ABSTRACT
PURPOSE: The purpose of this study is to evaluate the healing rate of medial meniscus root repair according to the duration of symptom and to determine the association between healing status and the clinical result after medial meniscus root repair. MATERIALS AND METHODS: Eighty-four patients who underwent arthroscopic meniscal root repair and second-look arthroscopy were included. Second-look arthroscopy evaluation of meniscal healing status was performed by dividing medial meniscal posterior root into the anterior half and posterior half and classifying by contact degree on the surface of the tibia and continuity. Clinical results were analyzed according to International Knee Documentation Committee (IKDC) subjective scores and Lysholm scores. In addition, after dividing cases according to acute group and chronic group by six-month symptomatic period, differences were evaluated. RESULTS: Significant differences in post-operative clinical results were observed between the acute group and chronic group. A significant difference in meniscal healing status was observed between the two groups (p<0.001). A higher postoperative IKDC score and Lysholm score was observed for the completely healed group, as confirmed by second-look arthroscopy, than for the other groups. CONCLUSION: In the aspect of improving the clinical result, arthroscopic medial meniscal posterior root repair is a good treatment modality. Early repair of medial meniscal posterior root may lead to improvements in the clinical result such as meniscal healing status.
Subject(s)
Humans , Arthroscopy , Knee , Menisci, Tibial , TibiaABSTRACT
This study is to evaluate clinical and arthroscopic second-look results of arthroscopic repairs of posterior root tears of medial meniscus which may cause loss of circumferential hoop tension and extrusion of meniscus. From October 2006 to May 2009, fifty-eight patients (59 knees) underwent arthroscopic pull-out repairs. Clinical results were evaluated using Hospital for Special Surgery (HSS) score and International Knee Documentation Committee (IKDC) score for 12-month follow-up. Second-look arthroscopy was done to evaluate meniscal healing in 21 cases. Magnetic resonance imaging (MRI) was performed to assess status of repaired meniscus and tibial tunnel position in 9 patients. Average preoperative HSS score and IKDC score of 59 cases were 69.5 and 36.0, respectively. Average postoperative HSS score and IKDC score of 59 cases had been changed into 90.3 (p<0.001) and 66.8 (p<0.001), respectively. Second-look arthroscopies revealed complete or incomplete healing except one case. Two patients showed increased one grade according to the Kellgren-Lawrence radiologic classification system and others showed no change. Of 9 patients who performed MRI, six patients showed complete healing. The average position of tibial tunnel was 4.8 mm anterior and 5.7 mm medial to center of posterior cruciate ligament. Arthroscopic pull-out repair technique using transtibial tunnel seems to be simple and effective procedure for posterior root tear of medial meniscus. Further evaluation of arthroscopic repair of posterior root tear of medial meniscus should be needed to prove the effectiveness on the prevention of osteoarthritis of knee.