Comparison of Long-term Radiographic Outcomes and Rate and Time for Conversion to Total Knee Arthroplasty Between Repair and Meniscectomy for Medial Meniscus Posterior Root Tears: A Systematic Review and Meta-analysis

Krivicich, Laura M.; Kunze, Kyle N.; Parvaresh, Kevin C.; Jan, Kyleen; DeVinney, Annie; Vadhera, Amar S.; LaPrade, Robert F.; Chahla, Jorge

doi:10.1177/03635465211017514

Cited by 52 publications

(41 citation statements)

References 43 publications

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Section: Meniscal Injuriesmentioning

confidence: 99%

“…Today, the preference for meniscus repair over meniscectomy is well established ( 9 ). Evidence suggests that non-degenerative meniscal tears are best repaired using knee arthroscopy, especially in young and active people ( 10 ). A recent study has demonstrated that compared to meniscectomy, meniscus repair causes lower rates of degenerative changes and reduces demand for knee replacement in the future ( 10 ).…”

Section: Meniscal Injuriesmentioning

confidence: 99%

“…Evidence suggests that non-degenerative meniscal tears are best repaired using knee arthroscopy, especially in young and active people ( 10 ). A recent study has demonstrated that compared to meniscectomy, meniscus repair causes lower rates of degenerative changes and reduces demand for knee replacement in the future ( 10 ). Posterior arthroscopy of the knee provides surgeons with the facilities to repair a variety of meniscus injuries.…”

Section: Meniscal Injuriesmentioning

confidence: 99%

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Is posterior knee arthroscopy using posterior portals necessary for orthopedic surgeons? The latest evidence on applications and techniques

et al. 2023

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Various uses of posterior knee arthroscopy have been shown, including all-inside repair of posterior meniscal lesions, posterior cruciate ligament (PCL) reconstruction or PCL avulsion fixation, extensile posterior knee synovectomy for pigmented villonodular synovitis or synovial chondromatosis, posterior capsular release in the setting of knee flexion contractures, and loose bodies removal. Posterior arthroscopy provides direct access to the posterior meniscal borders for adequate abrasion and fibrous tissue removal. This direct view of the knee posterior structures enables the surgeon to create a stronger biomechanical repair using vertical mattress sutures. During PCL reconstruction, posterior arthroscopy gives the surgeon proper double access to the tibial insertion site, which can result in less acute curve angles and the creation of a more anatomic tibial tunnel. Moreover, it gives the best opportunity to preserve the PCL remnant. Arthroscopic PCL avulsion fixation is more time-consuming with a larger cost burden compared to open approaches, but in the case of other concomitant intra-articular injuries, it may lead to a better chance of a return to pre-injury activities. The high learning curve and overcaution of neuromuscular injury have discouraged surgeons from practicing posterior knee arthroscopy using posterior portals. Evidence for using posterior portals by experienced surgeons suggests fewer complications. The evidence suggests toward learning posterior knee arthroscopy, and this technique must be part of the education about arthroscopy. In today's professional sports world, where the quick and complete return of athletes to their professional activities is irreplaceable, the use of posterior knee arthroscopy is necessary.

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Section: Meniscal Injuriesmentioning

confidence: 99%

Section: Meniscal Injuriesmentioning

confidence: 99%

Section: Meniscal Injuriesmentioning

confidence: 99%

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Is posterior knee arthroscopy using posterior portals necessary for orthopedic surgeons? The latest evidence on applications and techniques

et al. 2023

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“…Therefore, studies indicated that surgical treatment should be recommended to patients with high requirements and no to low-grade osteoarthritis [4,5]. Currently, there are several surgical options for the treatment of meniscus root tears, like meniscectomy, meniscal repair, and meniscus root reconstruction.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, there are several surgical options for the treatment of meniscus root tears, like meniscectomy, meniscal repair, and meniscus root reconstruction. Moreover, compared with meniscectomy or meniscal repair, some evidence indicates that meniscal root reconstruction can be performed to reestablish the normal biomechanics of the knee [5].…”

Section: Introductionmentioning

confidence: 99%

Medial meniscus posterior root tear reconstructed with gracilis autograft improve healing rate and patient reported outcome measures

Nie

Lan

2022

BMC Musculoskelet Disord

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Background Many surgeries have not reversed or prevented progressive symptomatic knee arthritis, and there is no consensus regarding the ideal repair or reconstruction technique for meniscal root treatment. Additionally, there is a lack of studies comparing the clinical efficacy evaluation of different repair techniques. The aim of the present study is to compare the clinical efficacy and healing rates of meniscus root in the treatment of medial meniscus posterior root tear (MMPRT) with the arthroscopically assisted meniscus root reconstruction with gracilis autograft and transtibial pull-out technique. Methods Patients with MMPRT (type II) who received treatment of posterior meniscus root attachment point through the tibial tunnel between January 2018 and April 2019 were included in this study. Patients were divided into 2 groups (arthroscopically assisted gracilis autograft reconstruction technique: 29 cases; transtibial pull-out technique group: 35 cases) according to the different treatment methods. The mean follow-up period was 26.9 ± 2.3 months. The demographics, functional recovery of the knee, and meniscus root healing rates (assessed using knee magnetic resonance imaging (MRI) at the final follow-up) were compared between the two groups. Results There was a statistically significant improvement in the Lysholm score, international knee documentation committee (IKDC) score, and visual analogue scale (VAS) score (P < 0.001 in both groups). Additionally, compared with the transtibial pull-out repair group, the arthroscopically assisted reconstruction with gracilis autograft showed significant improvement in the meniscus root healing rates, Lysholm score, and IKDC score at the end of follow-up (P < 0.05). Conclusions Compared with the transtibial pull-out technique, the arthroscopically assisted meniscus root reconstruction with gracilis autograft was advantageous for treating these patients with superior clinical outcome and higher meniscus root healing rates. Level of evidence Level III.

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Superior load‐to‐failure in an all‐suture anchor system for all‐inside meniscal repair compared to a PEEK‐cage anchor system in an experimental cadaveric test setting

Pichler,

Kiss,

Sator

et al. 2024

J. exp. orthop.

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PurposeThe purpose of this study was to compare the biomechanical properties of a latest generation all‐suture anchor repair device (ASARD) for meniscal repair with that of a latest generation PEEK‐cage anchor repair device (PCARD) in an experimental setting using cadaveric menisci.MethodsTwenty‐six menisci were obtained from the knees of fresh body donors. Artificially created meniscal lesions were treated randomly, using a single stitch with either an ASARD or a PCARD. Cyclic biomechanical testing, utilising a universal material testing machine and following an established protocol, was carried out and load‐to‐failure (LTF), displacement, stiffness, and mode‐of‐failure (MOF) reported.ResultsMean LTF was found to be 61% higher in the ASARD group at 107.10 N (standard deviation [SD], 42.34), compared to 65.86 N (SD, 27.42) in the PCARD group with statistical significance (p = 0.022). The ASARD exhibited a trend towards higher stiffness (10.35 N; SD, 3.92 versus 7.78 N; SD; 3.59) and higher displacement at cycles one, 100, and 499 (1.64, 3.27, and 4.17 mm versus 0.93, 2.19, and 2.83 mm) compared to the PCARD. Cheese wiring was the most common mode‐of‐failure in both groups (76.9%).ConclusionsThis study demonstrates that an ASARD shows a higher mean LTF than a PCARD when compared in an experimental biomechanical setting.Level of evidenceLevel III

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Comparison of Long-term Radiographic Outcomes and Rate and Time for Conversion to Total Knee Arthroplasty Between Repair and Meniscectomy for Medial Meniscus Posterior Root Tears: A Systematic Review and Meta-analysis

Cited by 52 publications

References 43 publications

Is posterior knee arthroscopy using posterior portals necessary for orthopedic surgeons? The latest evidence on applications and techniques

Is posterior knee arthroscopy using posterior portals necessary for orthopedic surgeons? The latest evidence on applications and techniques

Medial meniscus posterior root tear reconstructed with gracilis autograft improve healing rate and patient reported outcome measures

Superior load‐to‐failure in an all‐suture anchor system for all‐inside meniscal repair compared to a PEEK‐cage anchor system in an experimental cadaveric test setting

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