2025 ISAKOS Biennial Congress ePoster
Insufficient Restoration Of Meniscal Tension During Surgical Repair Of Medial Meniscus Root Tear Is Associated With Poor Surgical Outcomes: Clinical Implication Of Curtain-Cliff Sign
Hyun-Soo Moon, MD, PhD, Seoul KOREA, REPUBLIC OF
Min Jung, MD, PhD, Seoul KOREA, REPUBLIC OF
Kwangho Chung, MD, Seoul KOREA, REPUBLIC OF
Se-Han Jung, MD, Seoul KOREA, REPUBLIC OF
Junwoo Byun, MD, Seoul KOREA, REPUBLIC OF
Sung-Hwan Kim, MD, PhD, Seoul KOREA, REPUBLIC OF
Severance Hospital, Yonsei University College of Medicine, Seoul, KOREA, REPUBLIC OF
FDA Status Not Applicable
Summary
In patients where the restoration of meniscal tension appears insufficient immediately after surgical repair for MMRT, relatively poor clinical outcomes can be anticipated, suggesting that efforts to reinforce meniscal tension may be required during surgery, especially in cases showing the curtain-cliff sign.
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Abstract
Purpose
This study aimed to analyze the clinical outcomes of surgical repair for medial meniscus root tear (MMRT) based on the appearance of the meniscal tension observed immediately after surgery.
Methods
Medical records of patients who underwent arthroscopic transtibial pull-out repair of MMRT between 2010 and 2021 were retrospectively reviewed. Patients with at least a 2-year follow-up and whose overall meniscal status after the surgical repair could be evaluated via arthroscopic images or videos were eligible to be included. Patients were classified based on the presence of the curtain-cliff sign, potentially implying the postoperative meniscal hoop tension (group 1, patients without curtain-cliff sign; group 2, patients with curtain-cliff sign). Regression analysis was performed to evaluate whether the curtain-cliff sign reflects postoperative meniscus extrusion. Subsequently, comparative analyses were conducted between two groups regarding baseline demographic data, clinical scores, intra-operative data, and radiographic parameters.
Results
Seventy-nine patients were included. Regression analysis revealed a significant association between the curtain-cliff sign and postoperative meniscus extrusion, suggesting its potential to reflect the postoperative meniscal tension. In the between-group comparisons, there were no differences in baseline demographic data, preoperative clinical scores, and preoperative radiographic variables. However, at the final follow-up, group 2 showed a significantly lower IKDC subjective score compared to group 1 (P = 0.017). Additionally, group 2 exhibited significantly higher postoperative meniscus extrusion and more pronounced progression compared to preoperative status. Consistently, the progression of both the osteoarthritis grade and the hip-knee-ankle angle compared to preoperatively was significantly greater in group 2.
Conclusion
In patients where the restoration of meniscal tension appears insufficient immediately after surgical repair for MMRT, relatively poor clinical outcomes can be anticipated; the findings of this study suggest that efforts to reinforce meniscal tension may be required during surgical repair for MMRT in some cases, especially those showing the curtain-cliff sign.