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Postoperative change in medial meniscal length in concurrent all-inside meniscus repair with anterior cruciate ligament reconstruction

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Abstract

Purpose

Meniscus repair can restore meniscal function that transfers the axial compressive force to circumferential tensile strain. However, few reports have investigated the relationship between concurrent meniscus repair with acute anterior cruciate ligament (ACL) reconstruction and postoperative meniscal position. This study aimed to evaluate medial meniscal size and clinical results in patients who underwent ACL reconstruction and concomitant all-inside medial meniscus repair.

Methods

Twenty patients underwent ACL reconstruction and concurrent medial meniscus repair of a peripheral longitudinal tear using the FasT-Fix meniscal repair device. Medial tibial plateau length (MTPL) and width (MTPW) were determined by radiographic images. We evaluated the Lysholm score, anteroposterior instability, meniscal healing and magnetic resonance imaging (MRI)-based medial meniscal length (MML) and width (MMW). Correlations between MRI-based meniscal size, radiographic measurement and height were investigated.

Results

All patients showed complete healing of the repaired meniscus in arthroscopic evaluation. However, one patient needed a subsequent meniscus repair during the follow-up period. Lysholm score and anteroposterior instability improved significantly. A better correlation was observed between MMW and MTPW than between MML and MTPL. Concurrent all-inside medial meniscus repair with ACL reconstruction significantly increased MML percentage (%MML) (100 MML/MTPL) but did not affect MMW percentage (%MMW) (100 MMW/MTPW).

Conclusions

Concurrent all-inside medial meniscus repair with ACL reconstruction had satisfactory clinical results. %MML was increased by concurrent medial meniscus repair without affecting %MMW. Our results suggest that medial meniscus repair associated with ACL reconstruction may restore meniscal function by adjusting the anteroposterior length of the torn medial meniscus.

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References

  1. Vedi V, Williams A, Tennant SJ, Spouse E, Hunt DM, Gedroyc WM (1999) Meniscal movement. An in-vivo study using dynamic MRI. J Bone Joint Surg Br 81:37–41

    Article  CAS  PubMed  Google Scholar 

  2. Bloecker K, Guermazi A, Wirth W et al (2013) Tibial coverage, meniscus position, size and damage in knees discordant for joint space narrowing - data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 21:419–427

    Article  CAS  PubMed  Google Scholar 

  3. Alhalki MM, Hull ML, Howell SM (2000) Contact mechanics of the medial tibial plateau after implantation of a medial meniscal allograft. A human cadaveric study. Am J Sports Med 28:370–376

    CAS  PubMed  Google Scholar 

  4. Stone KR, Freyer A, Turek T, Walgenbach AW, Wadhwa S, Crues J (2007) Meniscal sizing based on gender, height, and weight. Arthroscopy 23:503–508

    Article  PubMed  Google Scholar 

  5. Haut TL, Hull ML, Howell SM (2000) Use of roentgenography and magnetic resonance imaging to predict meniscal geometry determined with a three-dimensional coordinate digitizing system. J Orthop Res 18:228–237

    Article  CAS  PubMed  Google Scholar 

  6. Ihara H, Miwa M, Takayanagi K, Nakayama A (1994) Acute torn meniscus combined with acute cruciate ligament injury. Second look arthroscopy after 3-month conservative treatment. Clin Orthop Relat Res 307:146–154

    PubMed  Google Scholar 

  7. Pujol N, Beaufils P (2009) Healing results of meniscal tears left in situ during anterior cruciate ligament reconstruction: a review of clinical studies. Knee Surg Sports Traumatol Arthrosc 17:396–401

    Article  PubMed  Google Scholar 

  8. Beaufils P, Hulet C, Dhénain M, Nizard R, Nourissat G, Pujol N (2009) Clinical practice guidelines for the management of meniscal lesions and isolated lesions of the anterior cruciate ligament of the knee in adults. Orthop Traumatol Surg Res 95:437–442

    Article  CAS  PubMed  Google Scholar 

  9. Shelbourne KD, Rask BP (2001) The sequelae of salvaged nondegenerative peripheral vertical medial meniscus tears with anterior cruciate ligament reconstruction. Arthroscopy 17:270–274

    Article  PubMed  Google Scholar 

  10. Feng H, Hong L, Geng XS, Zhang H, Wang XS, Jiang XY (2008) Second-look arthroscopic evaluation of bucket-handle meniscus tear repairs with anterior cruciate ligament reconstruction: 67 consecutive cases. Arthroscopy 24:1358–1366

    Article  PubMed  Google Scholar 

  11. Miao Y, Yu JK, Ao YF, Zheng ZZ, Gong X, Leung KK (2011) Diagnostic values of 3 methods for evaluating meniscal healing status after meniscal repair: comparison among second-look arthroscopy, clinical assessment, and magnetic resonance imaging. Am J Sports Med 39:735–742

    Article  PubMed  Google Scholar 

  12. Ahn JH, Lee YS, Yoo JC, Chang MJ, Park SJ, Pae YR (2010) Results of arthroscopic all-inside repair for lateral meniscus root tear in patients undergoing concomitant anterior cruciate ligament reconstruction. Arthroscopy 26:67–75

    Article  PubMed  Google Scholar 

  13. Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154

    Article  CAS  PubMed  Google Scholar 

  14. Shaffer B, Kennedy S, Klimkiewicz J, Yao L (2000) Preoperative sizing of meniscal allografts in meniscus transplantation. Am J Sports Med 28:524–533

    CAS  PubMed  Google Scholar 

  15. McDermott ID, Sharifi F, Bull AM, Gupte CM, Thomas RW, Amis AA (2004) An anatomical study of meniscal allograft sizing. Knee Surg Sports Traumatol Arthrosc 12:130–135

    Article  CAS  PubMed  Google Scholar 

  16. Ikuma H, Abe N, Uchida Y, Furumatsu T, Fujiwara K, Nishida K, Ozaki T (2008) Novel magnetic resonance imaging evaluation for valgus instability of the knee caused by medial collateral ligament injury. Acta Med Okayama 62:185–191

    PubMed  Google Scholar 

  17. Sakata K, Furumatsu T, Abe N, Miyazawa S, Sakoma Y, Ozaki T (2013) Histological analysis of failed cartilage repair after marrow stimulation for the treatment of large cartilage defect in medial compartmental osteoarthritis of the knee. Acta Med Okayama 67:65–74

    PubMed  Google Scholar 

  18. Sakata K, Furumatsu T, Miyazawa S, Okada Y, Fujii M, Ozaki T (2013) Comparison between normal and loose fragment chondrocytes in proliferation and redifferentiation potential. Int Orthop 37:159–165

    Article  PubMed Central  PubMed  Google Scholar 

  19. Barrett GR, Field MH, Treacy SH, Ruff CG (1998) Clinical results of meniscus repair in patients 40 years and older. Arthroscopy 14:824–829

    Article  CAS  PubMed  Google Scholar 

  20. Weiss CB, Lundberg M, Hamberg P, DeHaven KE, Gillquist J (1989) Non-operative treatment of meniscal tears. J Bone Joint Surg Am 71:811–822

    CAS  PubMed  Google Scholar 

  21. Magnussen RA, Mansour AA, Carey JL, Spindler KP (2009) Meniscus status at anterior cruciate ligament reconstruction associated with radiographic signs of osteoarthritis at 5- to 10-year follow-up: a systematic review. J Knee Surg 22:347–357

    Article  PubMed Central  PubMed  Google Scholar 

  22. DeHaan A, Rubinstein RA Jr, Baldwin JL (2009) Evaluation of success of a meniscus repair device for vertical unstable medial meniscus tears in ACL-reconstructed knees. Orthopedics 32(4)

  23. Pujol N, Tardy N, Boisrenoult P, Beaufils P (2013) Magnetic Resonance Imaging is not suitable for interpretation of meniscal status ten years after arthroscopic repair. Int Orthop [Epub ahead of print]

  24. Vrancken AC, Buma P, van Tienen TG (2013) Synthetic meniscus replacement: a review. Int Orthop 37:291–299

    Article  PubMed Central  PubMed  Google Scholar 

  25. Kim YM, Joo YB, Cha SM, Hwang JM (2012) Role of the mechanical axis of lower limb and body weight in the horizontal tear and root ligament tear of the posterior horn of the medial meniscus. Int Orthop 36:1849–1855

    Article  PubMed Central  PubMed  Google Scholar 

  26. Bylski-Austrow DI, Ciarelli MJ, Kayner DC, Matthews LS, Goldstein SA (1994) Displacements of the menisci under joint load: an in vitro study in human knees. J Biomech 27:421–431

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

We are grateful to Prof. Nobuhiro Abe for his support. This work was supported by grants from the Japan Society for the Promotion of Science (No. 24791546).

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Correspondence to Takayuki Furumatsu.

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Furumatsu, T., Miyazawa, S., Tanaka, T. et al. Postoperative change in medial meniscal length in concurrent all-inside meniscus repair with anterior cruciate ligament reconstruction. International Orthopaedics (SICOT) 38, 1393–1399 (2014). https://doi.org/10.1007/s00264-013-2238-1

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  • DOI: https://doi.org/10.1007/s00264-013-2238-1

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