Document Detail

Medial meniscus root tear refixation: comparison of clinical, radiologic, and arthroscopic findings with medial meniscectomy.
MedLine Citation:
PMID:  21035991     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: To investigate the clinical, radiologic, and arthroscopic findings of pullout repair in medial meniscus root tear (MRT) and to compare the results of pullout repair and partial meniscectomy.
METHODS: This study enrolled 58 consecutive patients with medial MRT who underwent partial meniscectomy (M group, n = 28) or pullout repair (R group, n = 30) between September 2003 and August 2007. The patients were evaluated by the Lysholm knee score, International Knee Documentation Committee (IKDC) subjective knee score, joint space narrowing, and Kellgren-Lawrence grade on simple radiographs. Medial meniscal extrusion and the state of the meniscus and articular cartilage on magnetic resonance imaging (MRI) were documented. We performed second-look arthroscopy in 14 patients with pullout repair and evaluated fixation strength and hoop tension of the meniscus and the state of the articular cartilage.
RESULTS: There were no differences in demographic data (age, sex, and body mass index) between the 2 groups. The mean follow-up was 48.5 months in the R group and 46.1 in the M group. Lysholm and IKDC scores improved significantly in both groups (P < .05). However, the R group had better Lysholm and IKDC scores and less joint space narrowing and progression of the Kellgren-Lawrence grade than the M group did (P < .05). In a subgroup analysis of the R group, medial meniscal extrusion on MRI decreased from 3.13 to 2.94 mm. Of the patients, 28 (93.3%) showed complete or partial healing of the meniscus. On MRI, 6 (20%) showed arthrosis progression. On second-look arthroscopic examinations in 14 patients in the R group, 9 (64.3%) showed normal fixation strength, 10 (71.4%) had normal restoration of hoop tension, 5 (35.7%) showed arthrosis progression, and 2 (6.7%) had repeat tears of the meniscus.
CONCLUSIONS: Arthroscopic pullout repair of a medial MRT gave significantly better clinical and radiologic results than partial meniscectomy, and sound healing with restoration of hoop tension of the meniscus was observed on MRI and second-look arthroscopy. We propose that this method is an effective treatment for medial MRT.
LEVEL OF EVIDENCE: Level III, retrospective comparative study.
Sang Bum Kim; Jeong Ku Ha; Soo Won Lee; Deok Won Kim; Jae Chan Shim; Jin Goo Kim; Mi Young Lee
Publication Detail:
Type:  Journal Article     Date:  2010-10-29
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  27     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  346-54     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Department of Orthopedic Surgery, Insung Hospital, Chuncheon, South Korea.
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