2025 ISAKOS Biennial Congress ePoster
Arthroscopic Meniscal Augmentation Techniques for an Extruded Medial Meniscus: A Systematic Review
Fardis Vosoughi, MD, Tehran IRAN, ISLAMIC REPUBLIC OF
Mahdi Gouravani, MD, Tehran IRAN, ISLAMIC REPUBLIC OF
Alireza Arvin, MD, Tehran IRAN, ISLAMIC REPUBLIC OF
Robert F. LaPrade, MD, PhD, Edina, MN UNITED STATES
Asma Mafhoumi, MD IRAN, ISLAMIC REPUBLIC OF
Iman Menbari Oskouie, MD IRAN, ISLAMIC REPUBLIC OF
Tehran University of Medical Sciences, Tehran, IRAN, ISLAMIC REPUBLIC OF
FDA Status Not Applicable
Summary
We found that applying a conventional transtibial pullout repair combined with a meniscus centralization technique or posterior anchoring might have a positive effect in postoperative radiologic and clinical outcomes enhancement and ME reduction. However, quantitative analysis of further studies with adequate sample size is recommended to reach consistent results.
ePosters will be available shortly before Congress
Abstract
Background
Meniscal extrusion (ME), which is defined as the progression of meniscal edge beyond the tibial plateau, could disturb the meniscal normal function in shock absorption and pressure distribution, leading to progressive degenerative changes in the knee joint. A meniscal posterior root tear (MPRT) is one of the most frequent pathologies associated with ME. However, it has been demonstrated that treating a MPRT alone with a meniscal root repair may not adequately reduce ME following surgery.
Purpose/Hypothesis: Our purpose was to identify studies that adopted meniscal reinforcement techniques to reduce the extruded meniscus in patients with pathological ME. We hypothesized that applying meniscal reinforcement techniques to address meniscal extrusion could enhance the clinical and radiologic outcomes following the meniscal surgery.
Study design: Systematic review
Methods
A systematic search was conducted in four electronic databases (PubMed, EMBASE, Scopus, Web of Science) to identify related studies that adopted meniscal reinforcement techniques to reduce the extruded meniscus in patients with pathological ME. The required data comprising study characteristics, patient data, augmentation techniques, and outcome measures was extracted from eligible studies.
Results
Ten studies consisting of 405 participants with a medial meniscal posterior root tear (MMPRT) in 346 cases or knee osteoarthritis (OA) in 59 patients who suffer from ME were idenitified. Painful popping was the only mentioned symptom that was reported in 5 studies. Five different types of meniscal root repair techniques were identified including the combination of two simple stitches (TSS) with a posteromedial pullout repair (PMP) in 3 studies, the combination of a transtibial pullout repair and meniscus centralization in 2 studies, the combination of two cinch stitches (TCS) with additional posterior anchoring (PA) in 2 studies, the combination of open wedge high tibial osteotomy (OWHTO) and meniscus centralization in two studies, and the combination of TSS or TCS with additional sutures in a single study. A significant decrease in post-operative ME progression was reported in studies that employed a conventional transtibial pullout repair in combination with meniscus centralization or posterior anchoring. Improvements in clinical assessments and patient satisfaction rates were reported in all studies.
Conclusion
We found that applying a conventional transtibial pullout repair combined with a meniscus centralization technique or posterior anchoring might have a positive effect in postoperative radiologic and clinical outcomes enhancement and ME reduction. However, quantitative analysis of further studies with adequate sample size is recommended to reach consistent results.