meniscus , the tibiofemoral contact area is 3 cm 2 , so the pressure is 70 / 80 kg / cm 2 , making it 3-4 times greater after meniscectomy by the fact that the surface contact area is reduced to 1 / 3 . Thus , in 1948 , T . J . Fairbank describes for the first time the serious degenerative changes associated with meniscectomy , praising since then the relevance of this structure for joint functionality . The increase in sport activity by children and adolescents has changed the paradigm of sports injuries in this age group , including complex meniscus and ACL injuries , with future catastrophic consequences on those cases of inadequate diagnosis and treatment . The options about the treatment will always be : conservative , meniscectomy or meniscus repair , depending on multiple factors , being the location of the injury the most fundamental . The injuries in the red zone of the meniscus ( vascularized ) or in the redwhite zone are always worth of reparation . On children , some authors ( Accadbled F , Cassard X et al , 2007 ) also suggest meniscus repair in the white-white zone . The notion that former injuries predisposes the
athlete to arthrosis in the course of his / her life makes sense on a biomechanical perspective , particularly if we accept that the current surgical techniques , despite the constant research of improvement , have not yet achieved perfection with regard to instability , alignment , regeneration and substitution , but also in a biochemical perspective , emphasizing the role of articulate aggression played by metalloproteinases and cytokines . The meniscus collagen implants , customized implants with different materials and matrices , combined with biological therapies , can be very important to minimize the absence of the meniscus , stalling or avoiding evolution to arthrosis .
Bibliography
1 . Fairbank , T . J . Knee joint changes after meniscectomy . J Bone Joint Surg Br . 1948 ; 30B : 664-670 .
2 . Accadbled F , Cassard X , Sales de Gauzy J , Cahuzac JP . Meniscal tears in children and adolescents : results of operative treatment . J Pediatr Orthop B . 2007 ; 16 ( 1 ): 56-60 .
Dr . Raul Maia e Silva . Medicina Física e Reabilitação ; Medicina Desportiva , Porto
The osteochondrosis . What can be done ?
About 15 % of all sports injuries in youth are disorders of ossification in epiphyses or apophisitis . 1 These disturbances of normal bone growth which primarily involve the physis and / or ossification centers are generically called osteochondrosis . In general , it is a heterogeneous a group of aseptic diseases , not related to one another , but they share some common characteristics : they involve the immature skeleton , involvement of epiphyses or apophisitis , fragmentation on X-ray , collapse , sclerosis , reossification . 2 The pathogenesis of the osteochondrosis is not completely clarified , but they behave like as necrosis of a previously normal epiphysis . It ’ s not exactly avascular necrosis because , despite the ischemia , there are still
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