Injury patterns of medial meniscus posterior root tears

Furumatsu, Takayuki; Okazaki, Yuki; Hino, Takanori; Kamatsuki, Yusuke; Masuda, S.; Miyazawa, Shinichi; Nakata, Eiji; Hasei, Joe; Kunisada, Toshiyuki

doi:10.1016/j.otsr.2018.10.001

Cited by 47 publications

(35 citation statements)

References 24 publications

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“…Thirty-eight patients (23 women and 15 men, a mean age of 63.2 years), who underwent transtibial pullout repairs for MMPRT between May 2018 and January 2019, were included ( Table 1). All the patients had an episode of a sudden posteromedial painful popping, continuous knee pain, and complete radial/ oblique MMPRT (meniscal root tear classification, types 2/4) [7,12]. Patients who had radiographic knee osteoarthritis involved in Kellgren-Lawrence grade III or more and a previous history of meniscus injury or knee surgery were excluded.…”

Section: Methodsmentioning

confidence: 99%

The accuracy of a newly developed guide system in medial meniscus posterior root repair: a comparison between two aiming guides

Furumatsu

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.

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Section: Methodsmentioning

confidence: 99%

The accuracy of a newly developed guide system in medial meniscus posterior root repair: a comparison between two aiming guides

Furumatsu

Kodama

Okazaki

et al. 2019

Knee Surg & Relat Res

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“…The interest in medial meniscus posterior root tears (MMPRT) has been increasing, and they have been widely studied. Knee motions associated with descending stairs and downhill slopes are the most common injury patterns of MMPRTs [9]. MMPRT pullout repair is recommended to prevent subsequent cartilage degeneration or meniscus extrusion [4], and favourable clinical outcomes have been reported after transtibial pullout repair of MMPRT [16,22].…”

Section: Introductionmentioning

confidence: 99%

Steep posterior slope and shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tears

Furumatsu

Kodama

Kamatsuki

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Purpose Bone morphological factors are important for menisci. Their association with medial meniscus posterior root tears, however, has not yet been studied. This study aimed to compare sagittal medial tibial slope and medial tibial plateau depth between knees with and without medial meniscus posterior root tears. Methods Nine healthy volunteers, 24 patients who underwent anterior cruciate ligament reconstruction, and 36 patients who underwent medial meniscus posterior root pullout repair were included. Magnetic resonance imaging examinations were performed in the 10°-knee-flexed position. The medial tibial slope and medial tibial plateau depth were compared among the groups. Results In healthy volunteers, the anterior cruciate ligament reconstruction group, and the medial meniscus posterior root tear group, the medial tibial slopes were 3.5° ± 1.4°, 4.0° ± 1.9°, and 7.2° ± 1.9°, respectively, and the medial tibial plateau depths were 2.1 ± 0.7 mm, 2.2 ± 0.6 mm, and 1.2 ± 0.5 mm, respectively. Patients with medial meniscus posterior root tears had a significantly steep medial tibial slope and shallow medial tibial plateau concavity compared to those of healthy volunteers (P < 0.01) and the anterior cruciate ligament group (P < 0.01). In the multivariate logistic regression analysis, body mass index, medial tibial slope, and medial tibial plateau depth were significantly associated with medial meniscus posterior root tears. Conclusions A steep posterior slope and a shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tear. Level of evidence Level III: Case-control study.

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“…The mechanism of posterior horn root tears has been hypothesized to be due to squatting or high-flexion exercises of the knee and in one study has been suggested to often be due to slight knee flexion while descending stairs. 13,14 Anterior horn tears may occur with activities performed in the knee in extension (e.g. kicking during soccer).…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of meniscus repair and partial meniscectomy: Does tear configuration matter?

Gan

Lie

Lee

2020

J Orthop Surg (Hong Kong)

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Purpose: We report our experience with the effect of location and configuration of meniscal tears on clinical outcomes. Methods: A retrospective review of patients who underwent partial meniscectomy or meniscal repair between 2008 and 2016 was conducted. One hundred fourteen knees in 106 patients were included, comprising 43 partial meniscectomies and 71 meniscal repairs. Patients were graded pre- and postoperatively with the International Knee Documentation Committee (IKDC) score and Tegner Activity Level Scale. Meniscal tears were classified according to location (anterior horn, body, posterior horn, and others) and type (radial, horizontal, longitudinal, and complex) and subgroups were analyzed for their effect on outcomes. Results: All tears, whether treated with partial meniscectomy or repair, showed significant improvement in postoperative scores ( p < 0.05); 39.47% of tears involved the posterior horn alone, 10.53% involved the body alone, 3.51% involved the anterior horn alone, and 46.49% were complex tears that spanned more than one area. Complex tears treated with repair had significantly better scores (IKDC, p = 0.002; Tegner, p = 0.008) than complex tears treated with meniscectomy. Longitudinal tears showed results suggesting better short-term outcomes with meniscectomy than with repair (IKDC, p = 0.036; Tegner p = 0.018), a potential statistical anomaly. Horizontal and radial tears showed no significant difference in outcomes, regardless of treatment. Tears in different locations (anterior horn, body, posterior horn, and others) showed no significant difference in outcomes, regardless of treatment. Conclusion: Meniscal surgery yields significant improvement in postoperative scores. Complex tears showed significantly better postoperative scores when treated with repair.

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Injury patterns of medial meniscus posterior root tears

Cited by 47 publications

References 24 publications

The accuracy of a newly developed guide system in medial meniscus posterior root repair: a comparison between two aiming guides

The accuracy of a newly developed guide system in medial meniscus posterior root repair: a comparison between two aiming guides

Steep posterior slope and shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tears

Clinical outcomes of meniscus repair and partial meniscectomy: Does tear configuration matter?

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