Meniscus tears, a prevalent knee joint injury, can significantly hinder joint functionality. Thus, the control of meniscus tears holds significant importance in preserving the joint's regular functionality. A non-invasive approach involves the recommendation of off-loading insoles; which therapists often prescribe based on their clinical experience. Based on the variety of meniscus tear types, it is essential to assess the effectiveness of different insoles when interacting with these distinct tears. This evaluation can be achieved through biomechanical investigations. To address this requirement, the present study utilized medical imaging to establish the precise lower limb geometry. To refine the acquired geometry, both longitudinal and radial tears were applied to the meniscus's geometry. The subsequent phase entails reconstructing the design of three off-loading insole models currently available in the Iranian market. The outcomes of these models demonstrate that the three-layer insole without honeycombs leads to a stress reduction of 1.1% at the apex of the radial tear. When dealing with a longitudinal tear situated on the inner meniscus, the application of a three-layer insole equipped with a honeycomb structure results in a 15% stress reduction. Utilizing a single-layer silicone insole results in an 8% decrease in stress on the external meniscus during longitudinal tears. Hence, the three-layer insole incorporating a honeycomb design is effective for managing longitudinal tears on the inner meniscus. Moreover, the research outcomes indicate that, when comparing the two tear types, longitudinal tears carry a greater risk than radial tears, exhibiting an increased likelihood of worsening.

Background/Objective: The concept of evaluating the musculoskeletal system with ultrasound was initially introduced in the late 1970s. For evaluating meniscal tears, which are a common injury in traumatic events of knee, linear probes with high resolution have been used. In this study, we compared the results of sonography with arthroscopy in diagnosing bucket handle tear of meniscus and MCL tear. Patients and Methods: 218 clinically symptomatic knee joints with clinical indication of arthroscopy were examined by sonography in a referral sport medicine center. The patients eventually had arthroscopic exam. The results were compared, and statistically analyzed using Fisher’s exact.Results: In this study, of 218 patient who had arthroscopy and sonography, the sensitivity and specificity of sonography in meniscal tear were 68.1% and 100%, respectively. 34 patients had bucket handle tear of the posterior horn of the medial meniscus on sonography; six cases (17.6%) of which had abnormally small posterior horns of medial meniscus (in favor of meniscal tear) but in 60 patients with other types of meniscal tear, sonography revealed tear in 58 (96.6%)(P<0.0001). Six patients had complete MCL tear in arthroscopy, while in sonography 4 complete MCL tears were shown. Sensitivity of ultrasound in diagnosing complete MCL tear was 66.6% and specificity of 98%. Conclusion: Ultrasound is easily applicable in evaluation of knee derangement: however, for bucket handle tears it has limited application. For MCL tears, sonography seems an accurate method. Ultrasonography is rapid, low-cost and non-invasive examination.

Background: Anterior cruciate ligament (ACL) tear is the most common ligamentous injury of knee in athletes. This is often accompanied with meniscal tear. In recent years, there had been more tendencies towards ACL reconstruction, even in cases of irreparable menisci. The study of patients who have had combined ACL and meniscus injury and have not had ligament reconstruction is warranted.Materials and Methods: 46 patients who had sustained both meniscus and ACL tears, and had been only treated by meniscectomy were studied with an average follow up of 10 years. The Lysholm Tenger and IKDC systems were used for assessment. Results: At the end of this intermediate-term follow up the Lysholm score was 84. The average Tenger activity level of 7.24 pre-injury had fallen to 4.71 in the last visit, the subjective IKDC scores was 73.5 on average. The objective IKDC score was D (severely abnormal) in 67%, C (abnormal) in 28%, B (near normal) in 4%. No one had A (normal) score, In spite of increased activity level post meniscectomy no patient experienced increased instability subjectively in presence, the patients did not have any major complaint and were happy with their knee.Conclusion: The knee with meniscectomy in presence of ACL tear did not have good functional outcome scores. The excision of torn part of meniscus, however, did not seem to increase the instability symptoms. The patients who can modify their sport activities and do not experience" giving way" symptoms would do well for at least 10 years without need for ligament reconstruction.We still recommend ACL reconstruction in those with irreparable meniscus tear, with uncontrollable giving way, or those who do not want to modify their activity level.

Background: This study investigated the effect of instilling a single drop of non-preserved cationic oil-in-water ophthalmic emulsion (Cationorm® ) on the lower (LTM) and upper tear meniscus (UTM) parameters of normal eyes. Methods: In this prospective, single-center, non-randomized, controlled pilot study, optical coherence tomography was used to estimate the UTM and LTM height, depth, and cross-sectional area in participants without a history of dry eye disease. In the right eye (study eye), we instilled one drop of Cationorm® in the lower conjunctival sac. Scans of the tear menisci were acquired at baseline, before the instillation, and at 5, 15, and 30 min thereafter. Control scans of the left eye (control eye) were obtained at the same timepoints. The tear meniscus parameters of the study eye were compared with the control eye at each timepoint. Results: Twenty subjects (11 male and 9 female; mean ± standard deviation of age: 37. 8 ± 10. 9 years) were included in the study. Compared to the control eye, instillation of a single drop of Cationorm® resulted in significantly higher LTM parameter values and a higher UTM cross-sectional area up to 30 min after instillation (all P < 0. 05). The UTM height and depth were significantly greater in the study eye than in the control eye up to 5 min (P < 0. 001 and 0. 007, respectively) and 15-min (P = 0. 045, and 0. 002, respectively) after Cationorm® instillation. In the study eye, Cationorm® resulted in a significant increase in LTM parameter values up to 30 min post-instillation (all P < 0. 001). The UTM height was significantly greater up to 15 min post-instillation than at baseline. The UTM depth and area increased significantly from baseline to 5 min after instillation (P = 0. 043, and 0. 002, respectively). Conclusions: Cationorm® seems to have a prolonged residence time on the ocular surface of healthy subjects as indicated by LTM parameters and to a lesser extent by UTM parameters

BACKGROUND AND OBJECTIVE: There are different diagnostic and therapeutic methods for meniscus tears. For obtaining optimal results, the characteristics of each one should be known. This study was performed with regard to epidemiology, causes, diagnostic methods, surgery and after surgery treatments. They were evaluated with regard to effective factors in prognostic. METHODS: This descriptive and cross - sectional study was done according to information which obtained from patients files, interviewing and physical and radiographic examination. Final evaluation was done according to the score of patients' consent of treatment and average score of physical examination with regard to clinical symptoms.FINDINGS: 77% of patients were under 35 years old. 88% of patients were male and 43% were sportmen. Pain and locking were the most common complaint in 80% and 58% of cases respectively. Arthrography was the most common diagnostic procedure (72%) with accuracy rate of 93% for medial and 74% for lateral meniscus. The rate of pain, swelling, locking and instability before surgery were 80%, 15%, 52% and 33% respectively; which after surgery reduced to 7% , 0, 13% and 10% respectively.CONCLUSION: In patients with trauma of knee especially young sportsmen, presence of meniscus should be considered seriously. Arthrography was known as an accessible, easy and effective method for diagnosis of meniscus tear. The ideal methods for treatment were repair of meniscus tear and partial menisectomy respectively. Post operative Jones bandage immobilization for 2 to 4 weeks and postoperative physiotherapy for 10 to 25 sessions had the most effective results.

Meniscal root tears are defined as radial tears located within 1 cm from the meniscal attachment or a bony root avulsion. This injury is biomechanically comparable to a total meniscectomy, leading to compromised hoop stresses resulting in decreased tibiofemoral contact area and increased contact pressures in the involved compartment. These changes are detrimental to the articular cartilage and ultimately lead to the development of early osteoarthritis. Surgical repair is the treatment of choice in patients without significant osteoarthritis (Outerbridge grades 3 or 4). Root repairs have been reported to improve clinical outcomes, decrease meniscal extrusion and slow the onset of degenerative changes. Here we describe the anatomy, biomechanics, clinical evaluation, treatment methods, outcomes, and post-operative rehabilitation for posterior meniscal root tears.

Background: Regarding the high incidence of meniscal injuries, a cost-effective, noninvasive, and also accurate diagnostic modality is highly needed. This study was conducted to assess the diagnostic value of sonography in detecting meniscus tears in comparison with arthrography.Methods: A total of 136 patients with symptoms of meniscal injury were examined with both sonography and arthrography by separate radiologists. The sensitivity, specificity, positive, and negative predictive values of sonography were calculated versus arthrography.Results: The sensitivity of sonography in diagnosing meniscustear was 75 percent, specificity 88 percent, positive predictive value 80 percent, and negative predictive value 85 percent.Conclusion: Our results show that we can't yet replace other methods with higher diagnostic value with sonography completely but regarding its advantages, it can be used along withother routine modalities.

Backgrounds: Characterization of mechanical behavior of meniscus is an important issue considering the significant role of meniscus in load bearing within the knee joint. Identification of mechanical change in meniscal tissue is of particular interest with respect to osteoarthritis (OA) research. Anterior Cruciate ligament (ACL) tear can. also have deep effect on the meniscus health. Meniscus injury is common in patients who have ACL tear. The objective of this study was to investigate the effect of longitudinal meniscal tear on tenside orces inside knee ing presence or absence of ACL, using finiie element models.Methods: 3-dimensional finite element model of knee joint were developed using CT scan images. Healthy anatomical structures were designed using mimics software. The obtained model was imported to Abaqus software to simulate forces across the knee meniscus in association with ACL.Results: The maximum shear stresses were 1.73 MPa and 1.48 MPa on medial and lateral menisc, respectively, e.e. mor tension on medial than lateral tension meniscus In presence of stable ACL tear the sustained maximum shear stresson medial meniscus was 8.33MPa, and with instable cruciate ligament tears. The maximum shear stress on medial meniscus was 9.65Mpa.Conclusions: The result confirmed that biomechanical response of ACL tear plays an important role in the tension and stability of the meniscus. A meniscus tear associated with ACL tear increases the level of stress and stress distribution diagram.

Background: Upper eyelid blepharoplasty, a corrective procedure for dermatochalasis, may transiently affect eyelid function and tear film stability. This study assessed the effect of upper eyelid blepharoplasty, subjectively through questionnaires, and objectively through tear film stability and production. Methods: This non-randomized, prospective, interventional study consecutively recruited the right eyes of patients with dermatochalasis who underwent bilateral upper eyelid blepharoplasty at a tertiary center. Preoperative assessments included a standardized ophthalmic examination, ocular surface disease index (OSDI) questionnaire, Schirmer’s test I, tear break-up time (TBUT) test, and anterior segment optical coherence tomography (AS-OCT) to measure tear meniscus height (TMH) and tear meniscus area (TMA). Postoperative evaluations were conducted at 1, 3, and 6 months. At the final follow-up, scar quality and patient satisfaction were assessed using the Patient and Observer Scar Assessment Scale. Results: Fifty eyes of 50 patients with a mean (standard deviation) age of 47.1 (1.6) years were included. Statistically significant postoperative changes were observed in the OSDI score, Schirmer’s test value, TBUT, and TMH at the 6-month follow-up (all P < 0.001). These parameters initially worsened at 1 month and then improved significantly at 3 and 6 months, returning to or surpassing baseline levels. TMA showed a transient postoperative decline, with full recovery at 6 months. Exceptionally strong positive correlations were found between TMH or TMA and TBUT or the Schirmer’s test value at most follow-up visits (all P > 0.05). Patient satisfaction was high, with 95% reporting satisfaction with cosmetic outcomes, and no cases of visible or hypertrophic scarring were observed at final follow-up. Conclusions: We observed significant yet transient changes in tear film parameters and subjective assessments following upper eyelid blepharoplasty. A strong correlation was observed between AS-OCT measurements and parameters of tear film stability and production. High patient satisfaction and favorable cosmetic outcomes, with no visible scarring, further support the safety and tolerability of this procedure. Further studies with larger cohorts, longer follow-up periods, and comparative designs are warranted to validate these findings and further explore the long-term effects on ocular surface health and patient-reported outcomes.