Arthroscopic Meniscectomy for Medial Meniscus Horizontal Cleavage Tears in Patients under Age 45

Kim, Jae Gyoon; Lee, Seung Yup; Chay, Suhwoo; Lim, Hong Chul; Bae, Jae Ik

doi:10.5792/ksrr.2016.28.3.225

Cited by 20 publications

(21 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As additional meniscal tissue is removed in partial meniscectomy, there is no way to restore the hoop stress that is important for the shock absorption function of menisci. 15 Thus, these results cautiously emphasize the importance of not only meniscal repair but also anatomic meniscal repair in patients with MMRTs to restore the contact area or contact pressure to that corresponding to the intact knee.…”

Section: Discussionmentioning

confidence: 72%

Clinical and Radiological Outcomes of Meniscal Repair Versus Partial Meniscectomy for Medial Meniscus Root Tears: A Systematic Review and Meta-analysis

Ro¹,

Kim

Heo

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Given the superiority of meniscal repair over partial meniscectomy according to biomechanical data, the clinical outcomes of meniscal repair are likely to be better than those of partial meniscectomy for a medial meniscus root tear (MMRT). Purpose/Hypothesis: This review was designed to compare the clinical and radiological results between meniscal repair and partial meniscectomy for MMRTs. It was hypothesized that meniscal repair would result in better clinical and radiological results compared with partial meniscectomy. Study Design: Systematic review; Level of evidence, 4. Methods: Studies were included in the review if they (1) included patients with MMRTs who underwent primary arthroscopic meniscal repair or partial meniscectomy and (2) analyzed validated patient-reported outcomes and/or radiological evaluations. Summary odds ratios (ORs) with 95% CIs were calculated to compare partial meniscectomy with meniscal repair for each outcome. Results: A total of 13 studies were included. The mean duration of follow-up was 33.5 and 47.2 months in the meniscal repair group and partial meniscectomy group, respectively. The change in the Lysholm score from preoperatively to postoperatively was statistically significantly in favor of meniscal repair (OR, 2.20 [95% CI, 1.55-3.12]), while no difference was found with respect to the change in the Tegner score between the 2 surgical approaches (OR, 1.21 [95% CI, 0.65-2.24]). The prevalence of postoperative severe knee osteoarthritis (OR, 0.31 [95% CI, 0.17-0.54]) as well as that of reoperations (OR, 0.05 [95% CI, 0.01-0.19]) were significantly in favor of meniscal repair. Conclusion Better outcomes were seen after meniscal repair compared with partial meniscectomy for MMRTs, with greater improvements in Lysholm scores, and lower rates of progression to knee osteoarthritis, and lower reoperation rate.

show abstract

Section: Discussionmentioning

confidence: 72%

Clinical and Radiological Outcomes of Meniscal Repair Versus Partial Meniscectomy for Medial Meniscus Root Tears: A Systematic Review and Meta-analysis

Ro¹,

Kim

Heo

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…However, some researchers have shown benefits of partial meniscectomy in certain settings. A retrospective review of patients under 45 years old with horizontal cleavage tears of the medial meniscus showed significant improvement in activity and pain scores after arthroscopic partial meniscectomy 29. Another study examined traumatic and atraumatic tears of the meniscus and whether surgical treatment would have favourable results in the two groups.…”

Section: Current Evidencementioning

confidence: 99%

Review of McGinty, Geuss and Marvin on partial or total meniscectomy

2017

View full text Add to dashboard Cite

“…Krych et al [4] have similar ndings. Due to the removal of additional root tissue during partial meniscectomy, the circumferential stress, which is important for the damping function of the meniscus, cannot be restored [5]. Therefore, these results cautiously emphasize the importance of meniscus repair.…”

Section: Introductionmentioning

confidence: 96%

Biomechanical assessment of disease outcome in surgical intervention for medial meniscal posterior root tears: efficacy and considerations

Rao

et al. 2022

Preprint

View full text Add to dashboard Cite

Background The adverse consequences of medial meniscus posterior root tear have become more and more familiar to surgeons, and the treatment strategies have become increasingly abundant. In this paper, the finite element gait analysis method was used to explore the differences in the biomechanical characteristics of the knee joint under different conditions. Methods The CT computed tomography images of the knee joint were collected, and the CT two-dimensional tomographic images were converted into three-dimensional models through the procedures of gray value adjustment and regional growth. A structure with bone, cartilage, and meniscus was constructed (i) a finite element model of the intact knee joint. Next (ii) the slight tear model, (iii) the severe tear model, (iv) the entire tear model, (v) partial meniscectomy model, and (vi) meniscus repair model were constructed on the basis of the intact knee joint model. Different models were developed and analyzed under normal gait loading conditions. Results Under the gait load, the contact mechanics, kinematics and contact area of the medial and lateral interarticular compartment of the slight tear model and the severe tear model were not significantly different from those of the intact knee joint, while the severe tear model was significantly higher than the intact knee joint in the comparison of the local stress of the posterior root of the meniscus, and the average stress and peak stress increased by 267.1% and 202.9%, respectively. In addition, by comparing the performance of the partial meniscectomy model with the intact knee joint model, it can be concluded that partial meniscectomy did not show an improvement in cartilage contact behavior, and the average stress in the medial compartment still increased by 19.9%. The average contact area of femur and tibial cartilage decreased by 40.7% and 17.7% respectively. Meniscus repair has excellently achieved the task of restoring the biomechanics of the medial meniscus, and it is worth noting that it has also paid a high cost to achieve this benign outcome. The average stress of the posterior root of meniscus and tibial plateau increased by 127.1% and 271.6% respectively compared with the intact model. Conclusions The biomechanics of the knee joint is not sensitive to the level of tear of the posterior root. The improvement of partial meniscectomy in relieving intra-articular overload is limited, and the risk factors for accelerating the progression of osteoarthritis still exist. Meniscus repair is recommended for patients with medial meniscus posterior root tear to restore the biomechanical properties of the meniscus.

show abstract

Arthroscopic Meniscectomy for Medial Meniscus Horizontal Cleavage Tears in Patients under Age 45

Cited by 20 publications

References 27 publications

Clinical and Radiological Outcomes of Meniscal Repair Versus Partial Meniscectomy for Medial Meniscus Root Tears: A Systematic Review and Meta-analysis

Clinical and Radiological Outcomes of Meniscal Repair Versus Partial Meniscectomy for Medial Meniscus Root Tears: A Systematic Review and Meta-analysis

Review of McGinty, Geuss and Marvin on partial or total meniscectomy

Biomechanical assessment of disease outcome in surgical intervention for medial meniscal posterior root tears: efficacy and considerations

Contact Info

Product

Resources

About