10 - Ansu Fati

serghei

serghei

Senior Member
We'll, maybe we're unfair, but the Cugat guy got his chance and fucked it up. Maybe someone else knows better.
 
Joan

Joan

Well-known member
Folks actually feeling competent to judge a professional surgeon based on Marca-tier rumors.
 
Bobo32

Bobo32

Senior Member
FCBarca said:
I had been looking into the doctors involved to see what areas of research they focus on since the holy grail of meniscus repair science is in bioengineering. I cannot tell from the French doctor but he seems to be an advocate for preserving as much of the meniscus as possible - so, at the very least, I would guess his involvement suggests a focalized/hybrid approach (Hence Dr. Maestro (Galician) too)

There's a real nice video of Dr. Cottet (If you speak/understand French) where he talks about meniscus repair
Click to expand...

I glanced at this with subs but didn't get all of it...
I thought complete meniscectomy was seen as the last resort by everybody since long, and that there's even more reason to keep as much as possible with the advent of stem cell therapy...

Here's a pretty recent study by Cugat, wonder if Fatis meniscus looks like this...
https://pubmed.ncbi.nlm.nih.gov/33134048/
 
FCBarca

FCBarca

Mike the Knife
Bobo32 said:
I glanced at this with subs but didn't get all of it...
I thought complete meniscectomy was seen as the last resort by everybody since long, and that there's even more reason to keep as much as possible with the advent of stem cell therapy...

Here's a pretty recent study by Cugat, wonder if Fatis meniscus looks like this...
https://pubmed.ncbi.nlm.nih.gov/33134048/
Click to expand...

Indeed, it is seen as last resort and in the video Cottet talks about the burden and how often repair or preserving most of meniscus is often overlooked due to degree of complexity

The cited procedure from Cugat is for a technique to repair and preserve the meniscus in cases where repair is not possible due to poor meniscal tissue quality and/or tear pattern - but we were never privy to the exact nature of Ansu's tear. The downsides to this sandwich approach to reshape the meniscus is that it apparently changes the normal shape of the meniscus & requires a competent joint capsule - there's a nice illustration in the article to show what the suture looks like. Suture may cut off the meniscal tissue ifquality is very poor and/or excessivetension is applied when the knot istied.

Same paper also very clearly states It is well known that total or even partial meniscectomy results in radiographic evidence of knee osteoarthritis.

Speculative of course in the end since we don't know details but the shift suggests clearly that whatever approach Cugat took (repeatedly) did not succeed. So the tear was probably of a complicated variety (We don't know size/length of tear, anterior/posterior horn, tissue degeneration or degree of vascularization)
 
Bobo32

Bobo32

Senior Member
FCBarca said:
Indeed, it is seen as last resort and in the video Cottet talks about the burden and how often repair or preserving most of meniscus is often overlooked due to degree of complexity

The cited procedure from Cugat is for a technique to repair and preserve the meniscus in cases where repair is not possible due to poor meniscal tissue quality and/or tear pattern - but we were never privy to the exact nature of Ansu's tear. The downsides to this sandwich approach to reshape the meniscus is that it apparently changes the normal shape of the meniscus & requires a competent joint capsule - there's a nice illustration in the article to show what the suture looks like. Suture may cut off the meniscal tissue ifquality is very poor and/or excessivetension is applied when the knot istied.

Same paper also very clearly states It is well known that total or even partial meniscectomy results in radiographic evidence of knee osteoarthritis.

Speculative of course in the end since we don't know details but the shift suggests clearly that whatever approach Cugat took (repeatedly) did not succeed. So the tear was probably of a complicated variety (We don't know size/length of tear, anterior/posterior horn, tissue degeneration or degree of vascularization)
Click to expand...

Yeah

As you say very speculative of course, but I found that article with the pictures and got a picture in my head of them trying multiple times to repair the tear, then doing that complete sandwich technique, and when that didn't work either, they found the only solution is to get rid of everything...
If that technique has been used, it looks to me to be a bit of a mess for another doctor to get into...
 
FCBarca

FCBarca

Mike the Knife
Bobo32 said:
Yeah

As you say very speculative of course, but I found that article with the pictures and got a picture in my head of them trying multiple times to repair the tear, then doing that complete sandwich technique, and when that didn't work either, they found the only solution is to get rid of everything...
If that technique has been used, it looks to me to be a bit of a mess for another doctor to get into...
Click to expand...

Yes but surgery is also only one phase of repair. The regenerative one that Cugat is meant to specialize in is not covered in any of the literature listed previously and here this ultimately failed as well. Whether the initial suture/surgery is the limiting factor or the structural regeneration Cugat attempted, surgery means the meniscus is at risk of not being a candidate for further repair (Without removal)

The healing capacity of the more central avascular zone of the meniscus is limited but elsewhere regeneration can help ensure improved joint support, it just depends on the type/degree of initial tear. Again, there are a lot of variables and hence why there are so many consultations to assess the most ideal outcome for his next step. I can only guess that this latest Portuguese visit that has been publicized might be a last ditch consult ahead of the full/partial removal

Whole thing is very odd but unfortunate for the player obviously. There seems to be suggested optimism to renew him as a sign of confidence in his future but there can be little doubt that an 18 yr old is facing a medical decision that could impact his playing career

That's significant pressure
 
Last edited:
Andresito

Andresito

Senior Member
Staff member
It's official that he will get his knee checked in Portugal.

Ansu Fati and his father have just landed in Porto, where the youngster will undergo surgery. There is full confidence that his meniscus problems will finally come to an end.
 
BarcaOG

BarcaOG

Banned
just one piece of bad news after another...

does fati have a senior contract with the club? i hope he and his family are making money while they can...
 
snowy

snowy

Well-known member
If partial meniscus and multiple surgeries lead to permanent scarring and arthritis, wouldn't something like this be an option? :thinking:

images


https://activeimplants.com
 
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