 patients. De Carlo M, Armstrong B. Pain may wake the patient from sleep as the tender medial aspect of the knee strikes the other side as the patient rolls over in bed. True locking is less common, and suggests a bucket-handle tear, with the torn fragment preventing full extension. {{configCtrl2.info.metaDescription}} â¦(You can also locate patient education articles on a variety of subjects by searching on "patient info" and the keyword(s) of interest. More guidelines Injury of the knee joint meniscus is one of the most prevalent injuries in the human body. To open click on the link, your computer or device will try and open the file using compatible software. To save the file right click or option-click the link and choose "Save As...". Non-operative treatment of degenerative posterior root tear of the medial meniscus. A meniscal tear occurs in 2 primary planes, vertical and horizontal. For and absorb shock, aid joint stability and provide lubrication. PDF Most of the documents on the RACGP website are in Portable Document Format (PDF). Magnetic resonance imaging as a tool to predict reparability of longitudinal full-thickness meniscus lesions. T 1rho mapping of cartilage and menisci in patients with hyperuricaemia at 3 T: a preliminary study absent bow tie sign - on sagittal view important injuries. Ercin E, Kaya I, Sungur I, Demirbas E, Ugras AA, Cetinus EM. basis of the findings, treatment can be considered in terms of
allograft transplantation, biosynthetic scaffolds, growth factor
growth factors) on meniscus tissue is being investigated.2 These are currently only being trialled in younger patients7 and the routine use of most of these technologies is some time away. The Royal Australian College of General Practitioners. Metcalf MH, Barrett GR. Clin Orthop Related Res 2010;468:1190–2. Survivorship analysis and clinical outcome of one hundred cases. Meniscal tears often occur in young patients who have suffered a twisting injury to the knee. According to Dandyâs classification of medial meniscal tears, a locked type I (complete) longitudinal tear extends the whole length of the meniscus to within 1 ⦠Arthroscopy 1998;14:824–9. Younger and elderly patients typically sustain different types of tears. These include meniscal
DS declares that he has no competing interests. The cover image shows probing during arthroscopy, which allows identification of a concealed fracture of the lunate in Kienböck disease. 3rd edn. Rehabilitation of the knee following sports injury. The degenerative aetiology and reduced vascularisation secondary to ageing also means that meniscal tears in the elderly population are less likely to be amenable to surgical management;7 only about 6% of patients over 40 years of age have operable lesions.24 To prevent re-injury of the meniscus, activity modification is important – for example, ceasing sports such as soccer or netball. In rare cases there will be signs and symptoms of a meniscal tear which can be tested by McMurray test. Tears can cause knee pain, swelling, limited range of motion, and catching, locking, and buckling of the knee joint. Bucket-handle meniscal tears are a type of displaced vertical meniscal tear where the inner part is displaced centrally. Brain Res Rev 2009;60:187–201. Acta Orthop Scand 1982;53:975–9. Submission to the Department of Health and Ageing. Can result from playing sport or normal activities of daily living. Referral to an orthopaedic surgeon is important if the diagnosis is uncertain or there is minimal improvement at clinical review. Meniscal tears
Orthopedics 2009;32:8. An experimental study in dogs. Rimington T, Mallik K, Evans D, Mroczek K, Reider B. A prospective study of the nonoperative treatment of degenerative meniscus tears. Most tears do not heal spontaneously and are treated arthroscopically by meniscus repair (if torn in a clear, clean pattern) or, less commonly, partial meniscectomy (if torn in a complex pattern). Lufkin R. The MRI manual. New advances in musculoskeletal pain. Superior and inferior branches of the medial and lateral geniculate arteries supply the peripheral third of the menisci via the perimeniscal capillary plexus.3,4, Meniscal tears occur due to a shear force between the femur and tibia. Clin J Sport Med 2009;19:9–12. Compression of the popliteal artery or vein can cause ischemia or thrombosis, respectively, whereas compression of the tibial or peroneal nerve can cause peripheral neuropathy. There is a history of sudden inability to fully extend the knee, with a rotational flexion/extension 'trick' required to regain full extension. anything contained in this publication. On examination, there may be joint effusion, joint line tenderness, and the joint is held in a flexed position.1 in late presentations, there may be significant quadriceps wasting. Age of injury peaks at 20–29 years.7 Partial meniscectomy (removal of the torn section) is one of the most commonly performed orthopaedic surgical procedures.8. Imaging techniques such as magnetic resonance
meniscal ligament. When doctors assess the severity of osteoarthritis, they use imaging studies to quantify joint damage by measuring the space that exists between the bones of a joint. The Journal of Shoulder and Elbow Surgery (JSES) and the American Shoulder and Elbow Surgeons (ASES) are proud to announce a new award, the Neviaser Award. for meniscal tear, review intra- and extra-articular anatomical
Vincken PW, ter Braak AP, van Erkel AR, et al. longitudinally orientated tears. A recent study demonstrated 46% of patients with degenerative meniscal tears elected not to have surgery after 4 weeks of nonoperative treatment, and their functional improvement matched patients in the operative group.21 Another study of degenerative tears demonstrated that supervised exercise caused the same reduction in knee pain and the same increase in function and satisfaction as partial meniscectomy plus exercise.23 As degenerative tears are more common in elderly patients, this group is more likely to respond to conservative treatment. Figure 4. seek to replace damaged tissue. Am J Sports Med 2008;36:1283–9. There is no resting pain. The knee meniscus: structure-function, pathophysiology, current repair techniques, and prospects for regeneration. [Epub ahead of print]. Skeletal Radiol 2007;36:145–51. Privacy | Terms of use, Assessment and management of common hand injuries in general practice, Emerging benefits of introducing complementary solids from 4 months, GP perspectives of assessing older and functionally impaired patients, A study into patient understanding of blood tests ordered by their doctor, Improving access to primary care for marginalised populations, Meniscal tear – presentation, diagnosis and management (, download the MS Word Viewer free of charge, Wikipedia: Comparison of reference management software, shock absorption and distributing load throughout the joint, providing nutrition for articular cartilage. Mui LW, Engelsohn E, Umans H. Comparison of CT and MRI in patients with tibial plateau fracture: can CT findings predict ligament tear or meniscal injury? The content of any advertising or promotional material contained Knee Surg Sports Traumatol Arthrosc 2009;17:1102–6. Proton weighted sagittal image demonstrates an example of a posterior horn medial meniscal horizontal tear (white arrow). imaging may be warranted but are no substitute for thorough
The clinician applies axial pressure to the foot and rotates the tibia internally and externally. Knee Surg Sports Traumatol Arthrosc 2008;16:482–6. Tears are typically vertical in young patients and horizontal in the elderly (Figure 5). The extent and severity of the meniscus tear are often indicative of the recovery after the procedure and for any subsequent degenerative symptoms in the knee joint. Great Britain: Hodder Arnold, 2005. The wear and tear of osteoarthritis is characterized by joint deterioration and a loss of cartilage. knee joint. 8. 2nd edn. J Bone Joint Surg Am 2005;87:715–24. History, clinical findings, magnetic resonance imaging, and arthroscopic correlation in meniscal lesions. Referral is also indicated if the diagnosis is uncertain for review and to access MRI. Nourissat G, Beaufils P, Charrois O, et al. [Figure caption and citation for the preceding image starts]: Anatomical structures around the menisciCreated by BMJ Publishing Group [Citation ends]. The examination of the knee and any arthroscopy provides a clear classification of meniscal lesions. Optimal diagnosis and management is essential to prevent long term sequelae. Medial and lateral knee joint menisci serve to transfer load
Clinical outcomes following isolated lateral meniscal allograft transplantation. Knee Surg Sports Traumatol Arthrosc 2011 Aug 11. DOC Some documents on this site are in Microsoft Word format. The accuracy of physical diagnostic tests for assessing meniscal lesions of the knee: a meta-analysis. Meniscal tear types include 1,5,6: basic tears. Consequently, menisci can tear due to traumatic injury or degenerative wear (e.g., in knee joint arthritis), and can compromise force distribution across the knee joint. horizontal tear (cleavage tear) Surgical treatment is usually reserved for younger patients with a vertical longitudinal tear within the vascularised outer third of the meniscus. Weakness, grinding, instability or giving way rarely result from meniscal pathology. For patients requiring meniscectomy, meniscal autograft has been utilised with good outcomes,29–31 but is only performed in specialist centres. Neviaser Award. The views expressed by the authors of articles in Australian Family Physician are their own and not JRY declares that she has no competing interests. Am J Sports Med 2006;34:919–27. and if the patient is not improving on Review, Refer to an
J Bone Joint Surg Am 1988;70:1209–17. Arthroscopic meniscal surgery: a national society treatment guideline and consensus statement external link opens in a new window. In older patients, referral is appropriate if conservative management fails to improve symptoms. Br Med Bull 2007;84:5–23. If the test is positive (suggesting a meniscal tear), the patient will feel pain and the clinician will feel and/or hear meniscal movement when the meniscus is compressed between the tibia and femur 32, Figure 2. American Board of Orthopaedic Surgery Practice of the Orthopaedic Surgeon: Part-II, certification examination case mix. If you don't have anything you can download the MS Word Viewer free of charge. Apley test (grinding) test: The patient lies prone, with their knee flexed to 90 degrees and their hip extended. Verdonk PC, Demurie A, Almqvist KF, Veys EM, Verbruggen G, Verdonk R. Transplantation of viable meniscal allograft. J Fam Pract 2001;50:938–44. Nonoperative treatments are often successful in patients with certain types of tear – patients who have no loss of joint function, suffer minimal pain or swelling and are willing to reduce their activities – temporarily or in the long term. Meniscal pain occurs during torsional, weight bearing knee movements (classically pivoting on the knee while walking) as a sharp stab lasting several seconds, often followed by a dull ache for several hours. There are different types of meniscal tears, describing the morphology of the injury. They more commonly occur in the medial meniscus and are often associated with anterior cruciate ligament (ACL) tears.. Radiographic features MRI. is published by The Royal Australian College of General Practitioners, 7 Partial meniscectomy (removal of the torn section) is one of the most commonly performed orthopaedic surgical procedures. Nonoperative treatments are an important part of the management of all patients, regardless of whether surgery is being considered. Biomaterials 2011;32:7411–31. Meniscal tears can be treated with conservative therapy, surgical repair, or partial or complete meniscectomy. 11 Plain radiography is only useful to exclude differentials and computed tomography (CT) is markedly inferior to MRI for meniscal imaging.12 Magnetic resonance imaging is the gold standard, first choice for investigation of suspected meniscal tears.2,13–16. Meniscal tears are mainly either traumatic or degenerative. As the risk of osteoarthritis is increased if meniscal structures are not optimally functional,7 it may also be appropriate to refer all young patients for opinion if symptoms do not rapidly improve. Crawford R, Walley G, Bridgman S, Maffulli N. Magnetic resonance imaging versus arthroscopy in the diagnosis of knee pathology, concentrating on meniscal lesions and ACL tears: a systematic review. Cole BJ, Dennis MG, Lee SJ, et al. Available at www.health.gov.au/internet/ main/publishing.nsf/Content/MBRT-DI-submissions-018/$FILE/018%20 RACGP%20Submission.pdf [Accessed 15 August 2011]. clinical history and examination. If there is a clinical suspicion of post-operative bleeding, fast and efficient initial management will reduce overall morbidity and mortality. On the
Meniscal Tear Classification. If you do not have it you can download Adobe Reader free of charge. Most commonly it is impossible to fully extend the knee; more accurately described as stiffness (termed 'pseudo locking') due either to a small effusion (requiring increased force to bend the tense joint capsule) or to pain inhibition as the femoral condyle compresses the torn meniscus. Makris EA, Hadidi P, Athanasiou KA. Meniscal tear incidence may be as high as six per 1000 population6 with a 2.5 to 4 times male predominance. 2010. Harrison BK, Abell BE, Gibson TW. Magnetic resonance imaging is first line for investigating potential meniscal lesions, but should not replace thorough clinical history and examination. AJR Am J Roentgenol 1998;170:57–61. These files will have "PDF" in brackets along with the filesize of the download. National consensus on the definition, investigation, and classification of meniscal lesions of the knee external link opens in a new window. LE declares that he has no competing interests. Co-Director of Orthopedic Sports and Shoulder Service. Detailed review of funding for diagnostic imaging services. The Thessaly test for detection of meniscal tears: validation of a new physical examination technique for primary care medicine. (both clinical and radiographic) and management of these
Even partial meniscectomy may lead to osteoarthritis. Background . The menisci of the knee have several important roles: The medial meniscus is 'C' shaped whereas the lateral is a shorter incomplete circle with closer spaced 'horns'. Prospective evaluation of allograft meniscus transplantation: a minimum 2-year follow-up. MR imaging: effectiveness and costs at triage of patients with nonacute knee symptoms. Volume 41, No.4, April 2012 Pages 182-187. Research is currently investigating the possibility of implantation of collagen, allogenic and xenogenic cells, embryonic and adult stem cells, or scaffolds derived from polymers, hydrogels, tissues and extracellular matrix,7 and action of biological stimuli (eg. The classification of meniscal tears can be done according to anatomic abnormality. J Bone J Surg Am 2006;88:660–7. Files on the website can be opened or downloaded and saved to your computer or device. inaccuracies contained therein or for the consequences of any action taken by any person as a result of Arthroscopic repair of isolated meniscal tears in patients 18 years and younger. See the article by McLean and Bain, âLong-Term Outcome of Surgical Treatment for Kienböck Disease Using an Articular-Based Classification⦠100 Wellington Parade, East Melbourne, Victoria 3002, Australia orthopaedic surgeon. Liodakis E, Hankemeier S, Jagodzinski M, Meller R, Krettek C, Brand J. and gene therapy, or a combination of these. Arthroscopy 2006;22:771–80. Knee Surg Sports Traumatol Arthrosc 2010;18:535–9. necessarily those of the publisher or the editorial staff, and must not be quoted as such. Locking presents in two ways. controlling the movements of the knee joint. This article outlines the aetiology, presentation, diagnosis
Missouri: Mosby, 1998. HT declares that he has no competing interests. In younger patients, this is typically a twisting force on a weightloaded flexed knee. MP3 Most web browsers will play the MP3 audio within the browser, Your comment is being submitted, please wait, A hazardous lifeOur role in injury prevention, Meniscal tearPresentation, diagnosis and management, Shoulder injuries Management in general practice, Cervical spineAssessment following trauma, Hands, fingers, thumbsAssessment and management of common hand injuries in general practice, Initial assessment of the injured shoulder, The Ottawa knee rulesA useful clinical decision tool, Feeding in the first year of lifeEmerging benefits of introducing complementary solids from 4 months, Dementia and drivingAn approach for general practice, Fitness to driveGP perspectives of assessing older and functionally impaired patients, Patients and testsA study into patient understanding of blood tests ordered by their doctor, The Kirketon Road Centre Improving access to primary care for marginalised populations, January/February - Teaching in general practice, Australian Family Physician (incorporating Annals of General Practice) For any urgent enquiries please contact our customer services team who are ready to help with any problems. This is termed the 'red-red zone' (denoting area of vascularity).2,4 repair of the 'red-white zone' (watershed area between vascular and avascular meniscus) is controversial25 with many different surgical techniques.26 tears in the 'white-white zone' (avascular zone) are rarely repaired – rather the damaged segment is resected (meniscectomy). Thessaly test: The clinician holds the patient's outstretched hands for support, while the patient stands flat-footed with their knee flexed to 20 degrees and rotates their body and knee three times, internally and externally. Patients are often aware of movements that aggravate mensical pain, but should also be educated to avoid twisting on a weight bearing, flexed knee. KRS is an author of several references cited in this topic. Age of injury peaks at 20â29 years. Helms CA, Laorr A, Cannon WD, Jr. History and examination The review is prefaced by a presentation of the prerequisite knee joint biomechanics background and a description of biomechanical gait pattern recognition as a diagnostic tool. apalia R, Del Buono A, Osti L, Denaro V, Maffulli N. Meniscectomy as a risk factor for knee osteoarthritis: a systematic review. Meniscal injury is common, and the medial meniscus is more frequently injured. Immediate conservative measures include the RICE regimen: Longer term measures include activity modification, nonsteroidal antiinflammatory drugs (NSAIDs) and physiotherapy.4,19–21 Nonsteroidal anti-inflammatory drugs are often recommended for 8–12 weeks,20 although paracetamol can be considered if NSAIDs are contraindicated or poorly tolerated.22 Where available, intensive physiotherapy is very useful and should include range of motion, proprioceptive work and muscle strengthening exercises. Arthroscopic meniscal surgery: a national society treatment guideline and consensus statement external link opens in a new window, National consensus on the definition, investigation, and classification of meniscal lesions of the knee external link opens in a new window, external link opens in a new windowOsteoarthritis, Use of this content is subject to our disclaimer. Follow the prompts to chose a location. Attitudes toward total meniscectomy have undergone reversal in the past 30 years, and even today, practices are rapidly changing. Arthroscopic meniscal surgery: a national society treatment guideline and consensus statement, National consensus on the definition, investigation, and classification of meniscal lesions of the knee, You'll need a subscription to access all of BMJ Best Practice, sensation of knee instability or buckling/catching, tenderness at joint line and joint line crepitation, popliteal (Baker's) cyst in chronic cases, history of anterior cruciate ligament injury, plain film radiographs: AP x-ray, lateral knee x-ray, 45° PA flexion, and skyline views. The difference in tear type between these populations is explained by the three-dimensional fibrous structure of the meniscus: horizontal delamination occurs in degenerative injuries, while the fibrous structure is ruptured in a vertical fashion in younger patients. taken to reproduce articles accurately, but the publisher accepts no responsibility for errors, omissions or Common complaints include catching, locking, or buckling of the knee, knee pain, or any combination of these symptoms. Henning C, Lynch M, Clark J. Vascularity for healing of meniscus repairs. Unfortunately, general practitioners cannot currently order Medicare funded MRI, although this may change with The Royal Australian College of General Practitioners recent submission to the Australian Government Department of Health and Ageing. Arthroscopy 2010;26:1368–9. McMurray test: The patient lies supine on the bed with the hip and knee both flexed. Scholten RJ, Deville WL, Opstelten W, Bijl D, van der Plas CG, Bouter LM. Two Neviaser Awards will be presented annually at the ASES Annual Meeting. Clinical results of meniscus repair in patients 40 years and older. A comparative study with a short term follow up. Successful outcome requires close follow-up and adherence to physiotherapy. Damaged avascular meniscus must be removed.27 However, meniscectomy causes long term osteoarthritis,28 so is only performed when the patient suffers joint locking or mensical pain that is refractory to conservative management. Jarit G, Bosco J. Meniscal repair and reconstruction. Note: the cartilage deficit more anteriorly on the medial femoral condyle and altered subchondral cortical bone interface, Figure 5. Management. Tears present as severe pain, swelling, and possibly catching, clicking, difficulty on deep knee bending and locking of the knee in partial flexion. The athletic population is at greatest risk, especially those who participate in twisting sports (commonly football and basketball). Gillquist J, Hamberg P, Lysholm J. Endoscopic partial and total meniscectomy. Magnetic resonance imaging can also be effectively used to estimate the vascular zone classification (see Treatment) of tears.18 This is useful for the orthopaedic surgeon to predict meniscal repairability, assisting informed discussion with patients and scheduling appropriate operating theatre time.18 It is essential to remember that just because a tear can be seen on MRI, this does not mandate surgery. The meniscus is the most commonly injured structure in the
The knee: a comprehensive review. The test is positive if symptoms are reproduced on rotation 10. McMurray (Figure 1) and Apley tests (Figure 2) are often positive, although these are specific but not sensitive – specificity being 57–98% and 80–99%, and sensitivity being 10–66% and 16–58% respectively.2,9 The most useful clinical test for meniscal injury is the Thessaly test, which is demonstrated in Figure 3.
Shamrock Online App,
Taxi Charleston, Sc,
Hate Thy Neighbor Season 3,
Klm No Boarding Pass Available,
Ninja Mascot Logo,
Should I Trademark My Band Name,
St Christopher School Las Vegas,
Endocrinologist In Shifa International Hospital,
Hip Flexor Pain After Running,
All I Want All I Need Song,
Restaurants Grapevine Mills,
Hsbc Women's World Championship Singapore 2021,
Blue Moon 6 Pack Can,
Curtis And Amy Love Island,
Playboy Mansion 2020,
Nom De La Structure D Accueil,