Transtibial pullout repair of medial meniscus posterior root tears: effects on the meniscus healing score and ICRS grade among patients with mild osteoarthritis of the knee

被引：14

作者：

Kodama, Yuya ^{[1
,2
]}

Furumatsu, Takayuki ^{[1
]}

Okazaki, Yuki ^{[1
]}

Takihira, Shota ^{[1
]}

Hiranaka, Takaaki ^{[1
]}

Miyazawa, Shinichi ^{[1
]}

Kamatsuki, Yusuke ^{[1
,3
]}

Ozaki, Toshifumi ^{[1
]}

机构：

[1] Okayama Univ Hosp, Dept Orthopaed Surg, Kita Ku, 2-5-1 Shikata Cho, Okayama 7008558, Japan

[2] Iwakuni Med Ctr, Dept Orthopaed Surg, 1-1-1 Atagomachi, Iwakuni, Yamaguchi 7408510, Japan

[3] Kochi Hlth Sci Ctr, Dept Orthopaed Surg, 2125-1 Ike, Kochi 7818555, Japan

来源：

KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY | 2021年 / 29卷 / 09期

关键词：

Medial meniscus; Posterior root tear; Transtibial pullout repair; Meniscal healing; Cartilage degeneration; BIOMECHANICAL EVALUATION; NONOPERATIVE TREATMENT; RADIAL TEARS; HORN;

D O I：

10.1007/s00167-020-06332-7

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Purpose To assess the effects of transtibial pullout repair for medial meniscus posterior root tears (MMPRTs) among patients with early osteoarthritis of the knee as measured by the meniscus healing score and to determine whether the meniscus healing score correlates with the International Cartilage Repair Society (ICRS) grade progression. Methods Forty-seven patients with mild osteoarthritic knees (Kellgren-Lawrence grade <= 2 and varus alignment < 5 degrees) who underwent transtibial pullout repair less than 3 months after MMPRT onset were assessed. The association between meniscus healing scores at 1 year postoperatively and cartilage damage of the medial compartment (medial femoral condyle [MFC] and medial tibial plateau [MTP]) were evaluated. The MFC was divided into six zones (A to F) and the MTP into two zones (G and H). The mean ICRS grade for each zone was compared between the primary surgery and second-look arthroscopy. The correlation between cartilage damage and meniscus healing status at the time of second-look arthroscopy in each zone was analysed. Results The mean time interval from injury to surgery was 63 days, and all clinical scores showed significant improvement. There were no significant differences in the extent of cartilage damage in areas B, C, E, or F (n.s.) for MFC or in areas G and H (n.s.) for MTP. The meniscus healing score and cartilage damage were correlated in the loading areas (B, C, E, and H; - 0.53, - 0.45, - 0.33, and - 0.38, respectively; p < 0.05). Conclusion Transtibial pullout repair of MMPRTs among patients with mild osteoarthritic knees improved the clinical outcomes and showed a negative correlation between high meniscus healing scores and ICRS grades in the medial compartment loading area. This study suggests that early surgery should be undertaken for patients with mild osteoarthritic knee who develop MMPRTs.

引用

页码：3001 / 3009

页数：9

共 35 条

[1] Comparison between conservative treatment and arthroscopic pull-out repair of the medial meniscus root tear and analysis of prognostic factors for the determination of repair indication [J].