Treatment Outcomes of Meniscal Root Tears: A Systematic Review

Stein, Beth Shubin; Yayac, Michael; Conte, Evan J.; Hornstein, Joshua

doi:10.1016/j.asmr.2020.02.005

Cited by 16 publications

(18 citation statements)

References 27 publications

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“…Conversion to total knee arthroplasty and the progression of Kellgren-Lawrence grade are two noticeable concerns in choosing the treatment modality for meniscal root tear. Hence, root repair is a wise choice for active patients with acute root tears or those with root tears who have minimal or absent osteoarthritis [16, 19,23,29]. Noticeably, our results show no progression of osteoarthritis during the study time frame; nevertheless, one year is not enough time for such changes to appear.…”

Section: Discussionmentioning

confidence: 70%

The Functional Impact of Home-based Self-rehabilitation Following Arthroscopic Root Repair

Tahami

Vaziri

Tahmasebi

et al. 2021

Preprint

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Purpose: COVID-19 pandemic makes outdoors rehabilitation a potential hazard. Patient education to perform simple home-based exercises seems to be an interesting and sometimes a mandatory option. This study provides a comparison between the conventional and home-based virtual rehabilitation after surgical repair of medial meniscus root tears. Methods: All patients who underwent MPRT repair with a modified trans-tibial pull-out technique from March 2019 to March 2021 were evaluated. Those who underwent surgery after December 2019 were trained to perform self-rehabilitation. The rest had undergone outdoors specialized rehabilitation according to a unified protocol and these were used as a historical control group. All patients were followed up for a minimum of 2 year after surgery. Final Lysholm scores were utilized to compare functional outcomes. Results: Forty-three consecutive patients with medial meniscal root tears were studied. Thirty-nine (90.7%) were women and 4 (9.3%) were men. The mean age of participants was 53.2 ±8.1 years. The total Lysholm knee score, and all its items were significantly improved in both groups at a two-year follow-up (p<0.05), except the “Using cane or crutches” item (p=0.065). Nevertheless, the final Lysholm knee score improvement was higher in patients who performed outdoors specialized rehabilitation and in patients with shorter time-to-surgery.Conclusion: Regardless of age and gender, home-based rehabilitation after meniscal root repair with the modified trans-tibial pull-out technique improved the patients’ function at a two-year follow-up. Nonetheless, this effect was still significantly lower than that of the outdoors specialized rehabilitation. Future work is required to clarify basic protocols for home-based tele-rehabilitation programs and determine clinical, radiological and functional results.Level of evidence: Level IV, therapeutic, historically controlled study

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Section: Discussionmentioning

confidence: 70%

The Functional Impact of Home-based Self-rehabilitation Following Arthroscopic Root Repair

Tahami

Vaziri

Tahmasebi

et al. 2021

Preprint

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“…These include conservative treatment (NSAIDs, physiotherapy, exercise therapy), unicompartmental knee arthroplasty (UKA) for localized degenerative disease in balanced, neutral knees, total knee arthroplasty (TKA) for advanced degenerative disease, in unstable knees and varus-valgus malalignment. Arthroscopic partial meniscectomy was comparable with conservative treatment in the review conducted by Stein et al [18].…”

Section: Typementioning

confidence: 86%

Meniscal Root Tears—The Crippling Epidemic. Case Report and Literature Review

Crişan¹,

Vermeşan²,

Prejbeanu³

et al. 2021

Timisoara Med

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(1) Background: Meniscal lesions are one of the most prevalent pathologies in orthopedics; meniscal root tears have been recognized as a specific subset with poor mid- to long-term results after standard treatment options (observation, physical therapy, arthroscopic partial meniscectomy) and frequent progression to osteoarthritis. Meniscal root repair has emerged as a new technique with promising results. We present a case report and review the current literature regarding the diagnosis, indications to repair, current techniques, alternatives and expected outcomes. (2) Case report: A 49-year-old woman, with a body mass index of 30 and no significant comorbidities or history of trauma, involved in moderate to heavy physical activity, presented with left knee pain at the internal meniscal line, which worsened over the last 4 months, despite an intra-articular steroid shot. Based on the magnetic resonance imaging (MRI), she was diagnosed with a type 2 medial meniscus posterior root tear and moderate internal compartment chondropathy (Outerbridge 2). She underwent side-to-side repair of the meniscal lesion and reattachment of the root through a bone tunnel over a button. Postoperatively, she was non-weight-bearing (NWB) for 6 weeks and with the knee immobilized at 30° of flexion. At 6 months’ follow-up, the patient was fully ambulant without crutches, with active knee flexion between 0° and 130°. (3) Conclusion: Meniscal root repair is reasonably accessible. It may provide additional benefits over current treatment options when used judiciously and with an adequate surgical technique.

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“…6,13 These cartilaginous injuries have the potential to affect professional athletes significantly, as soccer already predisposes players to early-onset knee osteoarthritis. 14,15 Such injuries may have financial repercussions as well given the uncertain impact meniscal tears can have on performance postinjury. However, published literature on meniscal repair outcomes in elite athletes remains sparse.…”

Section: Discussionmentioning

confidence: 99%

Medial Meniscus Repair in Major League Soccer Players Results in Decreased Performance Metrics for One Year and Shortened Career Longevity

Heath

Momtaz

Ghali

et al. 2021

OAJSM

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Background:The rate of medial meniscus tear (MMT) in professional soccer players is high. There are no studies on objective performance metrics following medial meniscus repair in these athletes. Purpose: Examine the impact of MMT treated with surgical repair on performance metrics and career longevity in Major League Soccer (MLS) players. Methods: MLS players who sustained an MMT between 1993 and 2019 were identified via publicly available databases. These players were each matched to 2 uninjured controls by debut date, experience, position, race, ethnicity, height, weight, and body mass index (BMI). Demographic data and performance metrics were then collected for both groups. Matches, minutes, goals, assists, shots, shots on target, duels, and duel percentage won are collectively referred to as performance metrics. Statistical analysis compared demographic distributions and performance metrics between the MMT and control groups. Results: Thirty-three MLS players who had undergone medial meniscus repair were identified and matched to 66 controls. All performance metrics decreased in the MMT group when compared to their controls in the first year after injury. This difference remained significant even when the performance metrics were normalized with respect to time, indicating that the injured players both played less and were not as productive. At 2 years after injury, performance metrics returned to pre-injury levels and were equivalent to those of the healthy controls. Career length was found to be significantly different between the two groups at 8.81 ± 3.9 years for the MMT group and 12.63 ± 3.51 years for the control group (P < 0.001). Conclusion: MLS players undergoing medial meniscus repair had decreased performance metrics in the first year after injury but returned to baseline levels of play at the second year after injury. Their careers were also shorter than those of their uninjured controls.

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Treatment Outcomes of Meniscal Root Tears: A Systematic Review

Cited by 16 publications

References 27 publications

The Functional Impact of Home-based Self-rehabilitation Following Arthroscopic Root Repair

The Functional Impact of Home-based Self-rehabilitation Following Arthroscopic Root Repair

Meniscal Root Tears—The Crippling Epidemic. Case Report and Literature Review

Medial Meniscus Repair in Major League Soccer Players Results in Decreased Performance Metrics for One Year and Shortened Career Longevity

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