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Postoperative external tibial rotation is correlated with inferior meniscal healing following pullout repair of a medial meniscus posterior root tear

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to evaluate the influence of tibial rotation on the postoperative healing status of the medial meniscus (MM) following pullout repair of the MM posterior root tear (MMPRT).

Methods

Ninety-one patients (68 women and 23 men; mean age 63.3 ± 8.8 years) who had undergone transtibial pullout repair of MMPRT were enrolled in the study. The tibial external rotation angle (ERA) in each patient was measured postoperatively using computed tomography in the extended knee position. The meniscal healing status following transtibial pullout repair was assessed by second-look arthroscopy (mean postoperative period 12 months) using a previously published scoring system (range 0–10). The association between the ERA and the meniscal healing score was investigated using univariate linear regression models. The ERA cut-off for improved meniscal healing score (≥ 7) was determined using receiver-operating characteristic analysis.

Results

The ERA and the meniscal healing score were significantly associated, confirming that increased ERAs were correlated with worse meniscal healing status (R =  − 0.28; P < 0.001). The optimum ERA cut-off value was 0.5°, with a sensitivity of 68% and a specificity of 63%. The mean meniscal healing scores were 7.3 and 6.2 among patients with ERAs < 0.5° and those with ERAs ≥ 0.5°, respectively (P < 0.001).

Conclusion

This study demonstrated that the ERA was significantly correlated with the postoperative meniscal healing status. Postoperative tibial rotation could be one of the factors affecting postoperative outcomes of pullout repair of MMPRT. Controlling the tibial rotation may possibly improve meniscal healing.

Level of evidence

III.

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Acknowledgements

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

Funding

No funding was received in support of this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan

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

  2. Department of Orthopaedic Surgery, Kousei Hospital, 3-8-35 Kouseicho, Kitaku, Okayama, 700-0985, Japan

    Takayuki Furumatsu & Yuki Okazaki

  3. Department of Orthopaedic Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi, 781-8555, Japan

    Yusuke Kamatsuki

Authors
  1. Takaaki Hiranaka
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  2. Takayuki Furumatsu
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  4. Keisuke Kintaka
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  8. Toshifumi Ozaki
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Contributions

TF designed the study. TH and YO contributed to the analysis and interpretation of data. All authors contributed to data collection and interpretation, and critically reviewed the manuscript.

Corresponding author

Correspondence to Takayuki Furumatsu.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Institutional Review Board of Okayama University (Ethical approval No. 1857).

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Written informed consent was obtained from all study participants.

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Hiranaka, T., Furumatsu, T., Okazaki, Y. et al. Postoperative external tibial rotation is correlated with inferior meniscal healing following pullout repair of a medial meniscus posterior root tear. Knee Surg Sports Traumatol Arthrosc 30, 1491–1498 (2022). https://doi.org/10.1007/s00167-021-06656-y

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