Influence of posteromedial corner injuries on clinical outcome and second-look arthroscopic findings after allograft transtibial anterior cruciate ligament reconstruction

Yoo, Jun-Young; Park, Hee-Gon; Kwon, Soonmin

doi:10.1186/s43019-020-00061-4

Cited by 5 publications

(6 citation statements)

References 25 publications

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“…Basically, higher engagement in physical and sports activities will lead to a higher chance of ACL injury. 7) It can be presumed that the number of people engaging in high-level athletics is higher in Western countries than in Korea.…”

Section: Discussionmentioning

confidence: 99%

An Increasing Trend in the Number of Anterior Cruciate Ligament Reconstruction in Korea: A Nationwide Epidemiologic Study

et al. 2022

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Background Most epidemiologic studies of anterior cruciate ligament reconstruction (ACLR) to date have been conducted in Western populations, whereas no studies have been conducted in Asian populations. In this study, the incidence and trend of ACLR in Korea were investigated through an epidemiological big data analysis. Methods The data were collected by the Health Insurance Review and Assessment Service from 2008 to 2016 in Korea. Patient records with the coding of cruciate ligament reconstruction were allocated, and ACLR patients were further refined by medical diagnosis coding. The total number and incidence of ACLR procedures per 100,000 person-years were investigated and more detailed analysis was conducted according to sex and age. Furthermore, concomitant surgical procedures performed during ACLR were investigated. Results The total number and incidence of ACLR procedures rose from 10,248 and 21.8 to 14,500 and 29.1 between 2008 and 2016, respectively. The incidence of ACLR procedures increased by 33.5% over this 9-year period. Over this period, the total number and incidence increased from 8,543 and 36.4 to 11,534 and 46.4, respectively, in males and from 1,705 and 7.2 to 2,966 and 11.9, respectively, in females. ACLR was performed more frequently in males than in females; however, the increase rate was higher in females than males. ACLR was performed most frequently in patients in their 20s, followed by patients in their 30s, 40s, and 10s. The most frequent concomitant procedures performed during ACLR were meniscectomy (13.6% in 2008 and 9.8% in 2016) and meniscal repair (5.8% in 2008 and 8.8% in 2016). Conclusions The incidence of ACLR consistently rose between 2008 and 2016 in Korea. The current study will enhance our understanding of the epidemiology of ACLR, which is needed to devise cost-effective preventive measures.

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Section: Discussionmentioning

confidence: 99%

An Increasing Trend in the Number of Anterior Cruciate Ligament Reconstruction in Korea: A Nationwide Epidemiologic Study

et al. 2022

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“… 8 , 20 However, the clinical outcomes of MM repair were known to be less successful than those of LM repair. 21 , 54 Kim et al 21 reported that the healing rate was 80% with MM repair but 91.2% with LM repair. Recent systemic review studies reported that the overall healing rate ranged from 75.6% to 76.1% with MM repair but 80.5% to 87.4% with LM repair.…”

Section: Discussionmentioning

confidence: 99%

“… 1 , 5 , 6 , 14 , 31 , 48 , 53 However, observation of failed healing after meniscal repair indicated that findings using an MRI scan may not entirely correlate with clinical failures or findings of second-look arthroscopy. 40 , 51 , 53 , 54 Several studies have noted that some incomplete or unhealed meniscal lesions identified on MRI scans were found to be completely healed at the time of second-look arthroscopy and healed clinically. 31 , 41 These MRI findings of incomplete or unhealed meniscal lesions could be found for many years after successful meniscal repair.…”

Section: Discussionmentioning

confidence: 99%

“… 10 , 12 , 47 Thus, intraoperative diagnosis and appropriate treatment of MMPH peripheral longitudinal tears are important to restore knee biomechanics and improve the clinical outcomes of ACL surgery. 10 , 12 , 24 , 26 , 47 , 54 Furthermore, an increased healing rate of meniscal lesions has been reported when concomitant meniscal repair and ACL reconstruction (ACLR) are performed. Preoperative suspicion and aggressive treatment are important for an increased healing rate of meniscal lesions.…”

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confidence: 99%

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Clinical and MRI Outcomes of Repaired Peripheral Longitudinal Tears of the Posterior Horn of the Medial Meniscus With ACL Reconstruction: Results According to Tear Size

Kim,

Min,

Kim

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Arthroscopic repair of longitudinal tears in the medial meniscal posterior horn (MMPH) has been reported to result in high rates of meniscal healing when performed alongside anterior cruciate ligament reconstruction (ACLR). However, studies that have focused on longitudinal tears and their impact on clinical outcomes after arthroscopic repair are insufficient. Purpose: To investigate the clinical outcome and healing status after concomitant arthroscopic ACLR and repair of MMPH peripheral longitudinal tears, with respect to the tear length. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 263 patients who underwent concurrent arthroscopic suture repair of longitudinal tears of the MMPH and ACLR were enrolled. All patients had 2-year postoperative magnetic resonance imaging (MRI) evaluations, and 61% of patients underwent a second-look arthroscopy. The exclusion criteria were partial meniscectomies and multiligament injuries. Patients were assessed pre- and postoperatively for clinical scores, amount of anterior translation, grade of pivot shift, and presence of meniscal tear extension. According to the length of longitudinal tears, patients were classified into 2 groups: (1) patients with tears that were located in the posterior compartment and (2) patients with tears that extended to the midbody of the meniscus. Binary stepwise logistic regression analysis was used to evaluate the risk factors for unhealed menisci as identified by MRI. Results: A total of 83 patients were included in this study—52 patients (group 1) had MMPH tears without tear extension and 31 patients (group 2) had MMPH tears with tear extension. There were no differences in outcomes between the groups, including the healing rate after meniscal repair ( P > .05). Based on postoperative MRI scans, 67 patients (80.7%) were categorized as completely healed and 16 patients (19.3%) as unhealed. There were no significant differences between the completely healed and unhealed groups in outcomes or the rate of preoperative midbody tear extension. Higher body mass index and lower preoperative Lysholm scores were identified as risk factors for unhealed menisci. Conclusion: Overall, the rate of complete healing of MMPH tears repaired concomitantly with ACLR was 80.7% (67/83), and midbody tear extension did not affect the healing rate of the repaired meniscus. Results indicate that suture repair for unstable MMPH tears should be considered regardless of tear size.

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“…The MCL is one of the major ligaments supporting the knee joint and is the most commonly injured ligament [1,66,67]. Considering the neglected injuries and the recent increasing popularity of sports participation among both the general public and professional athletes, the frequency of MCL injuries might be much higher than expected.…”

Section: Summary and Future Directionmentioning

confidence: 99%

Mesenchymal Stem Cells for Enhanced Healing of the Medial Collateral Ligament of the Knee Joint

et al. 2023

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Background and Objectives: The medial collateral ligament (MCL) is one of the major supporting ligaments of the knee joint, and MCL injuries are common where excessive valgus loading is applied to the knee joint. Although most MCL injuries can be treated conservatively, healing of the MCL can take several weeks to months. Furthermore, once injured, the biomechanical properties of the healed MCL differ from those of the native MCL, resulting in an increased risk of re-injury and chronic remnant symptoms. Mesenchymal stem cells (MSCs), owing to their therapeutic potential, have been investigated in various musculoskeletal injuries, and some preclinical studies regarding MSC-based approaches in MCL injuries have shown promising results. Despite satisfactory results in preclinical studies, there is still a lack of clinical studies in the orthopedic literature. This article describes the basic knowledge of the MCL, standard treatments for MCL injuries, and recent studies regarding the application of MSCs for enhanced healing of the MCL. MSC-based approaches are expected to be a potential therapeutic option for enhanced healing of the MCL in the future.

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Influence of posteromedial corner injuries on clinical outcome and second-look arthroscopic findings after allograft transtibial anterior cruciate ligament reconstruction

Cited by 5 publications

References 25 publications

An Increasing Trend in the Number of Anterior Cruciate Ligament Reconstruction in Korea: A Nationwide Epidemiologic Study

An Increasing Trend in the Number of Anterior Cruciate Ligament Reconstruction in Korea: A Nationwide Epidemiologic Study

Clinical and MRI Outcomes of Repaired Peripheral Longitudinal Tears of the Posterior Horn of the Medial Meniscus With ACL Reconstruction: Results According to Tear Size

Mesenchymal Stem Cells for Enhanced Healing of the Medial Collateral Ligament of the Knee Joint

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