Arthroscopic Pullout Suture Repair of Posterior Root Tear of the Medial Meniscus: Radiographic and Clinical Results With a 2-Year Follow-up

Lee, Ju Hong; Lim, Young Jin; Kim, Ki Bum; Kim, Kyu Hyung; Song, Jongtae

doi:10.1016/j.arthro.2009.03.018

Cited by 180 publications

(251 citation statements)

References 28 publications

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“…Recent biomechanical studies reported that repaired MMRT restored the peak contact pressure close to the normal level [6][7][8]10]. In biomechanical research, several techniques [11][12][13][14] to repair MMRT have been reported and clinical investigations are being performed to determine the outcome of MMRT repair [15,16]. However, these results are rather conflicting and there are some trials to determine the prognostic factors of the MMRT repair [17].…”

Section: Introductionmentioning

confidence: 93%

Comparison between conservative treatment and arthroscopic pull-out repair of the medial meniscus root tear and analysis of prognostic factors for the determination of repair indication

Ahn

Jeong

Lee

et al. 2015

Arch Orthop Trauma Surg

130

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The MMRT pull-out repair group had better clinical results than that the conservative treatment group. However, severe varus alignment and severe degeneration of cartilage status were a poor prognostic factor, and there was no significant difference between the severe varus alignment or severe cartilage change and the conservative treatment group in the clinical results. The other optional treatment could be recommended for patients who have MMRT with a severe varus knee alignment or severe cartilage.

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Section: Introductionmentioning

confidence: 93%

Comparison between conservative treatment and arthroscopic pull-out repair of the medial meniscus root tear and analysis of prognostic factors for the determination of repair indication

Ahn

Jeong

Lee

et al. 2015

Arch Orthop Trauma Surg

130

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show abstract

“…Suture anchor 3,4 and pull-through suture repair 1,5,6 techniques have been reported with satisfactory results. These techniques, to date, have all required use of a posterior portal 1,3-5 and/or a curved sutureshuttling device, 1,5,6 both of which can be technically challenging.…”

Section: Discussionmentioning

confidence: 99%

“…These techniques, to date, have all required use of a posterior portal 1,3-5 and/or a curved sutureshuttling device, 1,5,6 both of which can be technically challenging. The technique described in this article does not require a posterior portal and uses a novel suture-passing device that conforms to the shape of the femoral condyle, facilitating its use within the knee joint.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, prior root repair techniques have used varying suture configurations: simple, 4,6 double simple, 3 and single-locking loop. 1 A recent biomechanical study showed a double-locking loop configuration, as described in our technique, to have higher maximum load to failure than other configurations.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Two main repair techniques have been described: suture anchor fixation and sutures pulled through a tibial tunnel. Although reported results show satisfactory healing, the techniques can be technically demanding because they require a posterior portal [3][4][5] and/or a curved suture-shuttling device, [4][5][6] which can be difficult to manipulate in the knee joint. A recent study evaluating the strengths of various root repair techniques showed that a double-locking loop suture configuration provides significantly higher load to failure than other suture configurations, with little increase in surgical time.…”

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confidence: 99%

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Arthroscopic Meniscal Root Repair Using a Ceterix NovoStitch Suture Passer

Blackman

Stuart

Levy

et al. 2014

Arthroscopy Techniques

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Meniscal root injuries can compromise knee function and lead to early degenerative changes if not appropriately treated. Numerous techniques have been described; however, the technical difficulties in performing these repairs are well known. Furthermore, the relative strengths of various repair techniques have been examined. This article describes a singleeworking portal meniscal root repair technique using a double-locking loop suture configuration with a novel suture-passing device that offers a strong, reproducible repair construct.

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Partial weight‐bearing and range of motion limitation significantly reduce the loads at medial meniscus posterior root repair sutures in a cadaveric biomechanical model

Sukopp,

Schwab,

Schwer

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of this study was to investigate the influence of medial meniscus posterior root avulsion (MMPRA) before and after surgical treatment on the biomechanics of the knee joint, including suture repair forces during daily and crutch‐assisted gait movements.MethodsMMPRA were investigated in eight human cadaver knee joint specimens by a dynamic knee joint simulator with daily (normal gait, gait with additional rotational movement, standing up, sitting down) and rehabilitation‐associated movements (crutch‐assisted gait with limited flexion range of motion [30°] and 30% [toe‐touch weight‐bearing, TTWB] and 50% of body weight [partial weight‐bearing, PWB]) with simulated physiologic muscle forces. Each specimen was tested in intact, torn and repaired (transtibial suture) state. The biomechanical parameters were: medial mean contact pressure and area, knee joint kinematics, medial displacement of the posterior meniscus horn and loading on the anchoring suture.ResultsSignificant reduction of the contact area due to the avulsion was observed in all movements except for PWB and sitting down. MMPRA repair significantly increased the contact areas during all movements, bringing them to levels statistically indistinguishable from the initial state. MMPRA resulted in a medial displacement up to 12.8 mm (sitting down) and could be reattached with a residual displacement ranging from 0.7 mm (PWB) to 5.7 mm (standing up), all significantly (p < 0.001) reduced compared to the torn state. The mean peak anchoring suture load increased from TTWB (77 N), PWB (91 N) to normal gait (194 N), gait rotation (207 N), sitting (201 N; p < 0.01) and to standing up (232 N; p = 0.03).ConclusionSurgical treatment of MMPRA allows restoration of physiological knee joint biomechanics. Crutch‐assisted movements reduce the loading of the repair suture, thus likewise the risk for failure. From a biomechanical point of view, crutch‐assisted movements are recommended for the early rehabilitation phase after MMPRA repair.Level of EvidenceLevel V.

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Arthroscopic Pullout Suture Repair of Posterior Root Tear of the Medial Meniscus: Radiographic and Clinical Results With a 2-Year Follow-up

Cited by 180 publications

References 28 publications

Comparison between conservative treatment and arthroscopic pull-out repair of the medial meniscus root tear and analysis of prognostic factors for the determination of repair indication

Comparison between conservative treatment and arthroscopic pull-out repair of the medial meniscus root tear and analysis of prognostic factors for the determination of repair indication

Arthroscopic Meniscal Root Repair Using a Ceterix NovoStitch Suture Passer

Partial weight‐bearing and range of motion limitation significantly reduce the loads at medial meniscus posterior root repair sutures in a cadaveric biomechanical model

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