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
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

2325967120914568

Informations 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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Auteurs

Philipp W Winkler (PW)

Sports and Joint Surgery, Gelenkpunkt, Innsbruck, Austria.
Department of Orthopaedic Sports Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.

Guido Wierer (G)

Research Unit for Orthopaedic Sports Medicine and Injury Prevention, Institute of Sports Medicine, Alpine Medicine and Health Tourism, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.
Department of Orthopaedics and Traumatology, Paracelsus Medical University, Salzburg, Austria.

Robert Csapo (R)

Sports and Joint Surgery, Gelenkpunkt, Innsbruck, Austria.
Research Unit for Orthopaedic Sports Medicine and Injury Prevention, Institute of Sports Medicine, Alpine Medicine and Health Tourism, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.

Caroline Hepperger (C)

Sports and Joint Surgery, Gelenkpunkt, Innsbruck, Austria.
Research Unit for Orthopaedic Sports Medicine and Injury Prevention, Institute of Sports Medicine, Alpine Medicine and Health Tourism, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.

Bernhard Heinzle (B)

Department of Radiology, MRT-CT Diagnostics, Wörgl, Austria.

Andreas B Imhoff (AB)

Department of Orthopaedic Sports Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.

Christian Hoser (C)

Sports and Joint Surgery, Gelenkpunkt, Innsbruck, Austria.
Research Unit for Orthopaedic Sports Medicine and Injury Prevention, Institute of Sports Medicine, Alpine Medicine and Health Tourism, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.

Christian Fink (C)

Sports and Joint Surgery, Gelenkpunkt, Innsbruck, Austria.
Research Unit for Orthopaedic Sports Medicine and Injury Prevention, Institute of Sports Medicine, Alpine Medicine and Health Tourism, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.

Classifications MeSH