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Large meniscus extrusion ratio is a poor prognostic factor of conservative treatment for medial meniscus posterior root tear

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to find a prognostic factor of medial meniscus posterior root tear (MMPRT) for surgical decision making.

Methods

Eighty-eight patients who were diagnosed as acute or subacute MMPRT without severe degeneration of the meniscus were treated conservatively for 3 months. Fifty-seven patients with MMPRT showed good response to conservative treatment (group 1), while the remaining 31 patients who failed to conservative treatment (group 2) received arthroscopic meniscus repair. Their demographic characteristics and radiographic features including hip-knee-ankle angle, joint line convergence angle, Kellgren–Lawrence grade in plain radiographs, meniscus extrusion (ME) ratio (ME-medial femoral condyle ratio, ME-medial tibial plateau ratio, ME-meniscus width ratio), the location of bony edema, and cartilage lesions in MRI were compared. Receiver operating characteristic (ROC) curve analysis was also performed to determine the cut-off values of risk factors.

Results

The degree of ME-medial femoral condyle and medial tibia plateau ratio of group 2 was significantly higher than group 1 (0.08 and 0.07 vs. 0.1 and 0.09, respectively, both p < 0.001). No significant (n.s.) difference in other variables was found between the two groups. On ROC curve analysis, ME-medial femoral condyle ratio was confirmed as the most reliable prognostic factor of conservative treatment for MMPRT (area under ROC = 0.8).

Conclusion

The large meniscus extrusion ratio was the most reliable poor prognostic factor of conservative treatment for MMPRT. Therefore, for MMPRT patients with large meniscus extrusion, early surgical repair could be considered as the primary treatment option.

Level of evidence

III.

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Author’s contribution

YHK collected data, performed statistical analysis, interpreted data, and wrote the manuscript. SHL participated in the design of the study. MCL participated in the design of the study, coordinated in the study, and drafted part of the manuscript. HSH participated in the design of the study and proofread the manuscript as the corresponding author. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea

    Yoon-Ho Kwak, Sahnghoon Lee, Myung Chul Lee & Hyuk-Soo Han

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  1. Yoon-Ho Kwak
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  2. Sahnghoon Lee
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Correspondence to Hyuk-Soo Han.

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The authors have no competing interests to declare.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

This study is retrospective study, then we were exempted informed consent by the institutional review board (IRB) of Seoul National University Hospital.

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Kwak, YH., Lee, S., Lee, M.C. et al. Large meniscus extrusion ratio is a poor prognostic factor of conservative treatment for medial meniscus posterior root tear. Knee Surg Sports Traumatol Arthrosc 26, 781–786 (2018). https://doi.org/10.1007/s00167-017-4441-x

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  • DOI: https://doi.org/10.1007/s00167-017-4441-x

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