Am J Sports Med
Department of Orthopedic Surgery, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
Published: March 2017
Background: Meniscal extrusion is related to degeneration of the native knee joint. However, the clinical effect of the phenomenon after meniscal allograft transplantation (MAT) has not been clearly identified. Purpose/Hypothesis: The purpose of this study was to evaluate the change in meniscal extrusion in both the coronal and sagittal planes after lateral MAT through the midterm follow-up period. We hypothesized that meniscal extrusion does not progress during the midterm follow-up period.
Study Design: Case series; Level of evidence, 4.
Methods: A total of 46 patients with a mean follow-up of 51.1 ± 7.1 months were included in the study. The patients underwent lateral MAT using the keyhole technique. Postoperative magnetic resonance imaging (MRI) was performed at 6-week, 1-year, and midterm (3- to 5-year) follow-up. In the coronal plane, the absolute value of meniscal subluxation and the relative percentage of extrusion (RPE) were measured. In the sagittal plane, meniscal subluxation was measured as the absolute and relative anterior cartilage meniscal distance (ACMD) and posterior cartilage meniscal distance (PCMD). The joint-space width (JSW) on weightbearing radiographs with 2 different knee positions was measured preoperatively and at 1-year and midterm follow-up. The Lysholm score was assessed at the same time points.
Results: In the coronal plane, the mean absolute meniscal extrusion at 6-week, 1-year, and final follow-up was 2.90 ± 0.94, 2.85 ± 0.97, and 2.83 ± 0.89 mm, respectively, and the mean RPE was 27.0% ± 9.4%, 27.1% ± 10.1%, and 27.8% ± 9.7%, respectively. There were no statistically significant differences in absolute and relative coronal extrusion among the 3 time periods ( P > .05). The percentage of patients with meniscal extrusion (≥3 mm) was 37.0% at 6-week follow-up and 34.8% at 1-year and final follow-up. In the sagittal plane, the mean absolute ACMD was 2.59 ± 1.75, 2.58 ± 1.85, and 2.37 ± 1.60 mm, respectively, and the mean relative ACMD was 20.7% ± 13.1%, 20.6% ± 13.8%, and 19.0% ± 12.2%, respectively, at the 3 follow-up time points. The mean absolute PCMD was -1.23 ± 3.34, -1.28 ± 3.08, and -1.42 ± 2.77 mm, respectively, and the mean relative PCMD was -10.3% ± 25.9%, -11.0% ± 24.6%, and -12.2% ± 23.2%, respectively, at the same time points. Sagittal extrusion was not significantly different between the time points ( P > .05). The mean JSW at 2 days preoperatively, 1 year postoperatively, and midterm follow-up was 5.40 ± 1.07, 5.44 ± 1.04, and 5.43 ± 0.98 mm, respectively, on anterior-posterior radiographs with full extension, and it was 4.90 ± 0.94, 4.94 ± 0.98, and 4.89 ± 0.96 mm, respectively, on posterior-anterior radiographs with 45° of flexion. The mean JSW values were not significantly different between the 3 different time points ( P > .05). The mean preoperative Lysholm score was 58. 9 ± 8.3; the score increased to 90.4 ± 9.7 at 1 year postoperatively and 90.5 ± 10.1 at final follow-up, which is a significant improvement compared with the preoperative status ( P < .05). There was no statistically significant difference between the scores at the 2 postoperative time points ( P > .05).
Conclusion: This study demonstrated that extrusion of the meniscal allograft did not significantly progress either in the coronal or sagittal plane after lateral MAT during the midterm follow-up period.
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http://dx.doi.org/10.1177/0363546516675605 | DOI Listing |
Orthop J Sports Med
January 2025
Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, Ohio, USA.
Background: Previous studies have demonstrated that lateral meniscal allograft transplantation (MAT) through medial arthrotomy showed less extrusion than that of the lateral arthrotomy. However, there is a paucity of literature reporting clinical and radiological outcomes after lateral MAT through the medial arthrotomy.
Hypothesis: Lateral MAT through a medial arthrotomy would show significantly improved clinical scores and minimal joint space narrowing compared with preoperative status.
J Med Ultrason (2001)
January 2025
Faculty of Rehabilitation, Kansai Medical University, 18-89 Uyamahigashicho, Hirakata, Osaka, 573-1136, Japan.
Purpose: Knee pain is a characteristic symptom of early-stage knee osteoarthritis. Recently, the association between knee symptoms and infrapatellar fat pad (IFP) degeneration has garnered attention. This study aimed to clarify the association between ultrasound-derived size and echo intensity (EI) in the IFP and knee symptoms.
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Department of Orthopaedic Surgery, Okayama Rosai Hospital, Minamiku, Okayama, Japan.
This Technical Note describes a surgical approach that combines circumferential fiber augmentation with transtibial pullout repair for the treatment of medial meniscal posterior root tears. To address the challenge of meniscal extrusion and subsequent joint space narrowing that predisposes to osteoarthritis, this technique uses an artificial ligament to add circumferential collagen fiber reinforcement to improve meniscal extrusion. This integrated approach is designed to address the limitations of conventional tibial pullout repairs by potentially providing better results in preventing meniscal extrusion.
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Faculty of Biomedical Sciences, Università Della Svizzera Italiana, CH-6900 Lugano, Switzerland.
: The aim of this study was to investigate how meniscal extrusion, assessed either with ultrasounds or magnetic resonance (MR), correlates with clinical symptoms in knee osteoarthritis (OA). One hundred patients with symptomatic knee OA were enrolled (60.3 ± 9.
View Article and Find Full Text PDFAm J Sports Med
January 2025
Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA.
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Hypothesis/purpose: It was hypothesized that MME would increase longitudinally after ACL injury and ACLR, with greater changes in the ipsilateral knee compared with the contralateral knee, leading to cartilage degeneration.
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