Pullout repair of a medial meniscus posterior root tear using a FasT-Fix ® all-inside suture technique

Kodama

Okazaki

et al. 2019

Knee Surg & Relat Res

Purpose: Posterior root repair of the medial meniscus (MM) can prevent rapid progression of knee osteoarthritis in patients with a MM posterior root tear (MMPRT). The anatomic reattachment of the MM posterior root is considered to be critical in a transtibial pullout repair. However, tibial tunnel creation at the anatomic attachment is technically difficult. We hypothesized that a newly developed point-contact aiming guide [Unicorn Meniscal Root (UMR) guide] can create the tibial tunnel at a better position rather than a previously designed MMPRT guide. The aim of this study was to compare the position of the created tibial tunnel between the two meniscal root repair guides. Materials and methods: Thirty-eight patients underwent transtibial pullout repairs. Tibial tunnel creation was performed using the UMR guide (19 cases) or MMPRT guide (19 cases). Three-dimensional computed tomography images of the tibial surface were evaluated using the Tsukada's measurement method postoperatively. The expected anatomic center of the MM posterior root attachment was defined as the center of three tangential lines referring to three anatomic bony landmarks (anterior border of the posterior cruciate ligament, lateral margin of the medial tibial plateau, and retro-eminence ridge). The expected anatomic center and tibial tunnel center were evaluated using the percentage-based posterolateral location on the tibial surface. The distance between the anatomic center and tunnel center was calculated. Results: The anatomic center of the MM posterior root footprint was located at a position of 79.2% posterior and 39.5% lateral. The mean of the tunnel center in the UMR guide was similar to that in the MMPRT guide (posterior direction, P = 0.096; lateral direction, P = 0.280). The mean distances between the tunnel center and the anatomic center were 4.06 and 3.99 mm in the UMR and MMPRT guide group, respectively (P = 0.455). Conclusions: The UMR guide, as well as the MMPRT guide, is a useful device to create favorable tibial tunnels at the MM posterior root attachment for pullout repairs in patients with MMPRTs.

Section: Methodsmentioning

confidence: 99%

The accuracy of a newly developed guide system in medial meniscus posterior root repair: a comparison between two aiming guides

Kodama

Okazaki

et al. 2019

Knee Surg & Relat Res

“…Patients who had radiographic knee osteoarthritis involved in the Kellgren-Lawrence grade III or more and previous history of meniscus injury or knee surgery were excluded. All the patients were diagnosed having the MMPRT with MRI examinations and met operative indications for the MMPRT pullout repair [15][16][17]. The presence of the MMPRT was defined according to characteristic MRI findings such as cleft, giraffe neck, ghost, radial tear, and meniscal extrusion signs of the MM posterior root within 9 mm from the attachment [18,19].…”

Section: Methodsmentioning

confidence: 99%

“…2 Ultrabraid and FasT-Fix reverse curve (Smith & Nephew, Andover, MA, USA) were used to stabilize the MM posterior horn in a modified Mason-Allen suture configuration(Fig. 1B)[15,17].A 4.5-mm tibial tunnel was created at an anatomic insertion of the MM posterior root using a PRT aiming guide (Smith & Nephew) [16]. Ultrabraid and uncut free-end of the FasT-Fix sutures were retrieved through the tibial tunnel.…”

mentioning

confidence: 99%

Arthroscopic scoring system of meniscal healing following medial meniscus posterior root repair

International Orthopaedics (SICOT)

Miyazawa

Fujii

et al. 2018

“…The presence of an MMPRT was based on characteristic MRI findings, including signs of cleft, giraffe neck, ghost, radial tear, and meniscal extrusion within 9 mm of the meniscal attachment [14,15]. Patients in Group A met the indication for MMPRT pullout repair [16][17][18]. Groups were then matched for age, sex, and body mass index, with 23 participants included in each of the two groups after matching (Fig.…”

Section: Study Patientsmentioning

confidence: 99%

Preliminary diagnosis of medial meniscus posterior root tears using the Rosenberg radiographic view

Kodama

Kamatsuki

et al. 2019

Knee Surg & Relat Res

Purpose: To verify the effectiveness of detecting medial meniscus posterior root tears (MMPRTs) using weightbearing posterior-anterior (PA) radiographs. Materials and methods: Twenty-three patients were diagnosed with an MMPRT using magnetic resonance imaging (Group A), with 23 matched individuals forming the control group (Group B). The distance between medial tibial eminence and the lateral edge of the medial femoral condyle (MTE-MFC distance) and medial joint space (MJS) width were measured on weight-bearing PA radiographs, with the knee flexed at 45°(Rosenberg view). Absolute medial meniscus extrusion (MME) was measured on magnetic resonance images. Results: The MTE-MFC distance was greater and the MJS width was smaller in Group A than Group B (7.7 ± 1.7 mm versus 6.0 ± 1.24 mm and 3.2 ± 0.8 mm versus 4.5 ± 0.7 mm, respectively; P < 0.05). The MTE-MFC distance and MJS width correlated with MME (r = 0.603 and 0.579, respectively; P < 0.05), and the extent of MME was greater in Group A than Group B (4.1 ± 1.1 mm versus 1.8 ± 1.5 mm, respectively; P < 0.05). Conclusions: MMPRTs increase the MTE-MFC distance and decrease the MJS width, with these measurements correlating to the MME. Therefore, measurement of the MTE-MFC distance and MJS width on the Rosenberg view could be a useful preliminary method for the diagnosis of an MMPRT.