2019 ISAKOS Biennial Congress Paper #37
Characteristic Location and Rapid Progression of Medial Femoral Condylar Chondral Lesions Accompanying Medial Meniscus Posterior Root Tear
Jae-Young Park, MD, Seoul KOREA, REPUBLIC OF
Seung-Bin Im, MD, Seoul KOREA, REPUBLIC OF
Tae-Hoon Kang, MD, Seoul KOREA, REPUBLIC OF
Duhyun Ro, MD, Prof. , Jongno-Gu, Seoul KOREA, REPUBLIC OF
Hyuk-Soo Han, MD, PhD, Seoul KOREA, REPUBLIC OF
Myung Chul Lee, MD, PhD, Prof., Seoul KOREA, REPUBLIC OF
Seoul National University Hospital, Seoul, KOREA, REPUBLIC OF
FDA Status Not Applicable
Summary
medial femoral condyle lesions accompanying medial meniscus posterior root tear were located more medially and progressed faster than those with non-root horizontal tear
Abstract
Purpose
This study aims to evaluate the characteristics of the chondral lesion at the medial femoral condyle (MFC) in patients with medial meniscal posterior root tear (MMPRT) and to compare the progression rate of the accompanying chondral disease in MMPRT with that in degenerative non-radial tear.
Methods
Thirty-one patients who did not respond over a 3-month conservative treatment and underwent arthroscopic surgery for MMPRT and 31 controls who underwent arthroscopic surgery for degenerative medial meniscus posterior horn horizontal tear (MMPHT) were included. Accompanying chondral lesions in the MFC were evaluated by magnetic resonance imaging (MRI) at initial diagnosis and from video taken at arthroscopic surgery using the International Cartilage Repair Society (ICRS)–Articular cartilage injury classification system. The difference in severity and extent of the chondral lesion between initial diagnosis and arthroscopic surgery was measured.
Results
Twenty-five patients with MMPRT (80.6%) and 29 patients (93.5%) with MMPHT had ICRS grade = 2 chondral injuries at MFC, respectively. In the MMPRT and MMPHT groups, the most severely injured areas of the MFC were the far medial compartment (52%) and central compartment (51%), respectively. Comparing the MRI and arthroscopic findings, 12 patients (39%) in the MMPRT-group showed progression of the chondral disease after a mean of 3.5 months, whereas only 3 patients (10%) in the MMPHT-group showed progression after a mean of 3.1 months (p = 0.005).
Conclusion
MFC lesions accompanying MMPRT were located more medially and progressed faster than those with non-root horizontal tear. Early intervention should be considered to prevent chondral lesion progression accompanying MMPRT.