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:15
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
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
收藏
页码:3001 / 3009
页数:9
相关论文
共 35 条
[21]   Tear gap and severity of osteoarthritis are associated with meniscal extrusion in degenerative medial meniscus posterior root tears [J].
Kim, Jae-Young ;
Bin, Seong-Il ;
Kim, Jong-Min ;
Lee, Bum-Sik ;
Oh, Sung-Mok ;
Park, Min-Ho .
ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH, 2019, 105 (07) :1395-1399
[22]   Preliminary diagnosis of medial meniscus posterior root tears using the Rosenberg radiographic view [J].
Kodama, Yuya ;
Furumatsu, Takayuki ;
Kamatsuki, Yusuke ;
Hiranaka, Takaaki ;
Takahata, Tomohiro ;
Sadakane, Masayuki ;
Ikuta, Haruhiko ;
Yasumitsu, Masaharu ;
Ozaki, Toshifumi .
KNEE SURGERY & RELATED RESEARCH, 2019, 31 (01)
[23]   Transtibial fixation for medial meniscus posterior root tear reduces posterior extrusion and physiological translation of the medial meniscus in middle-aged and elderly patients [J].
Kodama, Yuya ;
Furumatsu, Takayuki ;
Masuda, Shin ;
Okazaki, Yoshiki ;
Kamatsuki, Yusuke ;
Okazaki, Yuki ;
Hiranaka, Takaaki ;
Miyazawa, Shinichi ;
Yasumitsu, Masaharu ;
Ozaki, Toshifumi .
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2020, 28 (11) :3416-3425
[24]   Partial meniscectomy provides no benefit for symptomatic degenerative medial meniscus posterior root tears [J].
Krych, Aaron J. ;
Johnson, Nick R. ;
Mohan, Rohith ;
Dahm, Diane L. ;
Levy, Bruce A. ;
Stuart, Michael J. .
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2018, 26 (04) :1117-1122
[25]   Non-operative management of medial meniscus posterior horn root tears is associated with worsening arthritis and poor clinical outcome at 5-year follow-up [J].
Krych, Aaron J. ;
Reardon, Patrick J. ;
Johnson, Nick R. ;
Mohan, Rohith ;
Peter, Logan ;
Levy, Bruce A. ;
Stuart, Michael J. .
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2017, 25 (02) :383-389
[26]   There Is No Difference in Radiographic Outcomes After Average 9 Years After Arthroscopic Partial Medial Meniscectomy for Both Posterior Horn Tears and Posterior Horn Root Tears [J].
Kwon, Oh-Jin ;
Bin, Seong-Il ;
Kim, Jong-Min ;
Lee, Bum-Sik ;
Lee, Sang-Min ;
Park, Jun-Gu ;
Yoon, Gi-Woon .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2020, 36 (02) :524-532
[27]   Biomechanical Evaluation of the Transtibial Pull-Out Technique for Posterior Medial Meniscal Root Repairs Using 1 and 2 Transtibial Bone Tunnels [J].
LaPrade, Christopher M. ;
LaPrade, Matthew D. ;
Turnbull, Travis Lee ;
Wijdicks, Coen A. ;
LaPrade, Robert F. .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2015, 43 (04) :899-904
[28]   Repair versus nonrepair of medial meniscus posterior root tear A systematic review of patients' selection criteria, including clinical and radiographic outcomes [J].
Lee, Jin Kyu ;
Jung, Min ;
Yang, Jae Hyuk ;
Song, Si Young ;
Shin, Young-Soo ;
Cha, Myoungsoo ;
Jung, Dawoon ;
Seo, Young-Jin .
MEDICINE, 2020, 99 (10) :E19499
[29]   Non-operative treatment of degenerative posterior root tear of the medial meniscus [J].
Lim, Hong Chul ;
Bae, Ji Hoon ;
Wang, Joon Ho ;
Seok, Chang Woo ;
Kim, Min Keun .
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2010, 18 (04) :535-539
[30]   Role of nonoperative treatment in managing degenerative tears of the medial meniscus posterior root [J].
Neogi D.S. ;
Kumar A. ;
Rijal L. ;
Yadav C.S. ;
Jaiman A. ;
Nag H.L. .
Journal of Orthopaedics and Traumatology, 2013, 14 (3) :193-199