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Published in: European Journal of Orthopaedic Surgery & Traumatology 5/2020

01-07-2020 | Osteoarthrosis | Original Article

A repair technique using two simple stitches reduces the short-term postoperative medial meniscus extrusion after pullout repair for medial meniscus posterior root tear

Authors: Takaaki Hiranaka, Takayuki Furumatsu, Shin Masuda, Yoshiki Okazaki, Yuki Okazaki, Yuya Kodama, Yusuke Kamatsuki, Yuya Kajiki, Ximing Zhang, Toshifumi Ozaki

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 5/2020

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Abstract

Background

Two types of repair techniques, FasT-Fix modified Mason–Allen (F-MMA) and two simple stitches (TSS), for the treatment of a medial meniscus posterior root tear (MMPRT) were previously reported. However, whether these techniques could prevent postoperative medial meniscus extrusion (MME) progression is unknown. This study investigated and compared postoperative MME of the two repair techniques.

Methods

Forty-seven knees that had undergone pullout repair for MMPRT were retrospectively reviewed. These knees were divided into two groups as follows: In 26 knees, MMPRT was treated using the F-MMA technique and fixed with the knee flexed at 45° and 20 N of tension [F-MMA (45°–20 N) group], and in 21 knees, MMPRT was treated using the TSS technique and fixed with the knee flexed at 20° and 30 N of tension [TSS (20°–30 N) group]. The medial meniscus body width (MMBW), absolute MME (aMME), and relative MME (rMME = absolute MME/MMBW) were measured and compared using magnetic resonance imaging 3 months postoperatively. The Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales for clinical outcomes were compared between the two groups at 6 months postoperatively.

Results

At 3 months postoperatively, the aMME and rMME significantly decreased in the TSS (20°–30 N) compared to the F-MMA (45°–20 N) group. The TSS (20°–30 N) group had better KOOS subscale scores than the F-MMA (45°–20 N) group at 6 months postoperatively.

Conclusions

The TSS technique with appropriate tibial fixation can decrease MME soon after surgery. This may prevent osteoarthritis progression and improve clinical outcomes.
Literature
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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(3):699–707. https://doi.org/10.1177/0363546513499314 CrossRefPubMed 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(3):699–707. https://​doi.​org/​10.​1177/​0363546513499314​ CrossRefPubMed
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go back to reference Sharma L, Eckstein F, Song J, Guermazi A, Prasad P, Kapoor D, Cahue S, Marshall M, Hudelmaier M, Dunlop D (2008) Relationship of meniscal damage, meniscal extrusion, malalignment, and joint laxity to subsequent cartilage loss in osteoarthritic knees. Arthritis Rheum 58(6):1716–1726. https://doi.org/10.1002/art.23462 CrossRefPubMed Sharma L, Eckstein F, Song J, Guermazi A, Prasad P, Kapoor D, Cahue S, Marshall M, Hudelmaier M, Dunlop D (2008) Relationship of meniscal damage, meniscal extrusion, malalignment, and joint laxity to subsequent cartilage loss in osteoarthritic knees. Arthritis Rheum 58(6):1716–1726. https://​doi.​org/​10.​1002/​art.​23462 CrossRefPubMed
Metadata
Title
A repair technique using two simple stitches reduces the short-term postoperative medial meniscus extrusion after pullout repair for medial meniscus posterior root tear
Authors
Takaaki Hiranaka
Takayuki Furumatsu
Shin Masuda
Yoshiki Okazaki
Yuki Okazaki
Yuya Kodama
Yusuke Kamatsuki
Yuya Kajiki
Ximing Zhang
Toshifumi Ozaki
Publication date
01-07-2020
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 5/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-020-02647-w

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