PurposeMedial meniscus posterior root tears (MMPRT) induce medial meniscus extrusion (MME). However, the time-dependent extent of MME in patients suffering from the MMPRT remains unclear. This study evaluated the extent of MME after painful popping events that occurred at the onset of the MMPRT.Materials and MethodsThirty-five patients who had an episode of posteromedial painful popping were investigated. All the patients were diagnosed as having an MMPRT by magnetic resonance imaging (MRI) within 12 months after painful popping. Medial meniscus body width (MMBW), absolute MME, and relative MME (100×absolute MME/MMBW) were assessed among three groups divided according to the time after painful popping events: early period (<1 month), subacute period (1–3 months), and chronic period (4–12 months).ResultsIn the early period, absolute and relative MMEs were 3.0 mm and 32.7%, respectively. Absolute MME increased up to 4.2 mm and 5.8 mm during the subacute and chronic periods, respectively. Relative MME also progressed to 49.2% and 60.3% in the subacute and chronic periods, respectively.ConclusionsThis study demonstrated that absolute and relative MMEs increased progressively within the short period after the onset of symptomatic MMPRT. Our results suggest that early diagnosis of an MMPRT may be important to prevent progression of MME following the MMPRT.
Background: Lateral meniscus (LM) posterior root tears (PRT) are often associated with anterior cruciate ligament (ACL) injury and can result in rotational instability, joint overloading, and degenerative changes in the knee. Improved rotational stability and kinematics have been reported after LMPRT repair. However, it is unclear which repair technique can achieve the greatest reduction in lateral meniscus extrusion (LME).Hypothesis: We hypothesized that transtibial pullout repair would decrease LME to a greater extent than other repair techniques.Patients and Methods: Seventeen patients with ACL injury but complete LM posterior root were evaluated. Nine underwent ACL reconstruction (ACLR) and transtibial pullout repair, and eight underwent ACLR and other repairs such as inside-out suturing. Double-bundle ACLR was performed using hamstring tendons, and LMPRT pullout was performed through the bone tunnel for the PL bundle. Magnetic resonance imaging was performed immediately preoperatively and at >6 months postoperatively, and LME was measured from coronal images only.Results: A significant decrease in the size of LME from pre-to postoperative measurement was observed in the transtibial pullout repair group (−0.5 ± 0.7 mm) than the other-repair group (1.0 ± 0.9 mm, P < 0.01). Pre-and postoperative LME measurements were not significantly different between the two groups.Discussion: The most important finding of this study is that transtibial pullout repair results in Transtibial pullout repair of LMPRT combined with ACLR reduces LM extrusion a greater decrease in LME than other repair techniques in patients with ACL injury and LMPRT. This technique might be useful for restoring hoop tension by decreasing LME.
using the FasT-Fix all-inside suture device combined with Ultrabraid for stronger repair (FasT-Fix 36 modified Mason-Allen technique, F-MMA) [4]. Furumatsu et al. reported that F-MMA suture 37 configuration obtained better meniscal healing and superior clinical outcomes than single FasT-Fix 38 repairs in patients with MMPRTs [5].Recently, a new simple fixation technique using two simple stitches (TSS) under an expected initial tension was reported [6]. Other studies on transtibial pullout repair using TSS report that it is one of the major repair techniques of MMPRT treatment [7,8]. The biomechanical study revealed the superiority of F-MMA in the ultimate failure load compared to TSS suture configuration using porcine 43 models [4,9]. On the other hand, favourable clinical outcomes and high clinical survival rate were 44 reported using TSS technique [8, 10]. 45In the past, there have been no studies to compare the clinical efficacy between F-MMA and TSS 46 technique in the pullout repair of MMPRT. It was hypothesized that the clinical outcomes of TSS were comparable to those of the F-MMA suture configuration. This study aimed to compare the clinical
Purpose Bone morphological factors are important for menisci. Their association with medial meniscus posterior root tears, however, has not yet been studied. This study aimed to compare sagittal medial tibial slope and medial tibial plateau depth between knees with and without medial meniscus posterior root tears. Methods Nine healthy volunteers, 24 patients who underwent anterior cruciate ligament reconstruction, and 36 patients who underwent medial meniscus posterior root pullout repair were included. Magnetic resonance imaging examinations were performed in the 10°-knee-flexed position. The medial tibial slope and medial tibial plateau depth were compared among the groups. Results In healthy volunteers, the anterior cruciate ligament reconstruction group, and the medial meniscus posterior root tear group, the medial tibial slopes were 3.5° ± 1.4°, 4.0° ± 1.9°, and 7.2° ± 1.9°, respectively, and the medial tibial plateau depths were 2.1 ± 0.7 mm, 2.2 ± 0.6 mm, and 1.2 ± 0.5 mm, respectively. Patients with medial meniscus posterior root tears had a significantly steep medial tibial slope and shallow medial tibial plateau concavity compared to those of healthy volunteers (P < 0.01) and the anterior cruciate ligament group (P < 0.01). In the multivariate logistic regression analysis, body mass index, medial tibial slope, and medial tibial plateau depth were significantly associated with medial meniscus posterior root tears. Conclusions A steep posterior slope and a shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tear. Level of evidence Level III: Case-control study.
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