Outcomes after Surgical Repair of Medial Meniscal Root Tears: A Review

Edwards, Chad; Goldman, Brian H.; Turley, Jeffery; Richey, Bradley; Deal, Matthew Jordan; Kalbac, Daniel

doi:10.1055/s-0040-1710565

Cited by 10 publications

(11 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, significant improvements were found in 5 of 5 studies investigating HSS scores, with a mean improvement of 34.2 points, far greater than the MCID 23 of 8.72. Statistically significant improvements were found in 16 of 16 studies evaluating IKDC scores, and the mean change of 29.2 is substantially higher than the MCID 23 of 3.19 to 16.17. Tegner activity ratings demonstrated lower relative improvements, increasing from a mean 2.8 to 3.8 on a 10-point scale, which is not a high level of activity.…”

Section: Discussionmentioning

confidence: 81%

“…PMMRT repair provides a consistent clinical benefit. Of 24 studies, 23 reported that Lysholm scores demonstrated significant improvements, and the mean change of 30.7 compares favorably with the minimal clinically important difference (MCID) 23 of 10.1. Similarly, significant improvements were found in 5 of 5 studies investigating HSS scores, with a mean improvement of 34.2 points, far greater than the MCID 23 of 8.72.…”

Section: Discussionmentioning

confidence: 99%

“…Of 24 studies, 23 reported that Lysholm scores demonstrated significant improvements, and the mean change of 30.7 compares favorably with the minimal clinically important difference (MCID) 23 of 10.1. Similarly, significant improvements were found in 5 of 5 studies investigating HSS scores, with a mean improvement of 34.2 points, far greater than the MCID 23 of 8.72. Statistically significant improvements were found in 16 of 16 studies evaluating IKDC scores, and the mean change of 29.2 is substantially higher than the MCID 23 of 3.19 to 16.17.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Midterm Outcomes of Posterior Medial Meniscus Root Tear Repair: A Systematic Review

et al. 2021

View full text Add to dashboard Cite

Background: Whereas there has been growing interest in surgical repair of posterior medial meniscus root tears (PMMRTs), our understanding of the medium- and long-term results of this procedure is still evolving. Purpose: To report midterm clinical outcomes from PMMRT repairs. Study Design: Systematic review. Methods: A literature review for this systematic analysis was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We identified studies that reported the results of arthroscopic repair of PMMRTs. Functional and imaging outcomes were reviewed and summarized. Results: In total, 28 studies with a total of 994 patients (83% female) with an overall mean age of 57.1 were included in this review. Clinical outcomes (Lysholm, International Knee Documentation Committee, Hospital for Special Surgery, and Tegner scores) were improved at final follow-up in all studies. Of patients, 49% had radiographic progression of at least 1 grade in the Kellgren-Lawrence scale at a mean follow-up of 4.0 years in 11 studies. Cartilage degeneration had progressed at least 1 grade on magnetic resonance imaging scans in 23% of patients at a mean follow-up of 31.6 months in 4 studies. Conclusion: PMMRT repairs provide a functional benefit with consistent improvements in clinical outcome scores. There is some evidence that PMMRT repair slows the progression of osteoarthritis but does not prevent it at midterm follow-up.

show abstract

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Midterm Outcomes of Posterior Medial Meniscus Root Tear Repair: A Systematic Review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Previous systematic reviews evaluating outcomes after MMPR repair have reported similar improvements in Lysholm scores to those of the current study of approximately 30 points. 8,19 The Tegner score showed a mean improvement of only 0.60 points, which does not reach the minimal detectable change for knee injuries. 16 The lack of a significant improvement in Tegner scores may be caused by meniscus root repair being performed in a primarily older patient population, consisting of participants less likely to possess high levels of preoperative activity.…”

Section: # Discussionmentioning

confidence: 86%

Examining the Efficacy of Medial Meniscus Posterior Root Repair: A Meta-analysis and Systematic Review of Biomechanical and Clinical Outcomes

et al. 2022

View full text Add to dashboard Cite

Background: Medial meniscus posterior root (MMPR) injuries accelerate the progression of osteoarthritis. While partial meniscectomy was once considered the gold standard for treatment, meniscus root repair has become increasingly utilized with reported improvements in clinical and biomechanical outcomes. Purpose: To perform a systematic review of biomechanical outcomes and a meta–analysis of clinical and radiographic outcomes after MMPR repair. Study Design: Meta-analysis and systematic review; Level of evidence, 4. Methods: The PubMed, Embase, and Cochrane databases were queried in August 2021 for studies reporting biomechanical, clinical, and radiographic outcomes after MMPR repair. Biomechanical studies were assessed for main results and conclusions. Data including study characteristics, cohort demographics, and outcomes were extracted. Included clinical studies were analyzed with a random–effects meta-analysis of proportions for binary outcomes or continuous outcomes for mean differences between preoperative and postoperative time points. Subgroup analysis for studies reporting repair outcomes with concomitant high tibial osteotomy (HTO) was performed where appropriate. Results: A total of 13 biomechanical studies were identified and reported an overall improvement in mean and peak contact pressures after MMPR repair. There were 24 clinical studies, consisting of 876 patients (877 knees), identified, with 3 studies (106 knees) reporting outcomes with concomitant HTO. The mean patient age was 57.1 years (range, 23-74 years), with a mean follow–up of 27.7 months (range, 2-64 months). Overall, clinical outcomes (Lysholm, Hospital for Special Surgery, International Knee Documentation Committee, visual analog scale for pain, Tegner, and Knee injury and Osteoarthritis Outcome Score scores) were noted to improve postoperatively compared with preoperatively, with improved Lysholm scores in patients undergoing concomitant HTO versus MMPR repair alone. Meniscal extrusion was not significantly improved after MMPR repair compared with preoperative measurements. The progression in Kellgren-Lawrence grades from grade 0 to grades 1 to 3 occurred in 5.9% (21/354) of patients after repair, with no patients progressing from grades 1 to 3 to grade 4. Conclusion: MMPR repair generally improved biomechanical outcomes and led to improved patient–reported outcomes with greater improvements noted in patients undergoing concomitant HTO. Repair did not significantly improve meniscal extrusion, while only 5.9% of patients were noted to progress to low–grade osteoarthritis. The high level of heterogeneity in the included biomechanical and clinical investigations emphasizes the need for more well–designed studies that evaluate outcomes after MMPR repair.

show abstract

“…Meniscus root repair solely results in significantly satisfying clinical outcomes. 33,34 However, at the present time, there is a paucity of studies comparing the outcomes of solely OWHTO and OWHTO concomitant with meniscus posterior root repair, while a few studies showed that significant differences of the clinical and radiologic outcomes were not found between the procedures. 35,36 There is insufficient evidence to exclude the possibility that the meniscus root tear and meniscus root repair influenced the results of the present study.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

View full text Add to dashboard Cite

The study aimed to improve the 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 present study evaluated short-term patient-reported outcome measures; namely, the patient subjective satisfaction scores and Numeric Rating Scale (NRS) for walking pain after OWHTO aimed at neutral alignment with and without arthroscopic centralization for an extruded medial meniscus. A retrospective review of 50 primary OWHTO patients was conducted. Thirty-nine patients were included in the analysis after applying the exclusion criteria. The centralization group included 21 patients with knee osteoarthritis patients who underwent the OWHTO with arthroscopic meniscal centralization, while the control group included 18 patients who underwent OWHTO alone. The patient subjective satisfaction scores and NRS for walking pain were recorded at outpatient visits from before surgery to 3 years after surgery. In terms of the Lysholm knee scale, International Knee Documentation Committee subjective score, and Knee Osteoarthritis Outcome Score, the latest data (at least 2 years after surgery) were reviewed. Radiographic changes in joint space width and joint line congruence angle were measured 2 years postoperatively. Patient demographic data were also reviewed. One patient in the centralization group experienced a superficial surgical site infection. The patient subjective satisfaction and NRS scores for walking pain gradually improved by 1 year after surgery and were sustained until 3 years after surgery in both groups, with no significant difference between the groups. The course of patient-reported outcome measures from before surgery to 3 years after surgery for solely OWHTO aimed at neutral alignment and OWHTO aimed at neutral alignment with arthroscopic centralization showed the similar trends.

show abstract

Outcomes after Surgical Repair of Medial Meniscal Root Tears: A Review

Cited by 10 publications

References 16 publications

Midterm Outcomes of Posterior Medial Meniscus Root Tear Repair: A Systematic Review

Midterm Outcomes of Posterior Medial Meniscus Root Tear Repair: A Systematic Review

Examining the Efficacy of Medial Meniscus Posterior Root Repair: A Meta-analysis and Systematic Review of Biomechanical and Clinical Outcomes

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

Contact Info

Product

Resources

About