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The impact of preoperative MRI-detected lateral meniscal intra-substance signal abnormalities on mid-term functional outcomes following mobile-bearing unicompartmental knee arthroplasty

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Abstract

Purpose

There is a dilemma as to whether the presence of degenerative changes of lateral meniscus is a contraindication to medial unicompartmental knee arthroplasty (UKA). Therefore, the purpose of this study is to assess the influence of preoperative MRI-detected lateral meniscal intra-substance signal abnormalities on mid-term functional outcomes following mobile-bearing UKA.

Methods

We performed a retrospective review of the record on a consecutive series of patients who have undergone mobile-bearing medial UKA from September 2020 to June 2023. The mean duration of follow-up was 2.34 years. All records were collected from case system. MRI assessment of lateral meniscus was performed with the use of the Stoller’s classification system. Patients were categorized into two groups (grade 0 and ≥ grade 1). Patient-reported outcomes were assessed with the use of the American Knee Society functional Score (AKSS-F), American Knee Society Objective Score (AKSS-O), and Oxford Knee Score (OKS) preoperatively and at latest follow-up. Furthermore, range of motion (ROM) and hip-knee-ankle angle (HKA) were measured in preoperative and postoperative periods.

Results

A total of 92 patients (101 knees) were included in our study. No differences in AKSS-F, AKSS-O, OKS, HKA, or ROM were found between those who showed normal or abnormal signal change of lateral meniscus preoperatively (P < 0.05). Furthermore, there were also no significant differences between two groups concerning AKSS-F, AKSS-O, OKS, HKA, or ROM at latest postoperative follow-up (P < 0.05). Age and duration of disease were independent predictors of low postoperative AKSS-F and AKSS-O (P < 0.05). Nevertheless, ROM was an independent predictor of high postoperative AKKS-O (P < 0.05). Age and female were independent predictors of high postoperative OKS (P < 0.05).

Conclusion

The presence of preoperative MRI-detected lateral meniscal degenerative changes did not affect mid-term functional outcomes in patients who underwent mobile-bearing medial UKA. On the basis of the results of the current study, we believe that the presence of degenerative changes of lateral meniscus is acceptable in mobile-bearing medial UKA.

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Data availability

All of the data are available in contact with the correspondence author.

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Funding

This work was supported by National High Level Hospital Clinical Research Funding, Elite Medical Professionals Project of China-Japan Friendship Hospital (grant number ZRJY2021-GG08) and National Natural Science Foundation of China (grant numbers 81972130, 82072494).

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Authors and Affiliations

  1. Graduate School of Beijing University of Chinese Medicine, Beijing, China

    Handong Chen & Yesihati Mulatibieke

  2. China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Changquan Liu & Wanshou Guo

  3. Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, China

    Qidong Zhang

  4. Department of Orthopaedics, China-Japan Friendship Hospital, No. 2, Yinghuadong Road, Chaoyang District, Beijing, 100029, China

    Qidong Zhang & Wanshou Guo

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Contributions

Handong Chen, Qidong Zhang, and Wanshou Guo designed the study; Handong Chen and Changquan Liu did the data collection. Changquan Liu and Yesihati Mulatibieke did the data analysis. Handong Chen wrote the article. Qidong Zhang and Wanshou Guo revised the article. All authors read and approved the final manuscript.

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Correspondence to Qidong Zhang or Wanshou Guo.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the institutional review board of China-Japan Friendship Hospital (approval number 2020–50-k28).

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Informed consent was obtained from all individual participants included in the study.

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Handong Chen and Changquan Liu are co-first authors.

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Chen, H., Liu, C., Mulatibieke, Y. et al. The impact of preoperative MRI-detected lateral meniscal intra-substance signal abnormalities on mid-term functional outcomes following mobile-bearing unicompartmental knee arthroplasty. International Orthopaedics (SICOT) 47, 2467–2475 (2023). https://doi.org/10.1007/s00264-023-05919-2

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