RESUMEN
Abstract Objective This study aimed to identify the main knee complaints and injuries associated with baseball and their prevalence in the state of São Paulo, Brazil. Methods This epidemiological study analyzed data from an online questionnaire sent to baseball athletes from the state of São Paulo, Brazil, from 2019 to 2022. Results Ninety-eight athletes participated in the study. Their average age was 24.3 years, and 85.72% of the subjects were men. The most prevalent ethnicities were yellow (50%) and white (42.86%). Most athletes had incomplete or complete higher education (75.5%). Most (88.77%) have been training for over 1 year, and 40.82% played in more than 1 position. More than half also practiced another sport. Most (66.32%) athletes present knee complaints or symptoms, and 37.75% had suffered a knee injury playing baseball, with several mechanisms (contact with the ground, contact with another player, or no contact). More than half (59.45%) of the athletes required time away from baseball due to complaints, symptoms, or injuries. Conclusion Among the athletes interviewed, 66.32% had a knee complaint, and 37.75% had already had a knee injury, especially meniscal and ligament injuries. The injury rate was highest in the first year of practice.
Resumo Objetivo Identificar as principais queixas e lesões de joelho associadas ao beisebol, e sua prevalência em atletas de beisebol no estado de São Paulo. Métodos Estudo epidemiológico desenvolvido por meio da análise de dados obtidos por um questionário online, entre os anos de 2019 e 2022, distribuído entre atletas de beisebol do estado de São Paulo. Resultados Noventa e oito atletas participaram do estudo, com média de 24,3 anos de idade, sendo que 85,72% eram homens. As etnias mais prevalentes foram os amarelos (50%) e brancos (42,86%), e a maioria dos atletas possuía ensino superior incompleto ou completo (75,5%). Um total de 88,77% treinava há mais de 1 ano e 40,82% atuavam em mais de uma posição. Mais da metade praticava simultaneamente outro esporte. Um total de 66,32% dos atletas apresentava queixas ou sintomas no joelho e 37,75% já haviam sofrido alguma lesão no joelho associada à prática do beisebol através de diversos mecanismos (contato com solo, contato com outro jogador, sem contato). Um total de 59,45% dos atletas precisou ser afastado da prática devido às queixas, sintomas ou lesões apresentadas. Conclusão Dos atletas entrevistados, 66,32% apresentaram alguma queixa no joelho e 37,75% já tiveram alguma lesão diagnosticada nessa articulação, sendo as mais prevalentes as lesões meniscais e as ligamentares. A taxa de lesões foi maior no primeiro ano de prática.
Asunto(s)
Humanos , Masculino , Femenino , Béisbol , Tendinopatía , Atletas , Lesiones de Menisco Tibial , Traumatismos de la Rodilla/epidemiologíaRESUMEN
INTRODUCTION: all-in meniscal suture devices have evolved and simplified meniscal repair. In this study we will formulate the following research questions: what is the rate of survival and failure? What are the risk factors associated with failure? And what are the functional results after meniscal repair surgery? MATERIAL AND METHODS: ambispective study from 2001 to 2021 of patients with repairable meniscal injury with all-in meniscal suture devices. The survival and failure ratio were obtained with the Kaplan-Meier test, the risk factors associated with meniscal suture failure were assessed with the logistic regression test, and the pre- and post-surgical functional results were estimated with the test. t-Student. RESULTS: in 20 years of follow-up of 316 menisci repaired with all-in meniscal sutures, a survival rate of 95.9% was obtained. The absence of injury to the anterior horn of the meniscus was shown to be a protective factor [OR = 0.12], together with not practicing impact sports [OR = 0.2]. Post-surgery IKDC and Tegner-Lysholm results were shown to be very good to excellent (p < 0.0001). CONCLUSION: all-in meniscal suture devices are and will continue to be front-line weapons in the repair of meniscal tears. In 20 years of follow-up, a lower failure rate was evidenced, associated with excellent functional results.
INTRODUCCIÓN: los dispositivos de suturas meniscal todo adentro han evolucionado y simplificado la reparación meniscal. En este estudio formulamos las siguientes preguntas de investigación: ¿cuál es la tasa de supervivencia y falla?, ¿cuáles son los factores de riesgo asociado a falla? y ¿cuáles son los resultados funcionales posterior a la cirugía de reparación meniscal? MATERIAL Y MÉTODOS: estudio ambispectivo desde el 2001 al 2021 de pacientes con lesión meniscal reparable con dispositivos meniscales de sutura todo adentro. La razón de supervivencia y falla se obtuvo con el test de Kaplan-Meier, los factores de riesgo asociado con falla de la sutura meniscal se valoraron con el test de regresión logística y los resultados funcionales pre y postquirúrgicos fueron estimados con la prueba t-Student. RESULTADOS: en 20 años de seguimiento de 316 menisco reparados con suturas meniscal todo adentro se obtuvo que la razón de supervivencia de 95.9%. La ausencia de lesión del cuerno anterior del menisco se mostró como un factor protector [OR = 0.12], junto a la no práctica de deportes de impacto [OR = 0.2]. Se mostraron resultados del IKDC y Tegner-Lysholm posterior a la cirugía de muy buenos a excelentes (p < 0.0001). CONCLUSIÓN: los dispositivos de sutura de meniscal todo adentro son y seguirán siendo armas de primera línea en la reparación de las roturas meniscales. En 20 años de seguimiento se evidenció una menor tasa de falla, asociados con excelentes resultados funcionales.
Asunto(s)
Meniscos Tibiales , Lesiones de Menisco Tibial , Humanos , Artroscopía , Meniscos Tibiales/cirugía , Estudios Retrospectivos , Técnicas de Sutura , Suturas , Lesiones de Menisco Tibial/cirugíaRESUMEN
ABSTRACT Introduction: Meniscal injury is a common condition that can lead to disability due to pain and proprioceptive failure, requiring immediate attention. Combination therapies involve advanced approaches aiming to accelerate rehabilitation in athletes, and electroacupuncture presents therapeutic benefits, although there is still no evidence of its combination with sports therapy. Objective: This paper analyzes the performance of sports rehabilitation in athletes with meniscal lesions using electroacupuncture combined with sports therapy. Methods: The intervention in the control group was based on a traditional range of motion work, muscle strength, proprioceptive training, and other exercise therapies, while the experimental group received a 30 min electro-acupuncture protocol three times a week for four consecutive weeks. The surrogate data (gender, age, disease course, location) are the same. Before treatment, joint activity, muscle strength, total joint scale score of the LYSHOLM questionnaire, and other observational indices were measured during the 6th and 12th week of treatment. The non-parametric statistical method and T-test were used to analyze the changes of each index before and after treatment. After 12 weeks of treatment, the difference between the experimental group and the combination before treatment was significant. Results: The treatment effect of the experimental group was significantly better than the control group. Conclusion: The effect of sports rehabilitation of athletes with meniscus injury based on electroacupuncture combined with sports therapy showed high resolutive application value, indicating an alternative for non-surgical treatment in knee meniscus injuries. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução: A lesão meniscal é um acometimento comum que pode gerar incapacitação por dor e falha proprioceptiva, exigindo atenção imediata. Terapias combinadas envolvem abordagens avançadas com o objetivo de acelerar a reabilitação nos atletas, e a eletroacupuntura apresenta benefícios terapêuticos, embora ainda não possua evidencias de sua combinação com a terapia esportiva. Objetivo: Analisar o desempenho da reabilitação esportiva em atletas com lesão meniscal utilizando eletroacupuntura combinada à terapia esportiva. Métodos: A intervenção no grupo controle baseou-se no trabalho tradicional de amplitude de movimento, força muscular, treinamento proprioceptivo e outros tipos de terapias de exercício enquanto que ao grupo experimental foi adicionado um protocolo de eletro-acupuntura de 30 minutos de duração, 3 vezes por semana durante 4 semanas consecutivas. Os dados de substituição (sexo, idade, curso de doença, localização) são basicamente os mesmos. Antes do tratamento, a atividade articular, a força muscular, o escore total da escala articular do questionário LYSHOLM e outros índices de observação foram medidos na 6ª e 12ª semana do tratamento. O método estatístico não paramétrico e teste-T foram utilizados para analisar as alterações de cada índice antes e depois do tratamento. Após 12 semanas de tratamento, a diferença entre o grupo experimental e a combinação antes do tratamento foi significativa. Resultados: O efeito de tratamento do grupo experimental foi significativamente melhor do que o grupo controle. Conclusão: O efeito de reabilitação esportiva de atletas com lesão meniscal baseada em eletroacupuntura combinada à terapia esportiva demonstrou alto valor de aplicação resolutiva, indicada como alternativa para o tratamento não cirúrgico em lesões no menisco do joelho. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
Resumen Introducción: La lesión meniscal es una lesión común que puede causar incapacidad por dolor y fallo propioceptivo, requiriendo atención inmediata. Las terapias combinadas implican enfoques avanzados con el objetivo de acelerar la rehabilitación en los deportistas, y la electroacupuntura presenta beneficios terapéuticos, aunque todavía no hay pruebas de su combinación con la terapia deportiva. Objetivo: Analizar el rendimiento de la rehabilitación deportiva en atletas con lesión meniscal utilizando electroacupuntura combinada con la terapia deportiva. Métodos: La intervención en el grupo de control se basó en el trabajo tradicional de amplitud de movimiento, fuerza muscular, entrenamiento propioceptivo y otros tipos de terapias de ejercicio, mientras que al grupo experimental se le añadió un protocolo de electroacupuntura de 30 minutos de duración, 3 veces a la semana durante 4 semanas consecutivas. Los datos sustitutivos (sexo, edad, evolución de la enfermedad, localización) son básicamente los mismos. Antes del tratamiento, se midieron la actividad articular, la fuerza muscular, la puntuación total de la escala articular del cuestionario LYSHOLM y otros índices de observación en la 6ª y 12ª semana de tratamiento. Se utilizó el método estadístico no paramétrico y la prueba T para analizar los cambios de cada índice antes y después del tratamiento. Tras 12 semanas de tratamiento, la diferencia entre el grupo experimental y la combinación antes del tratamiento era significativa. Resultados: El efecto del tratamiento del grupo experimental fue significativamente mejor que el del grupo de control. Conclusión: El efecto de la rehabilitación deportiva de atletas con lesión de menisco basada en la electroacupuntura combinada con la terapia deportiva mostró un alto valor de aplicación resolutiva, indicada como alternativa de tratamiento no quirúrgico en las lesiones de menisco de rodilla. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
Asunto(s)
Humanos , Traumatismos en Atletas/rehabilitación , Electroacupuntura , Terapia por Ejercicio/métodos , Lesiones de Menisco Tibial/rehabilitación , Traumatismos de la Rodilla/rehabilitación , Dimensión del Dolor , Fuerza MuscularRESUMEN
Abstract The first meniscal suture was performed in 1885 and took about a century to become popular. Currently, all-inside meniscal repair devices are widely used. However, this technique presents the disadvantage of being a method dependent on specific devices, presenting a higher cost than other techniques. This high cost limits the use of such a technique in many locations. The objective of the present technical note is to describe a microinvasive meniscal suture technique as a modification of the all-inside technique, using a disposable 40 x 12 mm procedure needle. The authors believe that the proposed modification to the technique can make it more popular, enabling the use of the microinvasive technique in places with limited resources.
Resumo A primeira sutura meniscal foi realizada em 1885 e levou cerca de um século para tornar-se popular. Atualmente, os dispositivos de reparo meniscal all-inside são amplamente utilizados. Contudo, esta técnica apresenta a desvantagem de ser um método dependente de dispositivos específicos, apresentando um custo superior aos de outras técnicas. Este valor elevado limita o uso de tal técnica em muitos locais. O objetivo da presente nota técnica é descrever uma técnica de sutura meniscal microinvasiva, como uma modificação da técnica all-inside, utilizando uma agulha descartável de procedimento de 40 x 12 mm. Os autores acreditam que a modificação proposta para a técnica pode torná-la mais popular, possibilitando o uso da técnica microinvasiva em locais com recursos limitados.
Asunto(s)
Humanos , Artroscopía , Técnicas de Sutura , Procedimientos Quirúrgicos Mínimamente Invasivos , Lesiones de Menisco Tibial/cirugíaRESUMEN
Meniscal root tears represent radial tears or avulsions of the meniscal cartilage at the tibial attachment site that profoundly affect meniscal biomechanics and kinematics. Meniscal root tears have the functional effect of a total meniscectomy and can lead to rapid degenerative change with development of early knee osteoarthritis (OA). A growing range of arthroscopic surgical techniques have been developed to repair meniscal root tears with the aim of restoring joint kinematics and contact pressures and delaying the development of OA. With increased understanding of the anatomy and biomechanics of the meniscal root, meniscal root injury repair has become the treatment of choice in knees with nonadvanced OA. This article reviews the anatomy and biomechanics of the meniscal roots, clinical and imaging diagnostic criteria of meniscal root tears, correlation between arthroscopy and MRI in the diagnosis and classification of meniscal root tears, and expected and abnormal MRI findings after meniscal root repair. Familiarity with MRI signs and classifications of meniscal root tears, as well as with root repair surgical techniques, can aid radiologists in correctly reporting preoperative and postoperative MRI findings.
Asunto(s)
Traumatismos de la Rodilla , Lesiones de Menisco Tibial , Artroscopía/métodos , Humanos , Traumatismos de la Rodilla/diagnóstico por imagen , Traumatismos de la Rodilla/cirugía , Imagen por Resonancia Magnética/métodos , Meniscos Tibiales/anatomía & histología , Meniscos Tibiales/diagnóstico por imagen , Meniscos Tibiales/cirugía , Lesiones de Menisco Tibial/diagnóstico por imagen , Lesiones de Menisco Tibial/cirugíaRESUMEN
Introducción: la artropatía enteropática representa una manifestación derivada de complicaciones inflamatorias intestinales. Presentación del caso: paciente de 53 años de edad, de piel blanca, femenina, que sufrió caída de sus pies, con trauma en rodilla izquierda que le ocasionó fractura de meseta tibial izquierda. Discusión: los estudios radiológicos fueron positivos y confirman el diagnóstico de la artropatía enteropática y fractura de platillos tibiales, se aplicaron pautas de tratamientos integradores funcionales. Conclusiones: con los tratamientos el paciente reportó efectos beneficiosos, se lograron los objetivos propuestos en la rehabilitación, así como la incorporación de la paciente a la sociedad con un mínimo de discapacidad e independencia(AU)
Introduction: enteropathic arthropathy represents a manifestation derived from intestinal inflammatory complications. Case presentation: 53-year-old white-skinned female patient who suffered a fall from her feet, with trauma to the left knee that caused a fracture of the left tibial plateau. Discussion: the radiological studies were positive and confirm the diagnosis of enteropathic arthropathy and tibial plateau fractures, functional integrative treatment guidelines were applied. Conclusions: with the treatments the patient reported beneficial effects, the objectives proposed in the rehabilitation were achieved, as well as the incorporation of the patient into society with a minimum of disability and independence(EU)
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Espondiloartropatías/epidemiología , Espondiloartropatías/rehabilitación , Enfermedades Inflamatorias del Intestino/complicaciones , Lesiones de Menisco Tibial/terapia , Radiografía/métodosRESUMEN
The objective of this study was to examine the association between preoperative meniscal extrusion of patients undergoing partial medial meniscectomy with clinical outcomes and progression of osteoarthritis and to determine the extent of meniscal extrusion associated with unsatisfactory clinical outcomes and progression of osteoarthritis. Ninety-five patients who underwent partial medial meniscectomy with a minimum follow-up of 5 years were retrospectively reviewed. Preoperative meniscal extrusion was evaluated with magnetic resonance imaging. Patients were assessed preoperatively and postoperatively with Lysholm and International Knee Documentation Committee (IKDC) subjective scores for clinical outcomes and with IKDC radiographic scale for osteoarthritis. An ANOVA (Analysis of Variance) was used to analyze the variations in meniscal extrusion and the clinical and radiological outcomes. A regression analysis was performed to identify factors that affect preoperative medial meniscus extrusion and that influence results after partial meniscectomy. An optimal cutoff value for meniscal extrusion associated with unsatisfactory clinical outcomes and progression of osteoarthritis was established. Significance was set at p < 0.05. The mean ± SD preoperative and postoperative Lysholm scores were 59.6 ± 15.5 versus 83.8 ± 13.1 (p < 0.001) and the mean preoperative and postoperative IKDC subjective scores were 59.4 ± 16.8 versus 82.0 ± 15.8 (p < 0.001). Meniscal extrusion greater than 2.2 mm (sensitivity, 84%; specificity, 81%) and 2.8 mm (sensitivity, 73%; specificity, 85%) was associated with unsatisfactory (poor/fair) Lysholm and IKDC subjective scores, respectively. The progression of osteoarthritis, characterized as a change of at least one category on the IKDC radiographic scale, occurred when meniscal extrusion was greater than 2.2 mm (sensitivity, 63%; specificity, 75%). Patients with higher body mass index (BMI) had significantly greater meniscal extrusion that patients with normal BMI (p < 0.001). The medial meniscus was more extruded in patients with horizontal and root tears. In conclusion, patients with preoperative meniscal extrusion of 2.2 mm or greater had unsatisfactory clinical outcomes and progression of osteoarthritis after partial medial meniscectomy at a minimum of 5 years follow-up. Higher BMI and horizontal and root tears were associated with greater preoperative meniscal extrusion.
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Osteoartritis , Lesiones de Menisco Tibial , Artroscopía/métodos , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Meniscectomía/métodos , Meniscos Tibiales/diagnóstico por imagen , Meniscos Tibiales/patología , Meniscos Tibiales/cirugía , Estudios Retrospectivos , Lesiones de Menisco Tibial/complicaciones , Lesiones de Menisco Tibial/diagnóstico por imagen , Lesiones de Menisco Tibial/cirugíaRESUMEN
Introducción: El objetivo del siguiente trabajo es mostrar los resultados clínicos de una serie de pacientes mayores de cuarenta años, tratados con reparación meniscal, evaluar detalles de las técnicas utilizadas, índice y causa de fallas y vuelta al deporte. Materiales y métodos: analizamos retrospectivamente pacientes intervenidos quirúrgicamente por nuestro equipo entre enero de 2012 y enero de 2018, a los que se les realizó reparación de lesión meniscal, asociada o no a lesión de LCA. Se excluyeron los pacientes menores de cuarenta años, aquellos con cirugías previas y seguimiento menor a cuatro años. Resultados: evaluamos cuarenta pacientes con edad promedio de cuarenta y ocho años (rango 4061). El seguimiento promedio fue de sesenta y seis meses (rango 4884). El promedio de suturas utilizadas fue 3 (rango 1 a 8 puntos). Cinco pacientes presentaron fallas (12.5%): cuatro asociadas a plástica de LCA y la restante por una reparación aislada. Los scores de Lysholm, IKDC y Tegner mostraron mejoría en el postoperatorio. Conclusión: según la evidencia disponible hasta la fecha, y los muy buenos resultados obtenidos en este estudio con un índice de falla del 12.5%, la edad, como factor independiente, no debe ser tomada como una contraindicación para la reparación meniscal. La reparación meniscal en pacientes mayores de cuarenta años tiene índices de fallas comparables a las reparaciones realizadas en pacientes jóvenes después de cuatro años de seguimiento. Nivel de Evidencia: IV
Purpose: Our aim is to evaluate clinical results in a series of meniscal repair in patients over forty years old. Reviewing the used technique, index and failure cause and return to sport. Materials and methods: we retrospectively reviewed our patients who underwent an arthroscopic meniscal repair between January 2012 and January 2018, with or without concomitant ACL reconstruction surgery. We excluded patients under forty years old, previous surgery, and a follow up of less than four years. Results: forty patients met our criteria. Mean age was forty-eight years old (range 4061). The mean follow-up was of sixty-six months (range 4884). The average number of sutures needed to make the repair was of three (range 18 sutures). Five patients failed (12.5%), four had an associated ACL reconstruction surgery and the latter was an isolated repair. Lysholm Score, IKDS and Tegner Score showed great results in the post-operative period. Conclusion: as more and more patients remain active into adulthood, the ability to preserve native meniscal tissue after injury is an important goal. According to the available evidence published so far, and our very promising results shown in this study with a 12.5% failure rate, age as an independent factor should not be considered as a non-repairing factor. Meniscal repair in patients over forty years old present similar results and failure rate comparable to repairs in younger patients after four years of follow-up. Level of Evidence: IV
Asunto(s)
Adulto , Persona de Mediana Edad , Artroscopía/métodos , Estudios de Seguimiento , Resultado del Tratamiento , Procedimientos Quirúrgicos Mínimamente Invasivos , Lesiones de Menisco Tibial/cirugíaRESUMEN
PURPOSE: To report the arthroscopic treatment results of a degenerative medial meniscus tear with a displaced flap into the meniscotibial recess, tibial peripheral reactive bone edema, and focal knee medial pain. As a secondary objective, we propose to identify possible factors associated with a good or poor prognosis of the surgical treatment of this lesion. METHODS: From 2012 to 2018, patients who had this specific meniscus pathology and underwent arthroscopic surgical treatment were retrospectively evaluated. Patients with Kellgren-Lawrence (KL) classification greater than 2 were excluded. KL classification, the presence of an Outerbridge grade III/V chondral lesion of the medial compartment, limb alignment, body mass index, and smoking were evaluated. The subjective outcomes included the International Knee Documentation Committee score, improvement in the pain reported by patients, and the Global Perceived Effect (GPE) scale score. RESULTS: A total of 69 patients were evaluated. The mean age was 58.6 ± 7.1 years. The follow-up time was 48.7 ± 20.8 months. Fifty-five (79.7%) patients reported pain improvement. The postoperative International Knee Documentation Committee was 62.6 ± 15.4, and the mean GPE was 2.3 ± 2.6. Fourteen patients (20.3%) showed no improvement in pain, and 7 patients (10.2%) presented complications. Groups that improved (GPE > 0) and did not improve (GPE < 0) did not present differences regarding age, sex, follow-up time, chondral lesions, or body mass index. Patients without improvement had a greater incidence of smoking (P = .001), varus alignment (P = .008), and more advanced KL classification (P < .001). In the multivariate analysis based on the GPE score, KL classification (P = .038) and smoking (P = .003) were significant. CONCLUSIONS: Arthroscopic surgical treatment of degenerative medial meniscal tears with a meniscal flap displaced into the meniscotibial recess and adjacent focal bone edema in the tibia shows good results in approximately 80% of cases. Smoking and KL grade 2 were factors associated with poor prognosis of surgical treatment. LEVEL OF EVIDENCE: Level IV (case series).
Asunto(s)
Meniscos Tibiales , Lesiones de Menisco Tibial , Anciano , Artroscopía , Edema/etiología , Humanos , Meniscos Tibiales/cirugía , Persona de Mediana Edad , Estudios Retrospectivos , Tibia/cirugía , Lesiones de Menisco Tibial/cirugíaRESUMEN
OBJECTIVE: To describe and evaluate the reproducibility by MRI of an arthroscopically-based classification for meniscal ramp lesions. We hypothesize that MRI would present good interobserver and intraobserver reliability to evaluate meniscal ramp lesions. MATERIALS AND METHODS: Twenty MRI of the knee with arthroscopically-proven meniscal ramp lesions were independently assessed by two skilled musculoskeletal radiologists and a third-year radiology resident. Reading was performed in a randomized and anonymous manner, in two steps, with a minimum of 1-month interval between each. Cohen's kappa coefficient statistic was used to analyze intra and interobserver reading agreement. Associate findings were also categorized. RESULTS: From 20 subjects, 17 were male, with mean age of 35 years. MRI reading showed type IV ramp lesion as most prevalent with eight cases (37%), followed by type V - four (21%), type I - four (20%), type III - three, (16%) and type II - one (6%). Regarding ramp lesion types, intraobserver agreement was substantial for both skilled readers (Kappa = 0.72), and moderate for the less experienced reader (Kappa = 0.51); interobserver agreement was moderate. Results between most experienced readers were also analyzed in two categories: stable (types I and II) and unstable (types III, IV and V), also resulting in moderate agreement (Kappa = 0.54). Intraobserver agreement was substantial for both readers (Kappa = 0.68). The most common associate findings were joint effusion (85%), posteromedial capsular structures injury (60%), and medial meniscus extrusion (60%). CONCLUSION: The arthroscopy classification for meniscal ramp lesions stability adapted for MRI has good reproducibility when applied by trained musculoskeletal radiologists.
Asunto(s)
Artroscopía/métodos , Articulación de la Rodilla/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Meniscos Tibiales/diagnóstico por imagen , Lesiones de Menisco Tibial/diagnóstico , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Curva ROC , Reproducibilidad de los Resultados , Lesiones de Menisco Tibial/clasificación , Adulto JovenRESUMEN
BACKGROUND: Complex meniscal lesions often require meniscectomy with favorable results in the short term but a high risk of early osteoarthritis subsequently. Partial meniscectomy treated with meniscal substitutes may delay articular cartilage degeneration. PURPOSE: To evaluate the status of articular cartilage by T2 mapping after meniscal substitution with polyurethane scaffolds enriched with mesenchymal stem cells (MSC) and comparison with acellular scaffolds at 12 months. METHODS: Seventeen patients (18-50 years) with past meniscectomies were enrolled in 2 groups: (1) acellular polyurethane scaffold (APS) or (2) polyurethane scaffold enriched with MSC (MPS). Patients in the MPS group received filgrastim to stimulate MSC production, and CD90+ cells were obtained and cultured in the polyurethane scaffold. The scaffolds were implanted arthroscopically into partial meniscus defects. Concomitant injuries (articular cartilage lesions or cartilage lesions) were treated during the same procedure. Changes in the quality of articular cartilage were evaluated with T2 mapping in femur and tibia at 12 months. RESULTS: In tibial T2 mapping, values for the MPS group increased slightly at 9 months but returned to initial values at 12 months (P > 0.05). In the APS group, a clear decrease from 3 months to 12 months was observed (P > 0.05). This difference tended to be significantly lower in the APS group compared with the MPS group at the final time point (P = 0.18). In the femur, a slight increase in the MPS group (47.8 ± 3.4) compared with the APS group (45.3 ± 4.9) was observed (P > 0.05). CONCLUSION: Meniscal substitution with polyurethane scaffold maintains normal T2 mapping values in adjacent cartilage at 12 months. The addition of MSC did not show any advantage in the protection of articular cartilage over acellular scaffolds (P > 0.05).
Asunto(s)
Cartílago Articular , Traumatismos de la Rodilla/cirugía , Trasplante de Células Madre Mesenquimatosas , Células Madre Mesenquimatosas , Osteoartritis de la Rodilla , Poliuretanos/química , Lesiones de Menisco Tibial/terapia , Andamios del Tejido , Adolescente , Adulto , Cartílago Articular/cirugía , Cartílago Articular/trasplante , Femenino , Humanos , Masculino , Meniscectomía , Menisco/cirugía , Persona de Mediana Edad , Osteoartritis de la Rodilla/cirugía , Ingeniería de Tejidos , Resultado del Tratamiento , Adulto JovenRESUMEN
PURPOSE: The primary objective of this study is to evaluate the contact areas, contact pressures, and peak pressures in the medial compartment of the knee in six sequential testing conditions. The secondary objective is to establish how much the medial meniscus is able to extrude, secondary to soft tissue injury while keeping its roots intact. METHODS: Ten cadaveric knees were dissected and tested in six conditions: (1) intact meniscus, (2) 2 mm extrusion, (3) 3 mm extrusion, (4) 4 mm extrusion, (5) maximum extrusion, (6) capsular based meniscal repair. Knees were loaded with a 1000-N axial compressive force at 0°, 30°, 60°, and 90° for each condition. Medial compartment contact area, average contact pressure, and peak contact pressure data were recorded. RESULTS: When compared to the intact state, there was no statistically significant difference in medial compartment contact area at 2 mm of extrusion or 3 mm of extrusion (n.s.). There was a statistically significant decrease in contact area compared to the intact state at 4 mm (p = 0.015) and maximum extrusion (p < 0.001). The repair state was able to improve medial compartment contact area, and there was no statistically significant difference between the repair and the intact states (n.s.). No significant differences were found in the average contact pressure between the repair, intact, or maximum extrusion conditions at any flexion angle (n.s.). No significant differences were found in the peak contact pressure between the repair, intact, or maximum extrusion conditions at any flexion angle (n.s.). CONCLUSION: In this in vitro model, medial meniscus extrusion greater than 4 mm reduced medial compartment contact area, but meniscal extrusion did not significantly increase pressure in the medial compartment. Additionally, meniscal centralization was effective in restoring the medial tibiofemoral contact area to intact state when the meniscal extrusion was secondary to meniscotibial ligament injury. The diagnosis of meniscal extrusion may not necessarily involve meniscal root injury. Since it is known that meniscal extrusion greater than 3 or 4 mm has a biomechanical impact on tibiofemoral compartment contact area and pressures, specific treatments can be established. Centralization restored medial compartment contact area to the intact state.
Asunto(s)
Traumatismos de la Rodilla , Lesiones de Menisco Tibial , Fenómenos Biomecánicos , Cadáver , Humanos , Articulación de la Rodilla/cirugía , Meniscos Tibiales/cirugía , Lesiones de Menisco Tibial/cirugíaRESUMEN
Purpose To evaluate clinical outcome following minimally invasive plate osteosynthesis (MIPO) associated with percutaneous transplantation of allogeneic adipose-derived mesenchymal stem cells (AD-MSC) at the tibial fracture site in dogs. Methods Thirty-six dogs presenting with nonarticular complete tibial fracture were included in this study. All fractures were treated by the same MIPO technique. The animals were divided in group 1 (n = 20) received a percutaneous application of 3 × 106 AD-MSC at the fracture site and group 2 (n = 16) did not receive any adjuvant treatment. Postoperative radiographic examinations were made at 15, 30, 60, 90 and 120 days. Results Fifty-eight percent of the patients were classified as skeletally immature. The median weight of the animals was 18.8 kg. The mean radiographic union time differed statistically between the AD-MSC group (28.5 days) and the control group (70.3 days). Sixty percent of dogs in group 1 and 56.25% of the group 2 were considered immature. Conclusions The use of allogeneic AD-MSC cell therapy and MIPO is a safe, viable and effective technique for promoting bone healing in nonarticular tibial fractures in dogs.(AU)
Asunto(s)
Animales , Perros , Células Madre Mesenquimatosas , Fijación Interna de Fracturas/veterinaria , Lesiones de Menisco Tibial/veterinaria , Cicatrización de HeridasRESUMEN
Introducción: El objetivo de nuestro trabajo es evaluar la evolución clínica, la condroprotección y la reacción inmunológica del trasplante de menisco (TM) con aloinjerto gama irradiado (GI) versus fresco congelado (FC) a veinticuatro meses. Materiales y métodos: veinte TM mediales en veinte pacientes, se evaluaron escalas de rodilla, Mapeo-T2 y segunda vista artroscópica, así como identificación de reacciones inmunológicas con la medición de citocinas inflamatorias por PCR en sangre y líquido sinovial. Trece trasplantes con injerto FC y siete GI, edad promedio de treinta y dos años. Resultados: mejoría significativa en escalas a veinticuatro meses: KOOS (dolor 67.80/79.30; síntomas 60.80/82.10; AVD 8.05/92.40; deportes 37/63.35; CV 28.90/71.30), Lysholm (62.20/85.80), IKDCs (50.17/72.12), EVA (3.35/0.4). El cartílago del compartimento trasplantado se mantuvo dentro de valores normales, sin diferencia a los veinticuatro meses (fémur: 33.43 versus 33.50 ms, p = 0.16) (tibia: 33.57 versus 34.35 ms, p = 0.21). Todos los pacientes mostraron integridad del injerto a los doce meses en la segunda vista artroscópica. Solo se observó aumento en las citoquinas plasmáticas IL-6 e IL-17 en un paciente del grupo GI, sin repercusión clínica. Conclusiones: mejoría clínica, adecuada integración y condroprotección significativa a veinticuatro meses en ambos tipos de injertos
Introduction: Our objective is to evaluate the clinical course, chondroprotection and immunological reaction of meniscus transplantation (TM) with gamma irradiated (GI) versus fresh frozen (FC) allograft at twenty-four months. Materials and methods: twenty medial TMs in twenty patients, knee scales, T2-mapping and second arthroscopic view were evaluated, as well as identification of immunological reactions with the measurement of inflammatory cytokines by PCR in blood and synovial fluid. Thirteen transplants with FC graft and seven GI grafts, average age of thirty-two years. Results: significant improvement on scales at twenty-four months: KOOS (pain 67.80 / 79.30; symptoms 60.80 / 82.10; AVD 8.05 / 92.40; sports 37 / 63.35; CV 28.90 / 71.30), Lysholm (62.20 / 85.80), IKDCs (50.17 / 72.12), EVA (3.35 / 0.4). The cartilage of the transplanted compartment remained within normal values, with no difference at twenty-four months (femur: 33.43 versus 33.50 ms, p = 0.16) (tibia: 33.57 versus 34.35 ms, p = 0.21). Conclusions: all patients showed integrity of the graft at twelve months in the second arthroscopic view. An increase in plasma cytokines IL-6 and IL-17 was only observed in one patient in the GI group, without clinical repercussion. Clinical improvement, adequate integration and significant chondroprotection at twenty-four months in both types of grafts
Asunto(s)
Adulto , Cartílago Articular , Trasplante Óseo/métodos , Aloinjertos , Lesiones de Menisco Tibial/cirugía , Articulación de la Rodilla/cirugíaRESUMEN
Meniscal tears account for approximately 15% of all knee injuries and almost 25% of them require surgical procedures. Magnetic Resonance Imaging (MRI) is widely used for noninvasive assessment of the knee joint and is considered reliable and a powerful tool for the detection of soft tissue injuries of the knee. The aim of the study was to evaluate the sensitivity, specificity, and accuracy of magnetic resonance imaging (MRI) to predict the meniscal tears repair in sports practitioners. 104 incoming consecutive patients who underwent knee joint ligament reconstruction and/or arthroscopy for the treatment of meniscal injury at knee joint were imaged using a 1.5-T MRI scanner prior to arthroscopy. MRI images were evaluated for anterior cruciate ligament (ACL), articular cartilage, and meniscal injury. Images were correlated with arthroscopic findings, used as the gold standard. The sensitivity, specificity, and accuracy of MRI in predicting meniscal repair were 61.1%, 65.94%, and 64.58%, respectively. The agreement between MRI and arthroscopy yielded a kappa index of 0.236, indicating fair agreement. When the menisci were evaluated separately, 65.85% sensitivity, 45.45% specificity, and 54.16% accuracy were found for the medial meniscus, while 46.15%, 79.51%, and 75.0% for the lateral meniscus, respectively. The accuracy was 62.09% in whose patients that arthroscopy was performed up to 3 months after MRI and 67.18% in those that this time frame was more than 3 months before surgery. The 54 meniscal injuries occurred more frequently in the posterior horn; most injuries had a longitudinal pattern and were located in the red-red (vascular) zone. We suggest that magnetic resonance imaging is only moderately accurate for the prediction of meniscus reparability.
Asunto(s)
Traumatismos en Atletas , Traumatismos de la Rodilla , Lesiones de Menisco Tibial , Atletas , Humanos , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Lesiones de Menisco Tibial/diagnóstico por imagen , Lesiones de Menisco Tibial/cirugíaRESUMEN
Dada la creciente popularidad de las actividades deportivas, el número de roturas del ligamento cruzado anterior (LCA) y lesiones meniscales ha aumentado en particular en niños y adolescentes. El manejo de estas lesiones es desafiante debido las fisis abiertas. Por un lado las opciones de reconstrucción del LCA incluyen técnicas: transfisarias, extra-articulares y intraepifisarias. Por otro lado se han descrito diferentes técnicas de reparación meniscal: "all-inside", "inside-out" y "outside-in". Estas tiene como objetivo lograr la cicatrización meniscal, evitando los efectos adversos de la meniscectomía. Presentamos un reporte de caso de un adolescente de 14 años con una rotura completa del LCA y una lesión del cuerno posterior del menisco interno que fue sometido a una reconstrucción transfisaria del LCA y a una reparación meniscal "inside-out".
With the raising popularity of sporting activity, the number of anterior cruciate ligament (ACL) ruptures and meniscal tears has increased in particular in children and adolescents. Management of these injuries is challenging due to open growth plates. On the one hand the ACL reconstructions options includes: transphyseal, extra-articular and epiphyseal-only techniques. On the other hand there have been described different meniscal repair techniques: "all-inside", "inside-out" and "outside-in". These aim to achieve meniscal healing, avoiding the adverse effects of meniscectomy. We present a case report of a 14-year adolescent with an ACL complete rupture and a posterior horn tear of the medial meniscus who underwent an ACL transphyseal reconstruction and a "inside-out" meniscal repair.
Dada a crescente popularidade das atividades esportivas, o número de rupturas do ligamento cruzado anterior (LCA) e lesões meniscais aumentou especialmente em crianças e adolescentes. O manejo destas lesões é desafiador devido às fissuras abertas. Por um lado as opções de reconstrução do LCA incluem técnicas: transfisárias, extra-articulares e intraepifisárias. Por outro lado, foram descritas diferentes técnicas de reparação meniscal: "all-inside", "inside-out" e "outside-in". Estes têm como objetivo alcançar a cicatrização meniscal, evitando os efeitos adversos da meniscectomia. Apresentamos um relatório de caso de um adolescente de 14 anos com uma ruptura completa do LCA e uma lesão do corno posterior do menisco interno que foi submetido a uma reconstrução transfisária do LCA e a uma reparação meniscal "inside-out".
Asunto(s)
Humanos , Masculino , Adolescente , Reconstrucción del Ligamento Cruzado Anterior/instrumentación , Reconstrucción del Ligamento Cruzado Anterior/métodos , Lesiones del Ligamento Cruzado Anterior/cirugía , Lesiones del Ligamento Cruzado Anterior/diagnóstico por imagen , Lesiones de Menisco Tibial/cirugía , Lesiones de Menisco Tibial/diagnóstico por imagen , Factores de Edad , Resultado del Tratamiento , Reconstrucción del Ligamento Cruzado Anterior/efectos adversosRESUMEN
SUMMARY: Meniscus tear is an important injury affecting the quality of life. This work is aimed to investigate the activity of CD68 and ADAMTS-5 in cells in synovial fluid in male and female patients with meniscal tear. In this study ,18 male and 22 female patients with meniscal tears were included. Local pain sensation during patients' physical examination, swelling, performing daily activities and difficulty in running-walking complaints were determined. 5 cc synovial fluids were aspirated from the lateral suprapatellar pouch part of the knees with meniscal pain. After routine histological follow-up of the samples, they were embedded in paraffin and sectioned with microtome and 5 micrometer thickness. CD68 and ADAMTS-5 primary antibodies were used for immunohistochemical analysis. Sections were taken and evaluated with a stylish microscope. The distribution of blood cells after meniscus tear was higher in female patients than in male patients. CD68 distribution in female patients appeared higher than in male patients. CD68 expression was high in macrophage cell cytoplasm. ADAMTS-5 expression was higher in female patients in degenerative cells and apoptotic cells. ADAMTS-5 is an important metallo-protein involved in the development of apoptotic signal and extracellular matrix synthesis in patients with ADAMTS-5 meniscus tear, and it may be an important criterion for the treatment developed after injury. CD68 and ADAMTS-5 activity was thought to be one of the important signal pathways that can be identified in the treatment of meniscus tear.
RESUMEN: La rotura del menisco es una lesión importante que afecta la calidad de vida. El objetivo fue investigar la actividad de CD68 y ADAMTS-5 en células del líquido sinovial en pacientes masculinos y femeninos con desgarro meniscal. Se incluyeron 18 pacientes masculinos y 22 femeninos con desgarros meniscales. Se determinó la sensación de dolor local durante el examen físico de los pacientes, la hinchazón, la realización de actividades diarias y la dificultad al correr y caminar. Se aspiraron 5 cc de líquido sinoviale de la parte de la bolsa suprapatelar lateral de las rodillas de los pacientes con dolor meniscal. Después del seguimiento histológico de rutina, las muestras se incluyeron en parafina y se seccionaron con un micrótomo de grosor de 5 micrómetros. Para el análisis inmunohistoquímico se usaron los anticuerpos primarios CD68 y ADAMTS-5. La distribución de las células sanguíneas después del desgarro del menisco fue mayor en pacientes femeninos que en pacientes masculinos. La distribución de CD68 en pacientes femeninos fue más alta que en pacientes masculinos. Además la expresión de CD68 fue alta en el citoplasma de los macrófagos. La expresión de ADAMTS-5 fue mayor en pacientes femeninos en las células degenerativas y células apoptóticas. ADAMTS-5 es una metaloproteína importante en el desarrollo de la señal apoptótica y la síntesis de matriz extracelular en pacientes con rotura de menisco ADAMTS-5, y puede ser un criterio importante para el tratamiento después de la lesión. La actividad de CD68 y ADAMTS-5 era una de las vías de señal importantes que se pueden identificar en el tratamiento de la rotura del menisco.
Asunto(s)
Humanos , Masculino , Femenino , Lesiones de Menisco Tibial/metabolismo , Lesiones de Menisco Tibial/patología , Articulación de la Rodilla/metabolismo , Articulación de la Rodilla/patología , Líquido Sinovial/química , Inmunohistoquímica , Antígenos CD/análisis , Sinoviocitos/metabolismo , Proteína ADAMTS5/análisis , Articulación de la Rodilla/citologíaRESUMEN
BACKGROUND: It is known that late surgical reconstruction of the anterior cruciate ligament (ACL) is associated with a medial meniscal (MM) tears. However, the association between factors relating to sports and work activities and joint instability, has not been examined in non-athletic subjects. OBJECTIVE: To compare sports and work activities and other factors associated with MM tears, in subjects with ACL rupture. METHOD: A case-control design study, of patients with ACL injury, 140 cases and 140 controls with and without a rupture of MM respectively, were included. Sociodemographic factors, sports and work activities were compared. RESULTS: The independent factors associated with MM ruptures were continuing sports activities after injury (odds ratio [OR]: 3.6; 95% confidence interval [95% CI]: 1.7-7.9), joint instability (OR: 2.2; 95% CI: 1.8-2.6), time between injury and surgical intervention (time of evolution) (OR: 1.003; 95% CI: 1.0-1.01) and age (OR: 1.1; 95% CI: 1.03-1.1). CONCLUSIONS: Intense activities of daily life such as continuing sports activities, after an ACL injury in non-athletic factory workers subjects, without previous training, as well as, age, joint instability and surgical delay are risk factors for rupture of MM.
ANTECEDENTES: Se sabe que la reconstrucción tardía del ligamento cruzado anterior (LCA) se asocia a rotura del menisco medial (MM). Sin embargo, la asociación entre factores referentes a las actividades deportivas, laborales e inestabilidad articular no se ha examinado en sujetos no deportistas. OBJETIVO: Comparar las actividades laborales, deportivas y otros factores asociados a rotura del MM en sujetos con rotura del LCA. MÉTODO: Diseño de casos y controles, de sujetos con rotura del LCA; 140 casos y 140 controles con y sin rotura de MM, respectivamente. Se compararon factores sociodemográficos, actividades deportivas y laborales. RESULTADOS: Los factores independientes asociados a roturas del MM fueron el continuar con actividades deportivas después de la lesión (razón de momios [RM]: 3.6; intervalo de confianza del 95% [IC 95%]: 1.7-7.9), la inestabilidad articular (RM: 2.2; IC 95%: 1.8-2.6), el tiempo de evolución entre la lesión y la reconstrucción (RM: 1.003; IC 95%: 1.0-1.01) y la edad (RM: 1.1; IC 95%: 1.03-1.1). CONCLUSIONES: Actividades intensas de la vida diaria, como continuar con deportes, después de una lesión del LCA en sujetos obreros, no deportistas, sin entrenamiento previo, así como la edad, el retraso en la reconstrucción y la inestabilidad articular, son factores de riesgo para rotura del MM.
Asunto(s)
Traumatismos en Atletas/etiología , Traumatismos Ocupacionales/etiología , Lesiones de Menisco Tibial/etiología , Actividades Cotidianas , Adulto , Factores de Edad , Lesiones del Ligamento Cruzado Anterior/complicaciones , Reconstrucción del Ligamento Cruzado Anterior/efectos adversos , Índice de Masa Corporal , Peso Corporal , Estudios de Casos y Controles , Intervalos de Confianza , Femenino , Humanos , Inestabilidad de la Articulación/complicaciones , Modelos Logísticos , Masculino , Traumatismos Ocupacionales/cirugía , Ocupaciones/clasificación , Ocupaciones/estadística & datos numéricos , Procedimientos de Cirugía Plástica , Factores de Riesgo , Rotura/etiología , Rotura/cirugía , Conducta Sedentaria , Deportes , Estadísticas no Paramétricas , Lesiones de Menisco Tibial/cirugíaRESUMEN
El menisco cumple un rol clave en la distribución de cargas, ampliando la superficie de contacto y mejorando la congruencia femorotibial. La lesión meniscal aumenta exponencialmente presiones y altera el área de contacto articular femorotibial. Evaluaremos la efectividad de reparaciones artroscópicas en lesiones meniscales aisladas y la tasa de retorno al deporte competitivo de contacto.Se evaluaron retrospectivamente once pacientes tratados con sutura meniscal artroscópica aislada, con un seguimiento mínimo de dos años. Criterios de inclusión: lesión meniscal aislada aguda o semi aguda (0-6 semanas), lesiones longitudinales zona roja-roja y zona roja-blanca, deporte competitivo de contacto. Criterios de exclusión: reparación meniscal asociada a otros procedimientos (por ejemplo, plástica del LCA), cirugía de revisión. Sexo: diez hombres, una mujer. Edad: mediana de veinticuatro años (14-35).Complicaciones: un paciente con pérdida de extensión >5°. Retorno al deporte: diez pacientes mismo deporte / mismo nivel, un paciente a menor nivel. Re-ruptura: un paciente, nueva entorsis en su tercera temporada postcirugía. Subjetivamente: diez pacientes muy satisfechos, uno regular. Podemos concluir que pacientes jóvenes con lesiones meniscales aisladas, reparadas artroscópicamente en las primeras seis semanas, tienen una excelente tasa de retorno al deporte competitivo de contacto, con alto grado de satisfacción. Nivel de Evidencia: IV
Our objective is to evaluate the effectiveness of isolated meniscal repairs and the rate of return to competitive sports and compare them with the literature.The meniscus plays a role in shock absorption, load distribution, increases the contact surface, improves femoral-tibial congruence. The meniscal injury alters the transmission of loads, thus increasing the pressures of the femoral-tibial contact between 20 and 50%.Eleven patients with eleven meniscal lesions treated with isolated arthroscopic meniscal suture were retrospectively evaluated. Inclusion criteria: patient with isolated acute or semi-acute meniscal injury (0-6 weeks), competitive contact sport.Eleven patients (eleven knees), minimum follow-up two years. Ten men, one woman. Median age twenty four years (14-35). Meniscal lesions: four red-red zone and seven red-white zone. Median time from injury to surgery: four weeks (1-13). Ten patients returned to their sport at the same level. One patient return to sport but at a lower level. The median time of return to the sport: sixteen weeks (12-28). Two dropouts of sport: one patient after a second competitive season, for reasons not related to surgery; one patient suffered a re-injury that required partial meniscectomy.Subjectively: Very satisfied ten patients, regular one patient. Complications: loss of extension more than 5° one patient. Pain: climatic discomfort in three patients, pain with maximum training loads in one patient.Young patients with simple red-red or red-white lesions, operated on within the first six weeks from injury have excellent clinical results and return to contact sport at same level. Level of evidence: IV
Asunto(s)
Adulto , Traumatismos en Atletas , Estudios de Seguimiento , Volver al Deporte , Lesiones de Menisco Tibial , Traumatismos de la RodillaRESUMEN
The present study aimed to evaluate the inter- and intra-observer reproducibility of the arthroscopic meniscus tear classification system in patients treated with meniscal suture, as well as to correlate these anatomical zones, according to the injury characteristics and the suture technique employed.Forty-six knee arthroscopies were analyzed for meniscal sutures. The evaluators recorded data of the zones described by Smigielski, types of injuries, meniscal vascularity, suture techniques, and types of suture knots applied to sutures. Data were analyzed with respect to inter and intra-observer agreement. All clinical and anatomical outcomes as well as the characterization of the injury and meniscal treatment were correlated.The intra- and inter-observer reproducibility (Kappa coefficient) for the arthroscopic classification system of meniscus injury proposed by Smigielski ranged from slight to moderate.The zone classification defines the menisci and their relationship with the surrounding anatomic landmarks of the knee; however, it has limited arthroscopic application. The practical knowledge of the classification system described in this study can help specifically guide treatment for various types of meniscal injury
El propósito del presente estudio es evaluar la reproducibilidad inter e intraobservador de la clasificación artroscópica de lesiones meniscales propuesta por Smigielski en pacientes tratados con suturas meniscales, así como correlacionar las zonas anatómicas con las características lesionales y el tipo de técnica de sutura empleada.Se analizaron cuarenta y seis artroscopías de rodilla con sutura meniscal de la lesión. Se examinó la zona descripta según Smigielski, el tipo de lesión meniscal, la vascularidad, la técnica de sutura meniscal y el tipo de nudo empleados. Los datos fueron evaluados para considerar la reproducibilidad intra e interobservador. Todos los resultados clínicos, anatómicos, características de la lesión, así como el tratamiento meniscal utilizado, se correlacionaron.La correlación intra e interobservador (coeficiente Kappa) para la clasificación artroscópica de lesiones meniscales propuesta por Smigielski fue leve o moderada. La clasificación por zonas que define la lesión meniscal y su relación con las estructuras anatómicas de la rodilla tiene aplicación limitada en la cirugía artroscópica. El conocimiento práctico de la clasificación podría servir como guía para la toma de conducta ante las lesiones meniscales reparables