Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 5/2016

01-05-2016 | Knee

A meta-analysis of clinical and radiographic outcomes of posterior horn medial meniscus root repairs

Authors: Kyu Sung Chung, Jeong Ku Ha, Ho Jong Ra, Jin Goo Kim

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 5/2016

Login to get access

Abstract

Purpose

Although interest in medial meniscus posterior root tear (MMPRT) repair has increased, few case series have been reported. This meta-analysis aimed to examine the clinical and radiological effects of MMPRT repair by pooling pre- and post-operative data from case-series reports.

Methods

A literature search was performed using MEDLINE/PubMed, the Cochrane Central Register of Controlled Trials, and EMBASE databases. Pre- and post-operative data were pooled to investigate the effects of MMPRT repair, including the Lysholm score improvement, meniscal extrusion (mm) reduction, progression of the Kellgren–Lawrence (K–L) grade, and cartilage status according to the Outerbridge classification. Treatment effects included paired standardized mean differences (difference in the pre- and post-operative mean outcomes divided by the standard deviation) for the Lysholm score and meniscal extrusion, as well as the pooled event rates of progression of K–L grade and cartilage status.

Results

As treatment effects, the Lysholm score increased by as much as 3.675 (P < 0.001), whereas meniscus extrusion was not reduced (n.s.). The overall pooled event rates of progression of K–L grade and cartilage status were 10.6 and 17.3 % (P < 0.001), respectively.

Conclusions

According to the current literature, MMPRT repair resulted in significant improvements in the post-operative clinical subjective scores compared with the preoperative status. However, meniscus extrusion was not reduced. Considering the occurrence of progression of K–L grade and cartilage status, it did not prevent the progression of arthrosis completely. Based on these results, repair results in favourable outcomes for MMPRT.

Level of evidence

Meta-analysis, Level IV.
Literature
1.
go back to reference Allaire R, Muriuki M, Gilbertson L, Harner CD (2008) Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am 90:1922–1931CrossRefPubMed Allaire R, Muriuki M, Gilbertson L, Harner CD (2008) Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am 90:1922–1931CrossRefPubMed
2.
go back to reference Bhatia S, LaPrade CM, Ellman MB, LaPrade RF (2014) Meniscal root tears: significance, diagnosis, and treatment. Am J Sports Med 42:3016–3030CrossRefPubMed Bhatia S, LaPrade CM, Ellman MB, LaPrade RF (2014) Meniscal root tears: significance, diagnosis, and treatment. Am J Sports Med 42:3016–3030CrossRefPubMed
3.
go back to reference Bin SI, Kim JM, Shin SJ (2004) Radial tears of the posterior horn of the medial meniscus. Arthroscopy 20:373–378CrossRefPubMed Bin SI, Kim JM, Shin SJ (2004) Radial tears of the posterior horn of the medial meniscus. Arthroscopy 20:373–378CrossRefPubMed
4.
go back to reference Cowan J, Lozano-Calderon S, Ring D (2007) Quality of prospective controlled randomized trials. Analysis of trials of treatment for lateral epicondylitis as an example. J Bone Joint Surg Am 89:1693–1699CrossRefPubMed Cowan J, Lozano-Calderon S, Ring D (2007) Quality of prospective controlled randomized trials. Analysis of trials of treatment for lateral epicondylitis as an example. J Bone Joint Surg Am 89:1693–1699CrossRefPubMed
5.
6.
go back to reference Han SB, Shetty GM, Lee DH, Chae DJ, Seo SS, Wang KH, Yoo SH, Nha KW (2010) Unfavorable results of partial meniscectomy for complete posterior medial meniscus root tear with early osteoarthritis: a 5- to 8-year follow-up study. Arthroscopy 26:1326–1332CrossRefPubMed Han SB, Shetty GM, Lee DH, Chae DJ, Seo SS, Wang KH, Yoo SH, Nha KW (2010) Unfavorable results of partial meniscectomy for complete posterior medial meniscus root tear with early osteoarthritis: a 5- to 8-year follow-up study. Arthroscopy 26:1326–1332CrossRefPubMed
8.
go back to reference Jung YH, Choi NH, Oh JS, Victoroff BN (2012) All-inside repair for a root tear of the medial meniscus using a suture anchor. Am J Sports Med 40:1406–1411CrossRefPubMed Jung YH, Choi NH, Oh JS, Victoroff BN (2012) All-inside repair for a root tear of the medial meniscus using a suture anchor. Am J Sports Med 40:1406–1411CrossRefPubMed
10.
go back to reference Kim JG, Lee YS, Bae TS, Ha JK, Lee DH, Kim YJ, Ra HJ (2013) Tibiofemoral contact mechanics following posterior root of medial meniscus tear, repair, meniscectomy, and allograft transplantation. Knee Surg Sports Traumatol Arthrosc 21:2121–2125CrossRefPubMed Kim JG, Lee YS, Bae TS, Ha JK, Lee DH, Kim YJ, Ra HJ (2013) Tibiofemoral contact mechanics following posterior root of medial meniscus tear, repair, meniscectomy, and allograft transplantation. Knee Surg Sports Traumatol Arthrosc 21:2121–2125CrossRefPubMed
11.
go back to reference Kim JH, Chung JH, Lee DH, Lee YS, Kim JR, Ryu KJ (2011) Arthroscopic suture anchor repair versus pullout suture repair in posterior root tear of the medial meniscus: a prospective comparison study. Arthroscopy 27:1644–1653CrossRefPubMed Kim JH, Chung JH, Lee DH, Lee YS, Kim JR, Ryu KJ (2011) Arthroscopic suture anchor repair versus pullout suture repair in posterior root tear of the medial meniscus: a prospective comparison study. Arthroscopy 27:1644–1653CrossRefPubMed
12.
go back to reference Kim SB, Ha JK, Lee SW, Kim DW, Shim JC, Kim JG, Lee MY (2011) Medial meniscus root tear refixation: comparison of clinical, radiologic, and arthroscopic findings with medial meniscectomy. Arthroscopy 27:346–354CrossRefPubMed Kim SB, Ha JK, Lee SW, Kim DW, Shim JC, Kim JG, Lee MY (2011) Medial meniscus root tear refixation: comparison of clinical, radiologic, and arthroscopic findings with medial meniscectomy. Arthroscopy 27:346–354CrossRefPubMed
13.
go back to reference Kim YM, Joo YB (2013) Pullout failure strength of the posterior horn of the medial meniscus with root ligament tear. Knee Surg Sports Traumatol Arthrosc 21:1546–1552CrossRefPubMed Kim YM, Joo YB (2013) Pullout failure strength of the posterior horn of the medial meniscus with root ligament tear. Knee Surg Sports Traumatol Arthrosc 21:1546–1552CrossRefPubMed
14.
go back to reference Koenig JH, Ranawat AS, Umans HR, Difelice GS (2009) Meniscal root tears: diagnosis and treatment. Arthroscopy 25:1025–1032CrossRefPubMed Koenig JH, Ranawat AS, Umans HR, Difelice GS (2009) Meniscal root tears: diagnosis and treatment. Arthroscopy 25:1025–1032CrossRefPubMed
15.
go back to reference LaPrade RF, LaPrade CM, James EW (2015) Recent advances in posterior meniscal root repair techniques. J Am Acad Orthop Surg 23:71–76CrossRefPubMed LaPrade RF, LaPrade CM, James EW (2015) Recent advances in posterior meniscal root repair techniques. J Am Acad Orthop Surg 23:71–76CrossRefPubMed
16.
go back to reference Lee DW, Kim MK, Jang HS, Ha JK, Kim JG (2014) Clinical and radiologic evaluation of arthroscopic medial meniscus root tear refixation: comparison of the modified Mason-Allen stitch and simple stitches. Arthroscopy 30:1439–1446CrossRefPubMed Lee DW, Kim MK, Jang HS, Ha JK, Kim JG (2014) Clinical and radiologic evaluation of arthroscopic medial meniscus root tear refixation: comparison of the modified Mason-Allen stitch and simple stitches. Arthroscopy 30:1439–1446CrossRefPubMed
17.
go back to reference Lee JH, Lim YJ, Kim KB, Kim KH, Song JH (2009) Arthroscopic pullout suture repair of posterior root tear of the medial meniscus: radiographic and clinical results with a 2-year follow-up. Arthroscopy 25:951–958CrossRefPubMed Lee JH, Lim YJ, Kim KB, Kim KH, Song JH (2009) Arthroscopic pullout suture repair of posterior root tear of the medial meniscus: radiographic and clinical results with a 2-year follow-up. Arthroscopy 25:951–958CrossRefPubMed
18.
go back to reference Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154CrossRefPubMed Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154CrossRefPubMed
19.
go back to reference Marzo JM, Gurske-DePerio J (2009) Effects of medial meniscus posterior horn avulsion and repair on tibiofemoral contact area and peak contact pressure with clinical implications. Am J Sports Med 37:124–129CrossRefPubMed Marzo JM, Gurske-DePerio J (2009) Effects of medial meniscus posterior horn avulsion and repair on tibiofemoral contact area and peak contact pressure with clinical implications. Am J Sports Med 37:124–129CrossRefPubMed
20.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151:264–269CrossRefPubMed Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151:264–269CrossRefPubMed
21.
go back to reference Moon HK, Koh YG, Kim YC, Park YS, Jo SB, Kwon SK (2012) Prognostic factors of arthroscopic pull-out repair for a posterior root tear of the medial meniscus. Am J Sports Med 40:1138–1143CrossRefPubMed Moon HK, Koh YG, Kim YC, Park YS, Jo SB, Kwon SK (2012) Prognostic factors of arthroscopic pull-out repair for a posterior root tear of the medial meniscus. Am J Sports Med 40:1138–1143CrossRefPubMed
22.
go back to reference Negrin L, Kutscha-Lissberg F, Gartlehner G, Vecsei V (2012) Clinical outcome after microfracture of the knee: a meta-analysis of before/after-data of controlled studies. Int Orthop 36:43–50CrossRefPubMedPubMedCentral Negrin L, Kutscha-Lissberg F, Gartlehner G, Vecsei V (2012) Clinical outcome after microfracture of the knee: a meta-analysis of before/after-data of controlled studies. Int Orthop 36:43–50CrossRefPubMedPubMedCentral
23.
go back to reference Nha KW, Wang KH, Shetty GM, Lee CS, Kim JI (2011) Posterior reattachment of a radial tear in the posterior root of the medial meniscus. Orthopedics 34:276–280CrossRefPubMed Nha KW, Wang KH, Shetty GM, Lee CS, Kim JI (2011) Posterior reattachment of a radial tear in the posterior root of the medial meniscus. Orthopedics 34:276–280CrossRefPubMed
24.
go back to reference Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg Br 43-B:752–757PubMed Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg Br 43-B:752–757PubMed
25.
go back to reference Ozkoc G, Circi E, Gonc U, Irgit K, Pourbagher A, Tandogan RN (2008) Radial tears in the root of the posterior horn of the medial meniscus. Knee Surg Sports Traumatol Arthrosc 16:849–854CrossRefPubMed Ozkoc G, Circi E, Gonc U, Irgit K, Pourbagher A, Tandogan RN (2008) Radial tears in the root of the posterior horn of the medial meniscus. Knee Surg Sports Traumatol Arthrosc 16:849–854CrossRefPubMed
26.
go back to reference Padalecki JR, Jansson KS, Smith SD, Dornan GJ, Pierce CM, Wijdicks CA, Laprade RF (2014) Biomechanical consequences of a complete radial tear adjacent to the medial meniscus posterior root attachment site: in situ pull-out repair restores derangement of joint mechanics. Am J Sports Med 42:699–707CrossRefPubMed Padalecki JR, Jansson KS, Smith SD, Dornan GJ, Pierce CM, Wijdicks CA, Laprade RF (2014) Biomechanical consequences of a complete radial tear adjacent to the medial meniscus posterior root attachment site: in situ pull-out repair restores derangement of joint mechanics. Am J Sports Med 42:699–707CrossRefPubMed
27.
go back to reference Petersen W, Forkel P, Feucht MJ, Zantop T, Imhoff AB, Brucker PU (2014) Posterior root tear of the medial and lateral meniscus. Arch Orthop Trauma Surg 134:237–255CrossRefPubMed Petersen W, Forkel P, Feucht MJ, Zantop T, Imhoff AB, Brucker PU (2014) Posterior root tear of the medial and lateral meniscus. Arch Orthop Trauma Surg 134:237–255CrossRefPubMed
28.
go back to reference Seo HS, Lee SC, Jung KA (2011) Second-look arthroscopic findings after repairs of posterior root tears of the medial meniscus. Am J Sports Med 39:99–107CrossRefPubMed Seo HS, Lee SC, Jung KA (2011) Second-look arthroscopic findings after repairs of posterior root tears of the medial meniscus. Am J Sports Med 39:99–107CrossRefPubMed
29.
go back to reference Smigielski R, Becker R, Zdanowicz U, Ciszek B (2015) Medial meniscus anatomy-from basic science to treatment. Knee Surg Sports Traumatol Arthrosc 23:8–14CrossRefPubMed Smigielski R, Becker R, Zdanowicz U, Ciszek B (2015) Medial meniscus anatomy-from basic science to treatment. Knee Surg Sports Traumatol Arthrosc 23:8–14CrossRefPubMed
30.
go back to reference Sung JH, Ha JK, Lee DW, Seo WY, Kim JG (2013) Meniscal extrusion and spontaneous osteonecrosis with root tear of medial meniscus: comparison with horizontal tear. Arthroscopy 29:726–732CrossRefPubMed Sung JH, Ha JK, Lee DW, Seo WY, Kim JG (2013) Meniscal extrusion and spontaneous osteonecrosis with root tear of medial meniscus: comparison with horizontal tear. Arthroscopy 29:726–732CrossRefPubMed
31.
go back to reference Watsend AM, Osestad TM, Jakobsen RB, Engebretsen L (2009) Clinical studies on posterior cruciate ligament tears have weak design. Knee Surg Sports Traumatol Arthrosc 17:140–149CrossRefPubMed Watsend AM, Osestad TM, Jakobsen RB, Engebretsen L (2009) Clinical studies on posterior cruciate ligament tears have weak design. Knee Surg Sports Traumatol Arthrosc 17:140–149CrossRefPubMed
32.
go back to reference Wright JG, Swiontkowski MF, Heckman JD (2003) Introducing levels of evidence to the journal. J Bone Joint Surg Am 85-A:1–3PubMed Wright JG, Swiontkowski MF, Heckman JD (2003) Introducing levels of evidence to the journal. J Bone Joint Surg Am 85-A:1–3PubMed
Metadata
Title
A meta-analysis of clinical and radiographic outcomes of posterior horn medial meniscus root repairs
Authors
Kyu Sung Chung
Jeong Ku Ha
Ho Jong Ra
Jin Goo Kim
Publication date
01-05-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 5/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3832-0

Other articles of this Issue 5/2016

Knee Surgery, Sports Traumatology, Arthroscopy 5/2016 Go to the issue