A novel suture technique using the FasT-Fix combined with Ultrabraid for pullout repair of the medial meniscus posterior root tear

Kodama

Okazaki

et al. 2019

Knee Surg & Relat Res

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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

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“…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

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“…Types of the MMPRT were determined by careful arthroscopic examinations (24 knees) or arthroplasty-associated direct observations (5 knees) according to the meniscal root tear classification ( Table 1 ) 22) . Transtibial pullout repairs (16 knees) were performed in patients who met operative indications for the pullout repair 23 – 25) . All-inside meniscal repairs (6 knees) were performed in the other patients.…”

Section: Methodsmentioning

confidence: 99%

Meniscal Extrusion Progresses Shortly after the Medial Meniscus Posterior Root Tear

Kodama

Kamatsuki

et al. 2017

Knee Surg Relat Res

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PurposeMedial meniscus posterior root tears (MMPRT) induce medial meniscus extrusion (MME). However, the time-dependent extent of MME in patients suffering from the MMPRT remains unclear. This study evaluated the extent of MME after painful popping events that occurred at the onset of the MMPRT.Materials and MethodsThirty-five patients who had an episode of posteromedial painful popping were investigated. All the patients were diagnosed as having an MMPRT by magnetic resonance imaging (MRI) within 12 months after painful popping. Medial meniscus body width (MMBW), absolute MME, and relative MME (100×absolute MME/MMBW) were assessed among three groups divided according to the time after painful popping events: early period (<1 month), subacute period (1–3 months), and chronic period (4–12 months).ResultsIn the early period, absolute and relative MMEs were 3.0 mm and 32.7%, respectively. Absolute MME increased up to 4.2 mm and 5.8 mm during the subacute and chronic periods, respectively. Relative MME also progressed to 49.2% and 60.3% in the subacute and chronic periods, respectively.ConclusionsThis study demonstrated that absolute and relative MMEs increased progressively within the short period after the onset of symptomatic MMPRT. Our results suggest that early diagnosis of an MMPRT may be important to prevent progression of MME following the MMPRT.