Background: Previous meta-analyses have demonstrated superior outcomes in patients undergoing arthroscopic repair of medial meniscus posterior root tears (MMPRTs) compared with meniscectomy. However, these analyses have considered only short- or midterm outcomes and low-quality evidence.
Purpose: To compare the mid- to long-term rates of radiographic osteoarthritis (OA) between repair and meniscectomy for MMPRT.
Study Design: Systematic review and meta-analysis; Level of evidence, 4.
Methods: PubMed, EMBASE, Ovid/MEDLINE, and Cochrane Central Register of Controlled Trials databases were queried for articles evaluating repair and meniscectomy for MMPRT. Articles were eligible if they had a minimum mean 4-year follow-up for radiographic OA or conversion to total knee arthroplasty (TKA) and were at least level 3 evidence. Radiographic OA was assessed using Kellgren-Lawrence (KL) progression. Rates of conversion to TKA and International Knee Documentation Committee (IKDC) scores were also extracted. DerSimonian-Laird binary random-effects models were created to evaluate differences in radiographic OA and TKA conversion rates, with odds ratios (ORs) representing pooled estimates. Continuous random-effects models with standardized mean differences (SMDs) were used to compare postoperative IKDC scores.
Results: Repair and meniscectomy cohorts were followed for a mean of 64.8 months and 62.5 months, respectively, for KL progression; and 82.8 months and 73.8 months, respectively, for TKA rates and IKDC scores. Overall, 59 of 144 (41%) patients undergoing surgical intervention for MMPRT demonstrated OA progression; 18 of 82 (22%) who underwent repair for MMPRT exhibited OA progression compared with 41 of 62 (66%) who underwent meniscectomy (OR, 0.17; 95% CI, 0.03-0.83; = .029). Overall, 30 of 143 (21%) patients converted to TKA; 9.8% (8/82) of patients who underwent repair converted to TKA (range, 47-131 months), while 36% (22/61) who underwent meniscectomy converted to TKA (range, 17.8-101 months) (OR, 0.15; 95% CI, 0.05-0.44; < .001). No significant differences between postoperative IKDC scores were observed (SMD, 0.51; 95% CI, -0.02 to 1.05; = .06).
Conclusion: Medial meniscus posterior root repair results in significantly lower rates of radiographic OA progression and conversion to TKA at >60-month follow-up. On the basis of these findings, we recommend consideration of repair of MMPRTs when degenerative changes are not severe, as it can yield improved outcomes.
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http://dx.doi.org/10.1177/03635465211017514 | DOI Listing |
J Am Acad Orthop Surg
January 2025
From the Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO.
Because of the crucial role of the menisci in maintaining cartilage and joint health, meniscal tears affect the long-term health of the knee. Although partial meniscectomy has a role in the treatment of complex degenerative tears and tears with low healing capacity, advances in the concepts and understanding of meniscal repair, along with improvements in repair techniques and instrumentation, have expanded the indications for meniscal repair. With appropriate patient selection and preoperative planning, repair of meniscal tears can lower the rate of degenerative changes when compared with meniscectomy.
View Article and Find Full Text PDFBioengineering (Basel)
January 2025
Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, IL 60612-7342, USA.
The anterior cruciate ligament (ACL) is a major ligament in the knee joint, and its function is crucial for both the movement and stability of the knee. Our research takes a novel approach by investigating the effect of meniscus tears on the ACL, how such tears will impact the stress on the ACL, and its overall compensation in response to the changes in the meniscus. : This study aims to investigate how the ACL compensates for the change in knee joint stability and contact pressures due to partial horizontal cleavage tears (HCTs) in the meniscus, such as partial meniscectomy and partial transplantation on knee joint stability and contact pressures.
View Article and Find Full Text PDFStem Cell Res Ther
January 2025
Cellular Biopharma (Shanghai) Co., Ltd, Building 3, No.85, Faladi Road, Pudong New Area, Shanghai, 200233, China.
Background: Mesenchymal stem cells have great potential for repairing articular cartilage and treating knee osteoarthritis (KOA). Nonetheless, little is known about the efficacy of human adipose-derived mesenchymal stem cells (haMSCs) for KOA in large animal models.
Methods: This study evaluated the therapeutic efficacy of haMSCs in knee articular cartilage repair in a sheep model of KOA.
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.
Cureus
December 2024
Department of Orthopedic Sports Medicine, Seifu Hospital, Sakai, JPN.
To the best of our knowledge, there are no reports on the results of the repair of radial tears of the midbody of the complete discoid lateral meniscus (DLM). A 14-year-old female underwent meniscal replacement with autologous tendon transplantation for early re-tear after repair of the radial tear in the midbody of complete DLM. Two years after the tendon transplantation, there was no effusion or swelling, and the patient was able to exercise completely without symptoms.
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