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A posterior anchoring method decreases pullout suture translation of the medial meniscus posterior root repair during knee flexion
Institution:1. Department of Orthopaedic Surgery, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama, Okayama 708-0841, Japan;2. Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan;1. Tianjin Hospital, No. 406 Jiefang South Rd, Hexi District, Tianjin 300211, China;2. Tianjin Medical University, No. 22 Qixiangtai Rd, Heping District, Tianjin 300041 China;1. Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan;2. Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan;3. Clinical center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan;1. Midwest Orthopaedics at Rush;2. Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.;1. Hospital for Special Surgery, Sports Medicine Institute, New York, New York, U.S.A.;1. Twin Cities Orthopedics, Edina-Crosstown, Edina, Minnesota, U.S.A.;2. Georgetown University School of Medicine, Washington, DC, U.S.A.;3. University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, U.S.A.
Abstract:BackgroundThe medial meniscus (MM) translates posteriorly and extrudes severely from the medial tibial plateau (MTP) during knee flexion in the MM posterior root tear (PRT) knee. Transtibial pullout repair of the MMPRT has been performed to regulate MM extrusion. This study aimed to evaluate pullout suture translation during knee flexion before and after posterior anchoring during pullout repair. We hypothesized that suture translation after posterior anchoring would be significantly decreased relative to that before posterior anchoring.MethodsThirty-five patients who underwent MM posterior root repair were prospectively investigated. Pullout repair was performed using two cinch sutures (outer and inner sutures) and posterior anchoring through the MM posterior horn and an additional bone tunnel on the MTP. The translation of the outer suture from 0° to 90° of knee flexion was measured and compared before and after posterior anchoring intraoperatively. The MM morphologic features were measured using preoperative magnetic resonance imaging, and the correlation between these values and outer suture translation was evaluated.ResultsThe average outer suture translation after posterior anchoring (1.6 ± 1.5 mm) was significantly decreased relative to that before posterior anchoring (2.5 ± 1.7 mm, P < 0.01). No significant correlations were observed between the MM morphological features and outer suture translation.ConclusionsThe posterior anchoring method with an MM posterior root repair is useful in decreasing posterior translation of the pullout suture during knee flexion, which might have an advantage in preventing suture pullout from the repaired MM, leading to good clinical outcomes.
Keywords:Intraoperative measurement  Medial meniscus  Posterior anchoring  Posterior root tear  Suture translation  MM"}  {"#name":"keyword"  "$":{"id":"k0035"}  "$$":[{"#name":"text"  "_":"Medial meniscus  MMME"}  {"#name":"keyword"  "$":{"id":"k0045"}  "$$":[{"#name":"text"  "_":"Medial meniscus medial extrusion  MMPRT"}  {"#name":"keyword"  "$":{"id":"k0055"}  "$$":[{"#name":"text"  "_":"Medial meniscus posterior root tear  MMBW"}  {"#name":"keyword"  "$":{"id":"k0065"}  "$$":[{"#name":"text"  "_":"Medial meniscus body width  MMPH"}  {"#name":"keyword"  "$":{"id":"k0075"}  "$$":[{"#name":"text"  "_":"Medial meniscus posterior height  MMPW"}  {"#name":"keyword"  "$":{"id":"k0085"}  "$$":[{"#name":"text"  "_":"Medial meniscus posterior width  MRI"}  {"#name":"keyword"  "$":{"id":"k0095"}  "$$":[{"#name":"text"  "_":"Magnetic resonance imaging  MTP"}  {"#name":"keyword"  "$":{"id":"k0105"}  "$$":[{"#name":"text"  "_":"Medial tibial plateau  PRT"}  {"#name":"keyword"  "$":{"id":"k0115"}  "$$":[{"#name":"text"  "_":"Posterior root tear
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