Quantitative Evaluation of Dynamic Lateral Meniscal Extrusion After Radial Tear Repair.
dynamic meniscal extrusion
lateral meniscus
magnetic resonance imaging
meniscal suture repair
radial tear
stress MRI
Journal
Orthopaedic journal of sports medicine
ISSN: 2325-9671
Titre abrégé: Orthop J Sports Med
Pays: United States
ID NLM: 101620522
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
09
12
2019
accepted:
23
12
2019
entrez:
22
4
2020
pubmed:
22
4
2020
medline:
22
4
2020
Statut:
epublish
Résumé
Radial tears of the lateral meniscus frequently accompany acute anterior cruciate ligament (ACL) injuries and lead to increased joint stress and pathological meniscal extrusion (ME). The dynamic behavior of the lateral meniscus after radial tear repair with respect to ME has not been described. To quantitatively assess dynamic lateral ME after all-inside radial tear repair. Case series; Level of evidence, 4. Patients who underwent ACL reconstruction and all-inside radial tear repair of the lateral meniscus and had no history of contralateral knee injuries were included. Magnetic resonance imaging scans were acquired in loaded (50% of body weight) and unloaded conditions of both the injured and noninjured knees. A custom-made pneumatically driven knee brace was used for standardized knee positioning in 10° of flexion and with axial load application. Quantitative measures included the absolute lateral ME, meniscal body extrusion ratio, and Δ extrusion. Preoperative and postoperative unloaded extrusion data were compared by paired A total of 10 patients with a mean follow-up of 47.9 months were enrolled. The intraclass correlation coefficient (ICC) confirmed good interrater reliability (ICC, 0.898) and excellent intrarater reliability (ICC, 0.976). In the unloaded injured leg, all-inside repair reduced ME from 3.15 ± 1.07 mm to 2.13 ± 0.61 mm (-32.4%; Lateral ME depends on the knee status and loading condition. All-inside repair of radial meniscal tears led to a reduction of extrusion with no alteration in dynamic lateral ME. Meniscus-preserving therapy is recommended in the case of a radial lateral meniscal tear to preserve its dynamic behavior.
Sections du résumé
BACKGROUND
BACKGROUND
Radial tears of the lateral meniscus frequently accompany acute anterior cruciate ligament (ACL) injuries and lead to increased joint stress and pathological meniscal extrusion (ME). The dynamic behavior of the lateral meniscus after radial tear repair with respect to ME has not been described.
PURPOSE
OBJECTIVE
To quantitatively assess dynamic lateral ME after all-inside radial tear repair.
STUDY DESIGN
METHODS
Case series; Level of evidence, 4.
METHODS
METHODS
Patients who underwent ACL reconstruction and all-inside radial tear repair of the lateral meniscus and had no history of contralateral knee injuries were included. Magnetic resonance imaging scans were acquired in loaded (50% of body weight) and unloaded conditions of both the injured and noninjured knees. A custom-made pneumatically driven knee brace was used for standardized knee positioning in 10° of flexion and with axial load application. Quantitative measures included the absolute lateral ME, meniscal body extrusion ratio, and Δ extrusion. Preoperative and postoperative unloaded extrusion data were compared by paired
RESULTS
RESULTS
A total of 10 patients with a mean follow-up of 47.9 months were enrolled. The intraclass correlation coefficient (ICC) confirmed good interrater reliability (ICC, 0.898) and excellent intrarater reliability (ICC, 0.976). In the unloaded injured leg, all-inside repair reduced ME from 3.15 ± 1.07 mm to 2.13 ± 0.61 mm (-32.4%;
CONCLUSION
CONCLUSIONS
Lateral ME depends on the knee status and loading condition. All-inside repair of radial meniscal tears led to a reduction of extrusion with no alteration in dynamic lateral ME. Meniscus-preserving therapy is recommended in the case of a radial lateral meniscal tear to preserve its dynamic behavior.
Identifiants
pubmed: 32313812
doi: 10.1177/2325967120914568
pii: 10.1177_2325967120914568
pmc: PMC7153201
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2325967120914568Informations de copyright
© The Author(s) 2020.
Déclaration de conflit d'intérêts
One or more of the authors has declared the following potential conflict of interest or source of funding: A.B.I. has received consulting fees from Arthrosurface and Medi Bayreuth and royalties from Arthrex. C.F. has received consulting fees from Medacta and royalties from Karl Storz and Medacta. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
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