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Published on: July 6, 2022
Medial joint space narrowing progresses after pullout repair of medial meniscus posterior root tear
Koki Kawada1, Takayuki Furumatsu2,3, Masanori Tamura1
1Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan.
Purpose:
The extent to which arthropathic changes progress after medial meniscus posterior root tear (MMPRT) repair remains controversial. This retrospective study assessed medial joint space (MJS) narrowing progression after pullout repair for MMPRT and identified the correlating factors.
Methods:
We included 56 patients who underwent pullout repair for MMPRT. The MJS of the bilateral knees was assessed with radiography using the fixed-flexion view. A second-look arthroscopy was performed one year post-operatively for all patients. The baseline characteristics, clinical scores, Kellgren-Lawrence (KL) grade, and medial meniscus extrusion (MME) were identified. Statistical comparisons and correlation analyses were conducted.
Results:
The MJS narrowing width was significantly larger in MMPRT knees than in contralateral knees (0.51 ± 0.85 mm vs. 0.09 ± 0.49 mm, p < 0.001). KL grade progression was observed in 23.2% (13/56) of patients. There was a significant difference between pre- and post-operative MME values, indicating MME progression (p < 0.001). Each clinical score showed significant improvement one year post-operatively (p < 0.001). Positive correlations were found between MJS narrowing and pre-operative MJS (coefficient = 0.510, p < 0.001), rate of change in MJS (coefficient = 0.929, p < 0.001), and increase in MME (ΔMME) (coefficient = 0.506, p < 0.001).
Conclusion:
Knees that underwent pullout repair for MMPRT showed progression of MJS narrowing by 0.51 mm at one year post-operatively, although clinical scores markedly improved. Correlating factors for MJS narrowing were pre-operative MJS, rate of change in MJS, and ΔMME. Preventing MME progression is essential for preventing arthropathic changes.
Insights
Medial meniscus posterior root tear repair showed joint space narrowing one year post-surgery, despite improved clinical scores. Preventing medial meniscus extrusion is key to limiting arthropathic changes.
Area of Science:
- Orthopedic surgery
- Knee biomechanics
- Radiographic assessment
Background:
- Medial meniscus posterior root tears (MMPRT) can lead to arthropathic changes.
- The progression of osteoarthritis after MMPRT repair is not fully understood.
- Pullout repair is a common surgical technique for MMPRT.
Purpose of the Study:
- To assess medial joint space (MJS) narrowing progression after MMPRT pullout repair.
- To identify factors correlating with MJS narrowing post-MMPRT repair.
Main Methods:
- Retrospective analysis of 56 patients undergoing MMPRT pullout repair.
- Radiographic assessment of MJS narrowing using fixed-flexion view.
- Evaluation of pre- and post-operative medial meniscus extrusion (MME) and Kellgren-Lawrence (KL) grade.
Main Results:
- Significant MJS narrowing (0.51 mm) observed in operated knees compared to contralateral knees (0.09 mm).
- 23.2% of patients showed Kellgren-Lawrence grade progression.
- Medial meniscus extrusion (MME) progression was significant (p < 0.001).
- Positive correlations found between MJS narrowing and pre-operative MJS, rate of MJS change, and increase in MME (ΔMME).
Conclusions:
- MMPRT pullout repair is associated with MJS narrowing progression at one year.
- Clinical scores significantly improved post-operatively.
- Pre-operative MJS, MJS change rate, and ΔMME are key factors influencing MJS narrowing.
- Preventing MME progression is crucial for mitigating arthropathic changes after MMPRT repair.
