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Medial meniscus posterior root repair reduces the extruded meniscus volume during knee flexion with favorable clinical outcome

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The volume of medial meniscus (MM) extrusion at 10° and 90° knee flexions using three-dimensional (3D) magnetic resonance imaging (MRI) and assessed relevant clinical outcomes at 1-year follow-up were evaluated.

Methods

Twenty-four patients who underwent MM posterior root repair were retrospectively reviewed. At 10° and 90° knee flexions, the meniscal extrusion distance and volume were measured using 3D meniscus models constructed by SYNAPSE VINCENT®. The correlation between Knee Injury and Osteoarthritis Outcome Score, Lysholm, International Knee Documentation Committee scores, Tegner activity, and pain visual analog scales and changes in MM extrusion were assessed.

Results

No significant differences in the MM medial extrusion were observed between 10° and 90° knee flexions postoperatively. MM posterior extrusion (MMPE) decreased significantly at 10° and 90° knee flexions postoperatively. At 90° knee flexion, the meniscus volume at the intra-tibial surface increased at 3 and 12 months postoperatively. The MM extrusion volume increased slightly at 10° knee flexion; however, the volume decreased significantly at 90° knee flexion postoperatively. The change in MMPE significantly correlated with clinical scores. All 12-month clinical scores were significantly improved compared to preoperative scores.

Conclusions

The progression of meniscus posterior extrusion and reduction of its volume at 90° knee flexion can be suppressed by MM posterior root repair. Postoperative clinical scores correlated with reductions of the posterior extrusion. Regarding clinical relevance, the dynamic stability of the meniscus can be maintained by MM posterior root repair, which is an effective therapeutic method for improving its clinical status.

Level of evidence

Level IV.

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Abbreviations

MM:

Medial meniscus

MME:

Medial meniscus extrusion

MMEV:

Medial meniscus extrusion volume

MMME:

Medial meniscus medial extrusion

MMPE:

Medial meniscus posterior extrusion

MMPRT:

Medial meniscus posterior root tear

MMRV:

Medial meniscus remaining volume

MMV:

Medial meniscus volume

MRI:

Magnetic resonance imaging

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Acknowledgements

We would like to thank Editage (http://www.editage.jp) for English language editing.

Funding

No funding was received.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan

    Ximing Zhang, Takayuki Furumatsu, Yuki Okazaki, Takaaki Hiranaka, Haowei Xue, Keisuke Kintaka & Toshifumi Ozaki

  2. Department of Orthopaedic Surgery, Chikamori Hospital, 1-1-16 Okawasuji, Kochi, 780-8522, Japan

    Yoshiki Okazaki

  3. Division of Radiology, Medical Technology Department, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, 700-8558, Japan

    Takatsugu Yamauchi

Authors
  1. Ximing Zhang
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  2. Takayuki Furumatsu
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  3. Yoshiki Okazaki
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  4. Yuki Okazaki
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  5. Takaaki Hiranaka
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  6. Haowei Xue
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  7. Keisuke Kintaka
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  8. Takatsugu Yamauchi
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  9. Toshifumi Ozaki
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Contributions

TF designed the study. XZ, YoO, and TF prepared the manuscript. XZ, YoO, YuO, and TH contributed to the data collection. TO, HX, KK and TY contributed to the analysis of data. All authors have critically reviewed the manuscript, approved the final version of the manuscript, and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Takayuki Furumatsu.

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The authors report no conflicts of interest.

Ethics approval

This retrospective study was approved by the Institutional Review Board of Okayama University (ID: 1857). All the procedures performed in studies involving human participants were consistent with the ethical standards of the institutional review board and the 1964 Helsinki Declaration and its later amendments.

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Zhang, X., Furumatsu, T., Okazaki, Y. et al. Medial meniscus posterior root repair reduces the extruded meniscus volume during knee flexion with favorable clinical outcome. Knee Surg Sports Traumatol Arthrosc 29, 4205–4212 (2021). https://doi.org/10.1007/s00167-021-06505-y

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