Augmentation of the Pullout Repair of a Medial Meniscus Posterior Root Tear by Arthroscopic Centralization

Koga, Hideyuki; Watanabe, Toshifumi; Horie, Masafumi; Katagiri, Hiroki; Otabe, Koji; Ohara, Toshiyuki; Katakura, Mai; Sekiya, Ichiro; Muneta, Takeshi

doi:10.1016/j.eats.2017.05.014

Cited by 74 publications

(61 citation statements)

References 8 publications

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“…A centralization technique has been developed to reduce meniscal extrusion; the capsule attached to the meniscus is sutured to the edge of the tibial plateau using suture anchors [13]. Arthroscopic centralization of the extruded lateral meniscus (LM) improved clinical outcomes at twoyear follow-up [14]. It also increased the radiographic lateral joint space width on standing at the 45°flexion view at 3 months; this was maintained for 2 years [14].…”

Section: Introductionmentioning

confidence: 99%

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The effect of a centralization procedure for extruded lateral meniscus on load distribution in porcine knee joints at different flexion angles

Kubota

Koga

Ozeki

et al. 2020

BMC Musculoskelet Disord

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Background: Meniscal extrusion results in loss of the ability to resist hoop strain and biomechanical overload on the joint articular surface. A centralization technique has been developed to overcome these problems. In this study, we analyzed the biomechanics of the extruded and centralized lateral meniscus (LM) in porcine knee joints at different flexion angles. Methods: Porcine knee joints (n = 8) were set in the universal tester and each knee was tested under the following states: 1) intact; 2) extrusion-meniscal extrusion was created by resecting the posterior root of the LM and posterior synovial capsule; and 3) centralization-centralization was performed by two anchors inserted in the lateral tibial plateau. Deviation distance of the meniscus, contact pressure, and contact area in the anterior LM, middle LM, posterior LM, and the contact pressure of the tibial cartilage were evaluated with an axial compressive force of 200 N at knee flexion angles of 30°, 45°, 60°, and 90°. Results: The deviation distance of LM significantly increased in extrusion but was restored to the intact status after centralization at all angles. Both the contact pressure and area significantly decreased in extrusion and were restored after centralization close to the intact status in the anterior and middle LM; in the posterior LM, however, decreased contact pressure and area were not restored after centralization. The contact pressure of the tibial cartilage increased significantly in extrusion but decreased close to the intact status after centralization. Conclusions: This centralization procedure could reduce extrusion of the LM and restore the load-distributing function of the anterior-middle LM. However, the procedure itself could not restore hoop function in cases where the defect lies in the posterior LM.

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Section: Introductionmentioning

confidence: 99%

“…Arthroscopic centralization of the extruded lateral meniscus (LM) improved clinical outcomes at twoyear follow-up [14]. It also increased the radiographic lateral joint space width on standing at the 45°flexion view at 3 months; this was maintained for 2 years [14].…”

Section: Introductionmentioning

confidence: 99%

The effect of a centralization procedure for extruded lateral meniscus on load distribution in porcine knee joints at different flexion angles

Kubota

Koga

Ozeki

et al. 2020

BMC Musculoskelet Disord

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“… 3 , 4 , 5 , 6 , 7 , 8 , 9 Techniques have been described for centralization of the medial meniscus following root or radial tearing to address this issue. 13 The central tenet of these techniques is to restore the normal contact pressures and contact area to the compartment.…”

Section: Discussionmentioning

confidence: 99%

Technique for Arthroscopically Assisted Superficial and Deep Medial Collateral Ligament–Meniscotibial Ligament Repair With Internal Brace Augmentation

Black

Schlepp

Zapf

et al. 2018

Arthroscopy Techniques

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Deep medial collateral ligament (MCL) injury leads to meniscal lift-off and extrusion of the medial meniscus, resulting in instability and increased medial compartment pressures with subsequent cartilage damage. Repair of the deep MCL meniscotibial ligament in concert with superficial MCL repair or reconstruction is intended to restore the native anatomy , stability, and function of the medial meniscus. We present an arthroscopically assisted technique using standard arthroscopy portals and a medial open approach.

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“…4,5 Meniscal extrusion decreased the tibiofemoral contact area and increased tibiofemoral contact pressure, leading to the worsening of knee osteoarthritis. 6 Koga et al 7,8 reported that arthroscopic centralization of the extruded meniscus, where the capsule adjacent to the meniscus was sutured to the edge of the tibial plateau, decreased meniscal extrusion. Arthroscopic centralization for an extruded lateral meniscus results in good clinical outcomes of the Lysholm knee scale and the Knee Osteoarthritis Outcome Score (KOOS) and radiographic outcomes with the lateral joint space widening at 2-years follow-up.…”

Section: Introductionmentioning

confidence: 99%

Short-term Outcomes after High Tibial Osteotomy Aimed at Neutral Alignment Combined with Arthroscopic Centralization of Medial Meniscus in Osteoarthritis Patients

Katagiri¹,

Nakagawa²,

Miyatake³

et al. 2020

Preprint

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Purpose To improve long-term outcomes of open-wedge high tibial osteotomy (OWHTO), procedures combining OWHTO aimed at neutral alignment and arthroscopic centralization for meniscal extrusion have been introduced. The purpose of the present study was to compare short-term clinical and radiological outcomes of medial joint space width (JSW) after the OWHTO aimed at neutral alignment with and without arthroscopic centralization for an extruded medial meniscus. Methods A retrospective review of 50 primary OWHTO patients was conducted. Thirty-five patients included for analysis after exclusion criteria was applied. Twenty-one knee osteoarthritis patients, who underwent the OWHTO with arthroscopic meniscal centralization, were included in the centralization group. Fourteen patients, who underwent solely OWHTO, were included in the control group. Lysholm knee scale, International Knee Documentation Committee (IKDC) subjective score, Knee Osteoarthritis Outcome Score (KOOS), and patient subjective satisfaction scores were recorded at the final follow-up. Radiographic changes of JSW and joint line congruence angle (JLCA) were measured 2 years postoperatively. Patient demographic data were also reviewed. Results IKDC subjective scores, KOOS subgroup scores, patient subjective satisfaction scores, and Lysholm score did not show significant differences between the two groups at the final follow-up. Change of the JSW in the centralization group was significantly greater than that in the control group 2 years postoperatively (Control group: -0.1 mm, Centralization group: 0.8 mm P =0.03). Conclusion Change of JSW after OWHTO aimed at neutral alignment with arthroscopic centralization for extruded medial meniscus was greater than solely OWHTO, and there was no significant difference in the short-term clinical outcomes between the 2 procedures at the final follow-up.

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Augmentation of the Pullout Repair of a Medial Meniscus Posterior Root Tear by Arthroscopic Centralization

Cited by 74 publications

References 8 publications

The effect of a centralization procedure for extruded lateral meniscus on load distribution in porcine knee joints at different flexion angles

The effect of a centralization procedure for extruded lateral meniscus on load distribution in porcine knee joints at different flexion angles

Technique for Arthroscopically Assisted Superficial and Deep Medial Collateral Ligament–Meniscotibial Ligament Repair With Internal Brace Augmentation

Short-term Outcomes after High Tibial Osteotomy Aimed at Neutral Alignment Combined with Arthroscopic Centralization of Medial Meniscus in Osteoarthritis Patients

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