Kodama, Yuya Department of Orthopaedic Surgery, Okayama University Hospital
Masuda, Shin Department of Orthopaedic Surgery, Okayama University Hospital
Okazaki, Yoshiki Department of Orthopaedic Surgery, Okayama University Hospital
Kamatsuki, Yusuke Department of Orthopaedic Surgery, Okayama University Hospital
Okazaki, Yuki Department of Orthopaedic Surgery, Okayama University Hospital
Hiranaka, Takaaki Department of Orthopaedic Surgery, Okayama University Hospital
Miyazawa, Shinichi Department of Orthopaedic Surgery, Okayama University Hospital ORCID
Yasumitsu, Masaharu Department of Orthopaedic Surgery, Iwakuni Clinical Center
Purpose To investigate changes in meniscal extrusion during knee flexion before and after pullout fixation for medial meniscus posterior root tear (MMPRT) and determine whether these changes correlate with articular cartilage degeneration and short-term clinical outcomes. Methods Twenty-two patients (mean age 58.4 ± 8.2 years) diagnosed with type II MMPRT underwent open magnetic resonance imaging preoperatively, 3 months after transtibial fixation and at 12 months after surgery, when second-look arthroscopy was also performed. The medial meniscus medial extrusion (MMME) and the medial meniscus posterior extrusion (MMPE) were measured at knee 10° and 90° flexion at which medial meniscus (MM) posterior translation was also calculated. Articular cartilage degeneration was assessed using International Cartilage Research Society grade at primary surgery and second-look arthroscopy. Clinical evaluations included Knee Injury and Osteoarthritis Outcome Score, International Knee Documentation Committee subjective knee evaluation form, Lysholm score, Tegner activity level scale, and pain visual analogue scale. Results MMPE at 10° knee flexion was higher 12 months postoperatively than preoperatively (4.8 ± 1.5 vs. 3.5 ± 1.2, p = 0.01). MMPE at 90° knee flexion and MM posterior translation were smaller 12 months postoperatively than preoperatively (3.5 ± 1.1 vs. 4.6 ± 1.3, 7.2 ± 1.7 vs. 8.9 ± 2.0, p < 0.01). Articular cartilage degeneration of medial femoral condyle correlated with MMME in knee extension (r = 0.5, p = 0.04). All clinical scores significantly improved 12 months postoperatively. However, correlations of all clinical scores against decreased MMPE and increased MMME were not detected. Conclusions MMPRT transtibial fixation suppressed the progression of MMPE and cartilage degeneration and progressed MMME minimally in knee flexion position at 1 year. However, in the knee extension position, MMME progressed and correlated with cartilage degeneration of medial femoral condyle. MMPRT transtibial fixation contributes to the dynamic stability of the MM in the knee flexion position.
Posterior root tear
Open magnetic resonance imaging
This is a post-peer-review, pre-copyedit version of an article published in Knee Surgery, Sports Traumatology, Arthroscopy. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00167-019-05810-x. This fulltext is available in Nov. 2020.
Knee Surgery, Sports Traumatology, Arthroscopy
|Web of Science KeyUT|