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procedures in orthopaedic surgery. 2 , 3 The role of the menisci in joint stability, 4 , 5 joint kinematics and load transfer 6 is well documented. Recent advances in meniscal repair techniques and biological augmentation have introduced a new
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Graft size in hamstring autograft anterior cruciate ligament (ACL) surgery is an important factor directly related to failure. Most of the evidence in the field suggests that the size of the graft in hamstring autograft ACL reconstruction matters when the surgeon is trying to avoid failures.
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The exact graft diameter needed to avoid failures is not absolutely clear and could depend on other factors, but newer studies suggest than even increases of 0.5 mm up to a graft size of 10 mm are beneficial for the patient. There is still no evidence to recommend the use of grafts > 10 mm.
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Several methods – e.g. folding the graft in more strands – that are simple and reproducible have been published lately to address the problem of having an insufficient graft size when performing an ACL reconstruction. Due to the evidence presented, we think it is necessary for the surgeon to have them in his or her arsenal before performing an ACL reconstruction.
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There are obviously other factors that should be considered, especially age. Therefore, a larger graft size should not be taken as the only goal in ACL reconstruction.
Cite this article: EFORT Open Rev 2018;3:93-97. DOI: 10.1302/2058-5241.3.170038
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combined early ACL reconstruction with an acute MCL repair ( Fig. 5 ). Fig. 5 Recommended algorithm for the treatment of acute injuries of the medial collateral ligament (MCL). Note. ACL, anterior cruciate ligament; MCL, medial collateral ligament
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and whether the damaged ligaments should be repaired or reconstructed. This article aims to summarize the key points in the management of these injuries based on the best available evidence. Initial assessment Knee dislocation or multiligament
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menisci. 25 Management strategies The vital functions of the meniscus and the development of osteoarthritis reported after its resection, has forced orthopaedic surgeons to protect as much as possible, to repair or to reconstruct the meniscus
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. 6 These anatomical and biomechanical factors increase the susceptibility of the rectus femoris to proximal avulsion injuries, and predispose the muscle to reinjury after non-operative treatment, requiring a need for operative repair at the injury
These authors contributed equally to this work
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These authors contributed equally to this work
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treatments of MRL exist, but the most definite and frequently applied is lesion repair. 19 Fig. 1 Ramp lesion of the medial meniscus and its features. Risk factors A large multivariate analysis established the following risk factors
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(RCT) evaluating the use of a chitosan-based scaffold combined with microfracture compared with microfracture alone has shown superior repair tissue quantity and quality over microfracture alone at five years but no difference in clinical outcomes. 21
Ripoll y De Prado Sports Clinic, Murcia-Madrid, FIFA Medical Centre of Excellence, Madrid, Spain
International Centre of Sports Traumatology of the Ave, Vila do Conde, Portugal
3Bs Research Group, I3Bs, Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Barco, Guimarães, Portugal
ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
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ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
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ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal
Orthopedic Department, University of Minho, Braga, Portugal
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ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, Barco, Guimarães, Portugal
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ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
Orthopaedic Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, Barco, Guimarães, Portugal
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, repair or replacement of the meniscus. 2 Recent basic science research reinforced the claim that the menisci are fundamental components of a healthy knee joint. 4 – 6 Menisci are C-shaped fibro-cartilage structures with a wedge-like cross
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Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal
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Dom Henrique Research Centre, Porto, Portugal
ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
School of Medicine, Minho University, Braga, Portugal
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collateral ligament pie-crusting release . Arthrosc Tech 2013 ; 2 : e41 – e43 . 18. Park Y-S Moon H-K Koh Y-G et al. Arthroscopic pullout repair of posterior root tear of the medial meniscus: the anterior approach
