Orthopedic Pathology: Meniscus

Created by lilk1d777 

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Meniscus

fibrocartilage C-shaped cushoins in knee, relatively vascular (outer region vs. AC-completely avascular)

Structure+composition of meniscus

fibrchondrocytes(synthesize type 1 collagen fibers), key general points, macromolecules, 65-70%H2O vs. AC-up to 80%

Type I dry wt of collagen vs type ll

l - 80-95%collagen 1-2%proteoglycan vs.ll - 60% 25-30%

Framework of Meniscal matrix

superficial and deep zone

superficial zone of meniscus

very thing random oriented collagen fibers

deep zone of meniscus

circumfrential collagen fibers and radial fibers

function of meniscus

load bearing(axial loads+circumferential str), shock absorbtion(compressive stiffness, 1/2 of AC)

injury/healing of meniscus

happens when a traumatic load exceeds strength of the meniscus, meniscal degeneration beings gradually ~30 tearing is messy

3 meniscal surgical interventions

1.meniscal repair 2.menisectomy 3.meniscal replacement

Meniscal repair

arthroscopic, sutures, tear must be peripheral, slow to heal but keeps orig cartilage

Menisectomy

most common, arthroscopic, risk of early OA, wt bearing may->pain

Meniscal replacement

sized matched allograft, @4wks lay down new matrix fibrochondrocytes repopulate @6wks revascularized periphery 3-5yrs has good results

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