Editorial Commentary: Increased Tibial Slope and Decreased Medial Proximal Tibial Angle Negatively Affect Anterior Cruciate Ligament Graft Maturation: Objective Evidence on When to Add a Lateral Extra-Articular Augmentation Procedure to a Soft-Tissue Ante

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Disclosures The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: C.M.L. reports speaking and lecture fees from Foundation Medical and Evolution Surgical and has a family member that reports relationships with Ossur Americas, Smith & Nephew, Linvatec Europe, and Responsive Arthroscopy that include consulting or advisory; a family member that reports relationships with Ossur Americas, Smith & Nephew, Arthroscopy Association of North America, and American Orthopaedic Society for Sports Medicine that include funding grants. R.F.L. reports consulting or advisory for Ossur Americas, Smith & Nephew, Linvatec Europe, and Responsive Arthroscopy; and funding grants from Ossur Americas, Smith & Nephew, Arthroscopy Association of North America, and American Orthopaedic Society for Sports Medicine. The other author (L.V.T.) declares that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. 6. Am J Orthop (Belle Mead NJ). 2016 Mar-Apr;45(3):183-7. Meniscal Root Tears: Identification and Repair. Doherty DB(1), Lowe WR. Author information: (1)The University of Texas Health Science Center at Houston, Houston, TX. david.b.doherty@uth.tmc.edu. Intact menisci are capable of converting the axial load of tibiofemoral contact into hoop stress that protects the knee joint. Total meniscectomy leads to rapid degeneration of the knee. Strong clinical and biomechanical data show meniscal root tears and avulsions are the functional equivalent of total meniscectomy. Lateral root tears commonly occur with knee ligament sprains and tears. Medial root tears are generally more chronic, and can be caused by preexisting knee arthritis. Meniscal root repair is indicated when there is identification of a meniscal root tear in a knee with minimal to no arthritis. Chronic root tears in the setting of osteoarthritis are treated conservatively. Meniscal root tears can acutely occur with cruciate ligament tears, can exaggerate symptoms of instability, and will have negative ramifications on outcomes of anterior cruciate ligament reconstruction if not addressed concomitantly. In this review, we describe the importance of the menisci for knee joint longevity through anatomy and biomechanics, the diagnostic workup, and ultimately a transosseous technique for repair of meniscal root tears and avulsions.