Meniscal Surgery
The effect of partial meniscectomy resection technique on the tissue architecture, metabolism, and cellular viability of the remaining meniscus
Approximately one million knee surgeries are performed every year in the US to remove damaged portions of the knee menisci to relieve associated mechanical symptoms and pain. Due to the direct relationship between the amount of meniscal tissue removed and the degree and progression of secondary osteoarthritis, preservation of as much functional meniscal tissue as is possible is an important goal of surgery. While mechanical instruments are most commonly used currently for partial meniscectomy, radiofrequency devices have also been used as resection tools based on their ability to create a ‘smoother’ surface with potential tissue sealing effects. However concerns have arisen regarding the long term effects of thermal damage created by these devices on the remaining meniscus.
Dr Kuroki (PI), Dr Jayabalan (Co-PI) and Dr Cook (Co-PI) have developed an in vitro arthroscopic model to assess the effect of modern surgical mechanical and heat producing instruments on the remaining meniscus across multiple clinically relevant outcome measures. Current findings suggest that the pursuit of more optimal methods for partial meniscectomy are warranted. Through this work we hope to outline resection techniques that strive for technical feasibility and ease, an accurate and smooth cut, maintenance of cell viability, tissue composition, and tissue architecture throughout the remaining meniscus. Optimizing partial meniscectomy in these ways could have positive benefits for millions of patients each year. (This work is funded by Ethicon Endosurgery and was recently accepted for presentation at the 55th Annual Orthopaedic Research Society Meeting, Las Vegas, NV.)