Medial joint space narrowing progresses after pullout repair of medial meniscus posterior root tear

Abstract

Purpose The extent to which arthropathic changes progress after medial meniscus posterior root tear (MMPRT) repair remains controversial. This retrospective study assessed medial joint space (MJS) narrowing progression after pullout of repair for MMPRT and identified the correlating factors. Methods We included 56 patients who underwent pullout of repair for MMPRT. The MJS of the bilateral knees was assessed with radiography using the fixed-flexion view. A second-look arthroscopy was performed one year post-operatively for all patients. The baseline characteristics, clinical scores, Kellgren–Lawrence (KL) grade, and medial meniscus extrusion (MME) were identified. Statistical comparisons and correlation analyses were conducted. Results The MJS narrowing width was significantly larger in MMPRT knees than in contralateral knees (0.51 ± 0.85 mm vs. 0.09 ± 0.49 mm, p < 0.001). KL grade progression was observed in 23.2% (13/56) of patients. There was a significant difference between pre- and post-operative MME values, indicating MME progression (p < 0.001). Each clinical score showed significant improvement one year post-operatively (p < 0.001). Positive correlations were found between MJS narrowing and pre-operative MJS (coefficient = 0.510, p < 0.001), rate of change in MJS (coefficient = 0.929, p < 0.001), and increase in MME (ΔMME) (coefficient = 0.506, p < 0.001). Conclusion Knees that underwent pullout of repair for MMPRT showed progression of MJS narrowing by 0.51 mm at one year post-operatively, although clinical scores markedly improved. Correlating factors for MJS narrowing were pre-operative MJS, rate of change in MJS, and ΔMME. Preventing MME progression is essential for preventing arthropathic changes.

Time-Dependent Increase in Medial Meniscus Extrusion Predicts the Need for Meniscal Repair in Patients with Partial Medial Meniscus Posterior Root Tears: A Case–Control Study

“…The MME progression suggests hoop function disruption and the need for meniscal repair to re-establish meniscus function. MME is also associated with joint space narrowing and osteoarthritis progression [ 14 ]. MME in asymptomatic adults was previously reported to be 1.64 mm [ 15 ], progressing shortly after the MMPRTs onset [ 16 ].…”

Meniscus root tears: state of the art

“…The mainstay of MRTs treatment is surgical repair with the primary objective of restoring knee kinematics by preserving the meniscal function in order to delay the onset of osteoarthritis [ 35 ]. However, advanced osteoarthritis, focal chondral injury, severe coronal and sagittal malalignment and knee instability are all considered contraindications to meniscal root repair [ 9 , 20 , 30 , 31 ].…”

Longitudinal changes in medial meniscus extrusion and clinical outcomes following pullout repair for medial meniscus posterior root tears: a 3-year evaluation

“…Consequently, MMPR repair is being performed more frequently. However, MMPR repair does not completely prevent the progression of osteoarthritic changes [ 6 , 7 ]. Moreover, it has been reported that there is a correlation between the MM extrusion (MME) progression and the narrowing of the medial joint space [ 6 ].…”

“…However, MMPR repair does not completely prevent the progression of osteoarthritic changes [ 6 , 7 ]. Moreover, it has been reported that there is a correlation between the MM extrusion (MME) progression and the narrowing of the medial joint space [ 6 ]. Therefore, a long-term evaluation of MME after MMPR repair is required.…”