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Mismatch Repair01:36

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Organisms are capable of detecting and fixing nucleotide mismatches that occur during DNA replication. This sophisticated process requires identifying the new strand and replacing the erroneous bases with correct nucleotides. Mismatch repair is coordinated by many proteins in both prokaryotes and eukaryotes.
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In order to be passed through generations, genomic DNA must be undamaged and error-free. However, every day, DNA in a cell undergoes several thousand to a million damaging events by natural causes and external factors. Ionizing radiation such as UV rays, free radicals produced during cellular respiration, and hydrolytic damage from metabolic reactions can alter the structure of DNA. Damages caused include single-base alteration, base dimerization, chain breaks, and cross-linkage.
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One of the common DNA damages is the chemical alteration of single bases by alkylation, oxidation, or deamination. The altered bases cause mispairing and strand breakage during replication. This type of damage causes minimal change to the DNA double helix structure and can be repaired by the base excision repair (BER) pathways. BER corrects damaged DNA sequences by removing the damaged base and restoring the original base sequence using the complementary strand as a template.
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Editorial Commentary: Lateral Extra-articular Tenodesis in Quadriceps Tendon Anterior Cruciate Ligament Reconstruction: Improved Rotational Control, but Are We Redefining Failure?

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Meniscal Root Repairs.

Robert F LaPrade1, Samuel G Moulton1, Tyler R Cram1

  • 1Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO 81657.

JBJS Essential Surgical Techniques
|November 9, 2018
PubMed
Summary
This summary is machine-generated.

Meniscal root tears require surgery to prevent osteoarthritis. This study details a transtibial repair technique to reattach the meniscus root, restoring knee function and mechanics.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Knee Biomechanics

Background:

  • Meniscal root tears are significant knee injuries often leading to osteoarthritis if untreated.
  • These tears can be missed on imaging and during arthroscopy due to recent understanding of meniscal root anatomy.
  • Transtibial meniscal root repair is the current standard for restoring native attachment and knee mechanics.

Purpose of the Study:

  • To describe the surgical technique for transtibial posterior medial meniscal root repair.
  • To highlight the anatomical and biomechanical principles underlying the procedure.
  • To outline the postoperative rehabilitation protocol.

Main Methods:

  • Arthroscopic visualization and probing to confirm the tear.
  • Debridement of the root attachment site and release of adhesions.
  • Creation of two transtibial tunnels for suture passage.
  • Suture repair of the meniscal root to the tibial plateau using a surgical button.
  • Postoperative management including non-weight-bearing, progressive range of motion, and gradual return to activity.

Main Results:

  • The described technique allows for the reattachment of the meniscal root to its native tibial plateau.
  • Restoration of tibiofemoral contact mechanics is the primary goal.
  • The procedure is applicable to both posterior medial and lateral meniscal root tears.

Conclusions:

  • Transtibial meniscal root repair effectively addresses significant meniscal root tears.
  • This surgical approach aims to prevent the rapid onset of osteoarthritis post-injury.
  • Adherence to the described surgical technique and postoperative protocol facilitates return to normal activity.