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In the pediatric population, meniscectomy should be exceptional. This study aimed to estimate the incidence and trends of hospitalization of pediatric meniscectomy in Italy. Data were collected from the National Hospital Discharge Reports (SDO) reported at the Italian Ministry of Health. This study referred to the pediatric population (0–14 years of age) from 2001 to 2016. A total of 5188 pediatric meniscectomies were performed. The global incidence was 3.9 for every 100,000 Italian residents under 14 years of age. The most frequent age class was 10–14 years. The men/women ratio was 1.1. The average number of days of hospitalization was 1.8 ± 1.4. Men showed more days of hospitalization than women. The 5–9 age group presented the highest length of hospitalization (2.3 ± 1.5 days). The main primary codified diagnoses were as follows: derangement of the posterior horn of the medial meniscus, other derangement of the lateral meniscus, old bucket handle tear of the medial meniscus, and derangement of the lateral meniscus. Primary codified procedures were the excision of semilunar cartilage of the knee and knee arthroscopy. The burden of pediatric meniscectomy is relevant in Italy. The information required to develop global standards for managing pediatric meniscal lesions may be provided by conducting further epidemiological studies. [ABSTRACT FROM AUTHOR]

Background: The management of the postoperative period after knee arthroscopic surgery may be challenging because surgical trauma deeply alters the joint microenvironment, causing the release of several catabolic molecules and proinflammatory factors that might slow down functional recovery. The possibility of using hyaluronic acid (HA) to promote postoperative pain relief and expedite functional improvement seems attractive, considering its biological properties. Purpose: The aim of the present double-blind randomized controlled trial was to evaluate the effects, in terms of pain control and functional recovery, provided by a single HA injection performed at the end of arthroscopic meniscectomy. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 90 patients, 18 to 55 years old, were included according to the following criteria: (1) chronic, symptomatic meniscal tears requiring partial resection; (2) a healthy contralateral knee; (3) no previous surgery on the index knee; and (4) no other concurrent articular lesions requiring surgical treatment (eg, cartilage or ligament injuries). Patients were randomized into 2 treatment groups: one underwent meniscectomy alone, whereas the other also received an injection of 3 mL HA at the end of the procedure. All patients were evaluated at baseline and then at 15, 30, 60, and 180 days using the following tools: International Knee Documentation Committee (IKDC) subjective, Knee injury and Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS) for pain, VAS for general health status, and Tegner scores. The transpatellar circumference and active and passive ranges of motion were also recorded during the follow-up evaluations. Results: No major adverse events were reported using HA postoperatively. A statistically significant increase in all the clinical scores was reported in both treatment groups, but no significant intergroup difference was documented at any follow-up evaluation. No difference was observed also in the objective measurements. The mean time to return to full sports activity was not different between groups, and a comparable satisfaction rate was recorded in both treatment groups. Conclusion: Early postoperative viscosupplementation did not provide significant clinical benefits after arthroscopic meniscectomy. Despite the lack of major adverse events, the administration of a single HA injection at the end of the surgical procedure is not a successful strategy to provide either faster functional recovery or symptomatic improvement after meniscectomy. Trial Registration: ClinicalTrials.gov identifier: NCT02629380. [ABSTRACT FROM AUTHOR]

The article discusses a study which evaluated 12 male professional soccer players who undergone meniscus allograft transplantation (MAT) at 12- and 36-month follow-up. The degree of knee pain was assessed using visual analog scale (VAS) and functional follow-up included Lysholm and subjective International Knee Documentation Committee (IKDC). The results showed that arthroscopic MAT in male soccer players allowed a return to play at the same level in 75 % of the cases at 36-month follow-up.

The article reports a study which analyzed the potential of the cartilage regenerative approach of matrix assisted autologous chondrocyte transplantation (MACT) in young patients with osteoarthritic knees. The results revealed that despite a statistically significant improvement, the clinical outcome of MACT procedure was poor. A higher improvement could be obtained in patients who had not undergone previous or combined meniscectomies, but this was limited over time.

Background: Loss of meniscal tissue can be responsible for increased pain and decreased function.Hypothesis: At a minimum 10-year follow-up, patients receiving a medial collagen meniscus implant (MCMI) would show better clinical, radiological, and magnetic resonance imaging (MRI) outcomes than patients treated with partial medial meniscectomy (PMM).Study Design: Cohort study; Level of evidence 2.Methods: Thirty-three nonconsecutive patients (men; mean age, 40 years) with meniscal injuries were enrolled in the study to receive MCMI or to serve as a control patient treated with PMM. The choice of treatment was decided by the patient. All patients were clinically evaluated at time 0 and at 5 years and a minimum of 10 years after surgery (mean follow-up, 133 months) by Lysholm, visual analog scale (VAS) for pain, objective International Knee Documentation Committee (IKDC) knee form, and Tegner activity level scores. The SF-36 score was performed preoperatively and at final follow-up. Bilateral weightbearing radiographs were completed before the index surgery and at final follow-up. Minimum 10-year follow-up MRI images were compared with preoperative MRI images by means of the Yulish score. The Genovese score was also used to evalute MCMI MRI survivorship.Results: The MCMI group, compared with the PMM one, showed significantly lower VAS for pain (1.2 ± 0.9 vs 3.3 ± 1.8; P = .004) and higher objective IKDC (7A and 10B for MCMI, 4B and 12C for PMM; P = .0001), Teger index (75 ± 27.5 vs 50 ± 11.67; P = .026), and SF-36 (53.9 ± 4.0 vs 44.1 ± 9.2; P = .026 for Physical Health Index; 54.7 ± 3.8 vs 43.8 ± 6.5; P = .004 for Mental Health Index) scores. Radiographic evaluation showed significantly less medial joint space narrowing in the MCMI group than in the PMM group (0.48 ± 0.63 mm vs 2.13 ± 0.79 mm; P = .0003). No significant differences between groups were reported regarding Lysholm (P = .062) and Yulish (P = .122) scores. Genovese score remained constant between 5 and 10 years after surgery (P = .5). The MRI evaluation of the MCMI patients revealed 11 cases of myxoid degeneration signal: 4 had a normal signal with reduced size, and 2 had no recognizable implant.Conclusion: Pain, activity level, and radiological outcomes are significantly improved with use of the MCMI at a minimum 10-year follow-up compared with PMM alone. Randomized controlled trials on a larger population are necessary to confirm MCMI benefits at long term. [ABSTRACT FROM AUTHOR]