It can also occur in patients that have had a tear that has flipped out of place and the meniscus has become blunted where the tear tore away from that portion of the meniscus. Of note, a new study in the Orthopaedic Journal of Sports Medicine examined different surgical techniques for meniscus radial tears. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. Meniscal tears are either partial or full thickness and stable or unstable. https://drrobertlaprademd.com/posterior-horn-of-the-medial-meniscus With ACL tears, the tibia slips forward on the femur. You’ve read your MRI report, and naturally, you’re concerned. Previous attempts to make it better provided only temporary relief. The majority of meniscal tears affect the medial meniscus and tend to involve the posterior horn. It commonly affects the anterior horn of the meniscus, as compared to the posterior horn, and is common on the lateral side, compared to the medial side. Someone who experiences a posterior horn medial meniscus root tear may feel joint line pain (located horizontally from inside to outside knee along where the joint sits) or even hear a popping sound. The most common location for a meniscus tear is the posterior horn of the medial meniscus. Radial tears of the medial meniscus posterior horn are a unique clinical entity that are associated with older age, females and obesity, and are strongly associated with an increased incidence and severity of cartilage degeneration compared to horizontal tears. This was devastating news after being a top triathlete (3rd in the world in my age group in 1989 & 1st nationally in my age group) and a big marathon runner. One of the most common causes is when one tears their ACL, the knee continues to slide forward and secondarily tears the posterior horn of the medial meniscus. These tears are found in people without knee pain. A partial meniscectomy eventually leads to a second surgery to remove the entire meniscus (total meniscectomy). Relax, surgery is not your first treatment option. These are difficult tears because they can go deep into the joint capsule. This meniscal extrusion can lead to a nonfunctional medial meniscus and the early development of osteoarthritis. Medial meniscus. Only patients who are inactive or who have significant arthritis should have the meniscus resected. Dr (Mr) Ram Venkatesh demonstrates a posterior horn tear of the meniscus About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test … After suturing, injection of PRP in the joint may potentially provide further biologic augmentation to increase the chances of the tear healing. If one already has significant arthritis, then it may not be worth having a repair and a program of rehabilitation may be indicated. The knees were macroscopically examined and their medial menisci were classified into four groups according to types of tears: "no tear", "radial tear of posterior horn", "other types of tear" and "worn-out meniscus" groups. Repairing a ramp lesion has been found to be very important because failure to repair it can result in the ACL reconstruction graft being overloaded and stretched out or failing. Because the posterior horn is relatively immobile compared to other parts of the medial meniscus, it is vulnerable to tears. The anterolateral portal is used for viewing, whereas the anteromedial portal is the working portal during repair of the posterior third of the meniscus. Anteri … read more These are usually defined as occurring with an ACL tear. I was told by one of the orthopedic surgeons that I worked with that I would never run again and would be lucky if I could ever hike again. Blunting of the medial meniscus usually means that instead of having a triangle-shaped point of the meniscus present that this portion of the meniscus is rounded out. The use of a stationary bike may be initiated at 6 weeks after surgery and patients are allowed to perform leg presses at ¼ body weight to a maximum of 70 degrees of knee flexion. I could not bear weight on my right side though I tried repeatedly, but finally I went and got an MRI and one of the orthopedic surgeons that I worked with was shocked when he saw the MRI result. Conclusions: Radial tears of the medial meniscus posterior horn are common. Pain with swelling of the knee which increases with any sort of movement of the knee, especially … If this is not the case, then the shape is abnormal, which can be a sign of a meniscal tear or a partial meniscectomy. Fish-mouth tears are common in older people as degeneration may be present in the meniscal tissue. While the medial meniscus absorbs 50% of the weight transmitted across the medial compartment, the posterior horn of the medial meniscus is the most important portion of the meniscus that provides the shock absorbing capacity. Patients were assigned to their group using random selection. Central tears are located on the inner side of the meniscus. More complex tears may need different suture patterns than the standard vertical mattress repair technique  and should be considered in younger patients whereby preserving the meniscus would be a strong goal. Explains two kinds of surgery. ensuring easy access to the posterior aspect of the medial meniscus. The type of meniscus repair that needs to be performed depends upon the vascularity of the tear and its location primarily. Therefore, the main time to use PRP with a posterior horn medial meniscus tear would be at the time of surgery. But some meniscus … Previous routine management with arthroscopic partial meniscectomy may not be needed after all. It has been reported that a medial meniscus root tear is equivalent to having the whole meniscus taken out, so having a medial meniscus root tear diagnosed quickly and treated soon is imperative to prevent the development of arthritis. A bucket-handle tear occurs when the meniscus tears or separates away from the joint lining and flips like a bucket handle and becomes stuck in the front of the knee. Following strict surgical indications, arthroscopic partial meniscectomy can help patients with low morbidity. For example, tears of the meniscus (cartilage in the knee) are more common in late middle age. Impact activities, deep squats, squatting and lifting, and sitting cross legged are limited for the first 4 months postoperatively to maximize healing of the meniscal repair. The middle genicular artery supply to posterior horns and medial inferior genicular artery supplies peripheral 20-30% of the medial meniscus. But some meniscus tears … The most common location for a meniscus tear is the posterior horn of the medial meniscus. The posterior horn is located on the back half of the meniscus. For patients who have an isolated medial meniscal repair (as in not with a concurrent ACL reconstruction), patients are kept non-weightbearing for 6 weeks. Includes interactive tool to help you decide. S83.249A is a billable codeused to specify a medical diagnosis of other tear of medial meniscus, current injury, unspecified knee, initial encounter. Medial Meniscus Tear MRI (Posterior Horn) - YouTube. EDINA- CROSSTOWN OFFICE Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. This is a part of the meniscus without vascular blood supply and therefore not amenable to repair. Diagnosis of this tear is often difficult because most patients have osteoarthritic knees masking meniscal tears and magnetic resonance imaging shows unacceptably high rates of false-negative results. Tears of the root can cause the meniscus to slip out of the joint, also called extrusion, which can significantly overload the cartilage. The researchers concluded: “ Radial … Smaller tears that are stable on probing have a good chance of healing, whereas those that are unstable, especially in the face of an ACL tear, should be repaired. The menisci — the medial meniscus and lateral meniscus - are crescent-shaped bands of thick, rubbery cartilage attached to the shinbone (tibia). I have looked many times for answers on my tibial tubercle osteotomy and never found any as detailed as i needed. The medial meniscus is the cushion that is located on the inside part of the knee. There are two ways to initiate a consultation with Dr. LaPrade: You can provide current X-rays and/or MRIs for a clinical case review with Dr. LaPrade. As Dolly Parton once said, Time marches on and sooner or later you realize it is marching across your face. The statistical analysis showed no difference in outcomes between the two groups. A sagittal viewMRI scan demonstrating a meniscocapsular injury of the posterior horn of the medial meniscus. Posterior Horn Medial Meniscus Tears – Howard J. Luks, MD Meniscus tears occur frequently. Explains when surgery is done. The most susceptible population is individuals who are already suffering from ACL (or anterior cruciate ligament) tear, because in all such instances, posterior horn of medial meniscus becomes the key role in preventing the knee slippage in … A horizontal tear (also known as fish-mouth tears) at the posterior horn of the medial meniscus means that the meniscus has torn along the horizontal plane - a type of tear that can be difficult to see when looking at some MRI's. It is our goal to provide the highest level of care and service to our patients. The posterior horn of the medial meniscus is that portion of the medial meniscus in the back part of the knee. Horizontal meniscal tears (from side to side dividing the posterior horn in two parts) are the topic of this study from the Center for Joint Disease in Korea. One orthopedic surgeon performed all of the procedures. Arthroscopy revealed a horizontal tear of PHMM, and a partial medial meniscectomy was performed. Thank you, Dr. LaPrade, for treating me with the care, focus, and expertise as if I was an Olympic athlete!- From your 63 year old very appreciative patent ~. Everyone participated in the same exercise program as the nonoperative group but without the benefit of a physical therapist’s supervision. Is a tear that extends across both zones, starting at the red zone and then extending downward into the white zone. I am 5-months post surgery, and am doing great, stationary biking and exercising every day, no pain.You know you are seeing the best when you find out he has written over 500 medical journal articles - among many other accomplishments.
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