The Early Arthroscopic Pullout Repair of Medial Meniscus Posterior Root Tear Is More Effective for Reducing Medial Meniscus Extrusion

• Published in: Acta medica Okayama Vol. 73; no. 6; pp. 503 - 510
• Main Authors: Kamatsuki, Yusuke, Furumatsu, Takayuki, Miyazawa, Shinichi, Kodama, Yuya, Hino, Tomohito, Okazaki, Yoshiki, Masuda, Shin, Okazaki, Yuki, Noda, Tomoyuki, Yamakawa, Yasuaki, Tetsunaga, Tomoko, Ozaki, Toshifumi
• Format: Journal Article
• Language: English
• Published: Japan 01-12-2019
• Subjects: Aged; Arthroscopy - methods; Female; Humans; Knee Injuries - surgery; Male; Menisci, Tibial - pathology; Menisci, Tibial - surgery; Middle Aged; Reconstructive Surgical Procedures - methods; Retrospective Studies; Tibial Meniscus Injuries - surgery; medial meniscus; medial meniscus extrusion; magnetic resonance imaging; posterior root tear; pullout repair
• ISSN: 0386-300X
• DOI: 10.18926/amo/57714

Clinical studies have demonstrated that transtibial pullout repair led to favorable midterm outcomes in patients with medial meniscus posterior root tears (MMPRTs) although medial meniscal extrusion (MME) continued to be present. It has been unclear whether these residual postoperative MMEs existed after the pullout repair or had progressed at the very short-term evaluation after surgery. We sought to determine which characteristics of patients with MMPRTs influence the incidence of postoperative MME. The cases of 23 patients whose date of injury was known were analyzed. All patients underwent MMPRT pullout fixation. Preoperative and 3-month postoperative magnetic resonance imaging (MRI) examinations were performed. MME was retrospectively assessed on the mid-coronal plane of MRI scans. The preoperative and postoperative MME values were 4.2±1.2 mm and 4.3±1.5 mm, respectively (p=0.559). Pullout repair surgery was performed significantly earlier after the MMPRT-specific injury in patients whose postoperative MME improved compared to the patients whose MME did not improve (p<0.001). Our findings demonstrated that an early transtibial pullout repair of an MMPRT was more effective in reducing MME than a late repair. Surgeons should not miss the optimal timing for the pullout repair of an MMPRT, considering the period from the injury and the preoperative MME.