Repair of the lateral posterior meniscal root improves stability in an ACL-deficient knee

Forkel, Philipp; Deimling, Constantin von; Lacheta, Lucca; Imhoff, Florian B.; Foehr, Peter; Willinger, Lukas; Dyrna, Felix; Petersen, Wolf; Imhoff, Andreas B.; Burgkart, Rainer

doi:10.1007/s00167-018-4949-8

Cited by 68 publications

(70 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…16,25 However, the included studies failed to provide enough information about the restoration of anterolateral rotational stability after LMPR repairs and combined ACLR. Despite the inspiring results provided by laboratory trials, 8,28 future studies are necessary to evaluate the effectiveness of LMPR repairs in controlling the dynamic stability of ACL-reconstructed knees in clinical scenarios.…”

Section: Discussionmentioning

confidence: 99%

Clinical, Radiographic, and Arthroscopic Outcomes of Surgical Repair for Radial and Avulsed Lesions on the Lateral Meniscus Posterior Root During ACL Reconstruction: A Systematic Review

Zheng

Song

et al. 2021

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Clinical outcomes of surgical repairs for tears of the lateral meniscus posterior root (LMPR) in patients undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) have not been comprehensively investigated. Purpose: To systematically review the clinical, radiographic, and arthroscopic results of surgical repairs for tears of the LMPR in patients undergoing ACLR. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic electronic search of the PubMed and Embase databases was performed to identify studies reporting clinical, radiographic, or arthroscopic results of surgical repairs for tears of the LMPR in patients undergoing ACLR. Each included study was abstracted regarding study characteristics, patient characteristics, surgical technique, and outcome measures. The methodological quality of the included studies was analyzed according to the Methodological Index for Non-Randomized Studies (MINORS) criteria. Results: Nine studies were included in this systematic review, representing a total of 215 knees in 215 patients. Overall, 123 side-to-side repairs and 89 pullout repairs were performed for tears of the LMPR during ACLR. After a mean follow-up of 33.9 months, significant improvements ( P < .05) were found in the mean Lysholm score (from 58.3 to 91.4) as well as the mean International Knee Documentation Committee subjective score (from 61.1 to 87.2). Weightbearing anteroposterior radiographs of 41 patients showed no significant narrowing of lateral joint space width. On magnetic resonance imaging scans, 31 patients demonstrated no significant progression of chondral lesions, and no significant decreases in meniscal extrusion on coronal planes were reported in another 76 patients. The complete/partial healing was 93.6% on second-look arthroscopy after side-to-side repairs for radial tears of the LMPR. The MINORS value showed a high risk of bias for all 9 studies. Conclusion: Patients with tears of the LMPR associated with ACL injuries achieved favorable functional scores after ACLR and LMPR repairs, and the side-to-side repair for radial tears of the LMPR succeeded in a high meniscal healing rate of >90%. However, the authors of this review were unable to definitively conclude whether LMPR repairs fully restore the hoop stress of the lateral meniscus.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical, Radiographic, and Arthroscopic Outcomes of Surgical Repair for Radial and Avulsed Lesions on the Lateral Meniscus Posterior Root During ACL Reconstruction: A Systematic Review

Zheng

Song

et al. 2021

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…L ateral meniscus (LM) posterior root tears are prevalent injuries, occurring in 8% to 14% of patients with concomitant anterior cruciate ligament (ACL) injuries. [1][2][3][4][5][6] Meniscal root tears have been compared with subtotal meniscectomies in terms of their ability to alter joint loads and contact stresses. [6][7][8][9][10] In addition, root tears are associated with meniscal extrusion, 8,11 rotational instability, [6][7][8][9][10] and have been linked to degenerative changes in the knee.…”

mentioning

confidence: 99%

“…[1][2][3][4][5][6] Meniscal root tears have been compared with subtotal meniscectomies in terms of their ability to alter joint loads and contact stresses. [6][7][8][9][10] In addition, root tears are associated with meniscal extrusion, 8,11 rotational instability, [6][7][8][9][10] and have been linked to degenerative changes in the knee. 10,12 Previous biomechanical studies demonstrate that the LM posterior root helps stabilize the knee against excessive anterior tibial translation in lower flexion angles and against internal rotation in greater flexion angles, 6,10 and, when torn, contributes to further translational and rotational instability in ACL-deficient knees.…”

mentioning

confidence: 99%

Posterior Lateral Meniscal Root Tears Increase Strain on the Reconstructed Anterior Cruciate Ligament: A Cadaveric Study

Uffmann

ElAttrache

Nelson

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

View full text Add to dashboard Cite

“…In cadaveric studies testing the kinematics of ACL-deficient knees, complete detachment of the LMPR root increased anterior tibial displacement of ACL-deficient knees during anterior loading and simulated pivot-shift loading. 14,15,33,38 Practically, the complete LMPR detachment performed in the cadaveric condition is more likely to behave as a root avulsion confirmed in the clinical setting. Our data demonstrated that in patients with a combined ACL injury and LMPR lesion, the percentage of patients with root avulsion of LMPR is much higher in the high-grade (≥6 mm) ATSLC subgroup (65.0%) than in the low-grade (<6 mm) subgroup (20.0%), and a root avulsion is independently predictive of high-grade ATSLC in extension, with an OR of 28.750, no matter whether the MFL was impaired or intact.…”

Section: Discussionmentioning

confidence: 98%

Lateral Meniscus Posterior Root Lesion Influences Anterior Tibial Subluxation of the Lateral Compartment in Extension After Anterior Cruciate Ligament Injury

et al. 2020

View full text Add to dashboard Cite

Background: The lateral meniscus posterior root (LMPR) lesion further decreases dynamic knee stability after anterior cruciate ligament (ACL) injury owing to the loss of the “wedge effect” maintained by the posterior horn of the lateral meniscus. However, the effect of LMPR lesions on the static tibiofemoral relationship in extension after ACL injuries is not determined. Purpose: To (1) determine the effect of LMPR lesions on anterior tibial subluxation of the lateral compartment (ATSLC) in extension in patients with ACL injuries and to (2) identify the LMPR-related factors associated with excessive ATSLC in extension. Study Design: Cohort study; Level of evidence, 3. Methods: Between January 2015 and December 2017, 405 consecutive patients with diagnosed ACL injuries who underwent primary ACL reconstructions were retrospectively reviewed. Among them, 45 patients with combined ACL injuries and LMPR lesions (ACL+LMPR group) and 51 patients with isolated ACL injuries (ACL group) were identified. Values of ATSLC in extension were measured on preoperative supine magnetic resonance imaging and classified into high grade (≥6 mm) and low grade (<6 mm). The mean ATSLC in extension and the proportion of patients with high-grade ATSLC in extension were compared between the groups by univariate analysis. In the ACL+LMPR group, predictors of high-grade ATSLC in extension—including age, sex, body mass index, affected side, cause of injury, period from injury (<12 or ≥12 weeks), LMPR lesion pattern (radial tear or root avulsion), and meniscofemoral ligament integrity (intact or impaired)—were assessed by univariate analysis and multivariate logistic regression analysis. Results: The mean ATSLC in extension in the ACL+LMPR group was significantly greater than that in the ACL group (5.6 mm vs 3.1 mm; P = .001). The proportion of patients with high-grade ATSLC in extension in the ACL+LMPR group was also significantly larger than that in the ACL group (44.4% vs 15.7%; P = .002). In addition, the root avulsion (instead of radial tear) (odds ratio, 28.750; 95% CI, 2.344-352.549; P = .009) and the period from injury ≥12 weeks (odds ratio, 17.095; 95% CI, 1.207-242.101; P = .036) were determined to be the 2 independent predictors of high-grade ATSLC in extension. However, age, sex, body mass index, affected side, cause of injury, and meniscofemoral ligament integrity were not. Conclusion: After ACL injuries, concomitant LMPR lesion further increased ATSLC in extension. Chronic LMPR avulsion was associated with high-grade ATSLC in extension.

show abstract

Repair of the lateral posterior meniscal root improves stability in an ACL-deficient knee

Abstract: A lateral meniscus root repair can reduce internal tibial rotation in the ACL-deficient knee. To check the condition of the lateral posterior meniscus root attachment is clinical relevant as a lateral meniscus root repair might improve rotational stability.

Cited by 68 publications

References 33 publications

Clinical, Radiographic, and Arthroscopic Outcomes of Surgical Repair for Radial and Avulsed Lesions on the Lateral Meniscus Posterior Root During ACL Reconstruction: A Systematic Review

Clinical, Radiographic, and Arthroscopic Outcomes of Surgical Repair for Radial and Avulsed Lesions on the Lateral Meniscus Posterior Root During ACL Reconstruction: A Systematic Review

Posterior Lateral Meniscal Root Tears Increase Strain on the Reconstructed Anterior Cruciate Ligament: A Cadaveric Study

Lateral Meniscus Posterior Root Lesion Influences Anterior Tibial Subluxation of the Lateral Compartment in Extension After Anterior Cruciate Ligament Injury

Contact Info

Product

Resources

About