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Bidirectional Evaluation for the Lateral Meniscal Extrusion After Repairing Isolated Longitudinal Tear

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Bidirectional Evaluation for the Lateral Meniscal Extrusion After Repairing Isolated Longitudinal Tear

Akira Tsujii, MD, PhD, JAPAN Seira Sato, MD, PhD, JAPAN Tomoki Ohori, MD, PhD, JAPAN Tatsuo Mae, MD, PhD, JAPAN Kazutaka Kinugasa, MD, PhD, JAPAN Yasukazu Yonetani, MD, PhD, JAPAN Masayuki Hamada, MD, JAPAN Ken Nakata, MD, PhD, JAPAN

Osaka University, Suita, Osaka, JAPAN

2023 Congress ePoster Presentation 2023 Congress Not yet rated

Anatomic Location

Knee

Anatomic Structure

Meniscus Lateral

Diagnosis / Condition

Tears

Treatment / Technique

Repair / Reconstruction

Diagnosis Method

MRI

Summary: Not only lateral extrusion but also posterior extrusion should be evaluated on MRI to assess meniscal function because the posterior extrusion changes largely after the operation over time.

Purpose

The incidence of meniscal repairs increases over the past few decades due to understanding of its crucial, chondroprotective, role in knee joints and due to advancements in surgical instruments. Meniscal extrusion has become widely recognized as one of the measurement methods for meniscal function because extruded meniscus is associated with meniscal tear, cartilage damage, and tibiofemoral osteoarthritis. We have already reported that postoperative lateral meniscus extruded posteriorly over time in the repaired meniscus with concomitant anterior cruciate ligament reconstruction (ACLR), but meniscal position might be changed because ACLR changes tibiofemoral relationship. It is unknown how meniscal extrusion changes in the isolated meniscus tear. Thus, the purpose of this study is to evaluate meniscal extrusion on magnetic resonance images (MRI) after repairing isolated lateral meniscus (LM) tear.

Methods

From 2014 to February 2022, 215 patients underwent isolated meniscal repair. Among them, patients who underwent inside-out repair for isolated LM longitudinal tears were retrospectively reviewed. After surgery, operated knee was immobilized with a brace for 2 weeks, then range of motion exercise and partial weight bearing were started, and full weight bearing was allowed at 4 weeks. Jogging was allowed at 3 months, and a return to sports activities was permitted after 6 months. Patients who underwent MRI at 3 time points (preoperatively, immediately after the operation, and 6 months postoperatively) were included, and patients who had locked lateral meniscus were excluded because preoperative MRI measurements were not available. Finally, 10 patients were included in this study. Meniscal extrusion was assessed in coronal and sagittal plane, and the changes from pre- to post-operative values were analyzed with the preoperative value as the baseline. Lateral extrusion was measured by the distance from the peripheral margin of the lateral tibial plateau to the meniscocapsular junction of the LM in coronal plane. Posterior extrusion was measured by the distance from the inner margin of the anterior horn of the LM to the meniscocapsular junction of the posterior horn of the LM in sagittal plane.

Results

There were 9 female and 2 male patients with a mean age of 26.2. All patients had no pain and swelling with no difficulty in daily activities at final follow-up. Mean changes of the lateral/posterior extrusion were -0.2 ± 0.8 / 0.8 ± 1.6 mm at immediately after the operation and -0.4 ± 0.7 / 1.7 ± 1.6 mm at 6 months postoperatively.

Conclusions

It was shown that posterior extrusion increased immediately after inside-out repair and it progressed at 6 months postoperatively, while lateral extrusion had not changed. This might be due to that the tear sites were posterior segment and the sutures were tightened against posterior joint capsule. As in the case of LM repair with concomitant ACLR, meniscal extrusion towards posterior direction progressed over time. Meniscal extrusion should be evaluated not only on coronal plane but also on sagittal plane.

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Do All Meniscal Ramp Lesions Require Repair? A Prospective Study Of Ramp Lesions with Concomitant ACL Injury? ePoster Presentation Silvampatti Ramasamy Sundararajan, MS(Orth), INDIA Meet Mehta, MD orthopaedics, INDIA Terence Dsouza, MS, DNB, FNB, INDIA Ramakanth Rajagopalakrishnan, D.ortho, DNB(ortho).D.SICOT, INDIA S Rajasekaran, MS(Orth),DOrth,DNB,FRCS(Ed),FRCS(Lon),MCh(Liv),PhD, INDIA
Comparing the Risk of Iatrogenic Peroneal Nerve Injury in All-inside Lateral Meniscus Repair between Preoperative and Real Arthroscopic Position MRIs ePoster Presentation Chaiwat Chuaychoosakoon, MD, THAILAND Wachiraphan Parinyakhup, MD, THAILAND Tanarat Boonriong, Principal, THAILAND
Continuous Vertical Inside-Out Versus Traditional Vertical Inside-Out Meniscal Repair: A Biomechanical Comparison ePoster Presentation José Leonardo Rocha De Faria , MD, MSc, BRAZIL Arthur Paiva Grimaldi Santos, M.Sc., BRAZIL Douglas Mello Pavão, MD, MSc, PhD, BRAZIL Mariana Radulski, Medical Student, BRAZIL Ana Carolina Leal, PhD, BRAZIL Ari Digiácomo Ocampo Moré, PhD, BRAZIL Alan de Paula Mozella, PhD, Prof., BRAZIL Joao ANTONIO MATHEUS GUIMARAES, BRAZIL Robert F. LaPrade, MD, PhD, UNITED STATES Carlos Rodrigo de Mello Roesler, PhD, BRAZIL Rodrigo Salim, MD,PhD, BRAZIL

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Bidirectional Evaluation for the Lateral Meniscal Extrusion After Repairing Isolated Longitudinal Tear

Bidirectional Evaluation for the Lateral Meniscal Extrusion After Repairing Isolated Longitudinal Tear

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Bidirectional Evaluation for the Lateral Meniscal Extrusion After Repairing Isolated Longitudinal Tear

Bidirectional Evaluation for the Lateral Meniscal Extrusion After Repairing Isolated Longitudinal Tear

Purpose

Methods

Results

Conclusions

More 2023 ISAKOS Congress Content