Meniscal Injury Does Not Significantly Affect the Dimensions of the Intact Meniscus in the Opposite Compartment of the Knee

Yoon, Kyoung Ho; Song, Sang Jun; Lee, Hee Sung; Park, Cheol Hee

doi:10.1177/2325967120904328

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…In the present study, the widths of the anterior horn, midbody, and posterior horn were 9.1, 7.5, and 9.5 mm, respectively, at 3 months after surgery and 8.6, 6.1, and 8.9 mm, respectively, at 24 months after surgery; the average normal widths of these lateral meniscal structures are 10.9, 9.6, and 9.7 mm, respectively. 37 In our study, the difference in midbody width was <3 mm compared with normal values.…”

Section: Discussioncontrasting

confidence: 40%

Morphological Changes in the Residual Meniscus After Reshaping Surgery for a Discoid Lateral Meniscus

et al. 2021

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Background: Arthroscopic reshaping surgery is the first treatment option for a symptomatic discoid lateral meniscus (DLM) to preserve the peripheral rim. However, the degree of postoperative morphological change in the residual meniscus is unclear. Purpose/Hypothesis: The purpose of this study was to measure the meniscus after reshaping surgery for a DLM, to verify when the morphological change occurred, and to examine the related risk factors. The hypothesis was that the residual meniscal width would decrease throughout the postoperative course. Study Design: Case-control study; Level of evidence, 3. Methods: We retrospectively reviewed the medical records of patients who underwent reshaping surgery for a symptomatic DLM and had undergone follow-up for ≥2 years. Magnetic resonance imaging (MRI) was routinely performed preoperatively and at 3, 6, 12, and 24 months postoperatively, and the width, height, and extrusion of the residual meniscus were measured. According to the width of the midbody on final MRI scans, we compared the preoperative and postoperative data for the preserved group (≥5 mm) and decreased group (<5 mm). The associated risk factors for a decreased meniscal width (<5 mm) of the midbody were analyzed on final MRI scans. Results: We included 61 knees of 54 patients in this study. The mean age at the time of surgery was 11.7 years. The intraobserver and interobserver reliabilities of the midbody width were 0.937 and 0.921, respectively. The width of the anterior horn, midbody, and posterior horn decreased significantly from 3 to 24 months after surgery (from 9.1 to 8.6 mm [ P < .001], from 7.5 to 6.1 mm [ P < .001], and from 9.5 to 8.9 mm [ P = .001], respectively). Meniscal extrusion of the midbody did not change significantly (from 1.2 to 1.5 mm; P = .062). Overall, 46 knees (n = 20/32 in the preserved group and n = 26/29 in the decreased group) had longitudinal tears that required meniscal repair. Clinical outcomes did not differ significantly between the 2 groups. Multivariate logistic analysis showed that intrameniscal degeneration (odds ratio, 4.36; P = .023) significantly increased the risk of a decreased meniscal width. Conclusion: The width of the anterior horn, midbody, and posterior horn decreased significantly from 3 to 24 months after surgery. In particular, the average decrease rate of the midbody was 19%. No clinical difference was seen in patients with a decreased width and height or with peripheral extrusion. Increased intrameniscal signals on preoperative MRI scans were associated with an increased risk of a decreased meniscal width. Surgeons should consider this result to determine the amount of resection.

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Section: Discussioncontrasting

confidence: 40%

Morphological Changes in the Residual Meniscus After Reshaping Surgery for a Discoid Lateral Meniscus

et al. 2021

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“…The width of the body of the lateral meniscus was reported to be 9.8 ± 1.9 mm. 8 Therefore, more remaining residual meniscus width must be needed, especially for AC shifts of the DLM. The advantages of this technique are as follows: (1) accurate saucerization can be provided by defining the starting point and the length of the cutting width of 1 cm; (2) the risk of excessive resection of the posterior segment is reduced by this technique; (3) this technique requires only standard meniscectomy and repair skills ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Saucerization With Inside-Out Repair and Anterocentral Shift of a Discoid Lateral Meniscus With Retention of Adequate Volume of Residual Meniscus

Hashimoto

Yamasaki

Reid

et al. 2021

Arthroscopy Techniques

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Preservation of the meniscus has been shown to influence the progression of osteoarthritic changes in the knee. Discoid lateral meniscus (DLM) is classified on the basis of the presence and location of instability resulting from deficient capsular attachments. Recently, meniscal stabilization after saucerization was recommended in cases of DLM to preserve the meniscus shape and avoid the progression of osteoarthritis. However, it is difficult to identify the accurate resection volume and residual meniscal width during surgery, especially when there is an anterocentral shift of the DLM. This Technical Note describes an arthroscopic technique for an anterocentral shift of the DLM in which we highlight the resection point and confirm the methods of retaining an adequate volume of residual meniscus to restore and maintain the shape and function of the meniscus. Level of Evidence Level 1, Knee; Level 2 , Meniscus.

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Concomitant anterior medializing osteotomy and MPFL reconstruction improves patellar tilt when compared to MPFL reconstruction alone

Pascual-Leone

Chipman

Meza

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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PurposeUnderstanding how surgical procedures influence anatomic factors associated with patellofemoral instability can help guide surgeons when planning treatments for individual patients. This study sought to understand how patellar tilt is affected in adolescent patients with elevated pre‐operative tibial tuberosity to trochlear groove (TT‐TG) values undergoing medial patellofemoral ligament reconstruction (MPFLR) with or without an anterior medializing osteotomy (AMZ). MethodsUtilizing a prospective database of 274 patellofemoral instability patients who underwent MPFLR ± AMZ by one of two orthopedic surgeons at a single institution, those who underwent MPFLR + AMZ were identified. Pre‐operative and post‐operative magnetic resonance imaging (MRI) were used to measure TT‐TG distance, while radiographs were used to measure patellar tilt (tilt). Patients were matched based on age at surgery (within 2 years) and pre‐operative TT–TG distance (within 2 mm) to a comparison cohort of patients who underwent isolated MPFLR (iMPFLR) without osseous procedures. ResultsA total of 56 patients were analyzed (28 per group). The mean age of the cohort was 15.5 ± 2.0 years and was similar between both groups (15.9 ± 1.9 versus 15.1 ± 2.0 years [n.s]). When comparing the two cohorts, significant pre‐ to post‐operative decreases in patellar tilt for both MPFLR + AMZ (6.6 degrees, p < 0.001) and iMPFLR (3.9 degrees, p = 0.013) were noted. While there were no differences in pre‐operative patellar tilt (21.2 ± 3.5 versus 21.1 ± 3.4 [n.s]), post‐operatively, MPFLR + AMZ had significantly less patellar tilt than iMPFLR (13.2 ± 5.5 versus 16.5 ± 4.4, p = 0.017). ConclusionsThis study found that patellar tilt significantly improved in participants undergoing either MPFLR + AMZ or iMPFLR. In addition, those undergoing MPFLR + AMZ were found to have significantly lower post‐operative tilt than those undergoing iMPFLR. If patellar tilt is found pre‐operatively to be significantly elevated and a risk for future dislocations, these findings suggest that surgeons might strongly consider MPFLR with AMZ to further address the increased tilt. Level of evidenceIII.

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Meniscal Injury Does Not Significantly Affect the Dimensions of the Intact Meniscus in the Opposite Compartment of the Knee

Cited by 3 publications

References 16 publications

Morphological Changes in the Residual Meniscus After Reshaping Surgery for a Discoid Lateral Meniscus

Morphological Changes in the Residual Meniscus After Reshaping Surgery for a Discoid Lateral Meniscus

Arthroscopic Saucerization With Inside-Out Repair and Anterocentral Shift of a Discoid Lateral Meniscus With Retention of Adequate Volume of Residual Meniscus

Concomitant anterior medializing osteotomy and MPFL reconstruction improves patellar tilt when compared to MPFL reconstruction alone

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