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Meniscoplasty And Centralization For Medial Meniscus Degenerative Tears With Extrusion: A Novel Technique And Initial Clinical Outcomes

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Meniscoplasty And Centralization For Medial Meniscus Degenerative Tears With Extrusion: A Novel Technique And Initial Clinical Outcomes

Benjamin Murray, DO, UNITED STATES S. Ali Ghasemi, MD, UNITED STATES James Raphael, MD, UNITED STATES Gene Shaffer, MD, UNITED STATES

Thomas Jefferson University, Philadelphia, PA, UNITED STATES

2025 Congress ePoster Presentation 2025 Congress Not yet rated

Anatomic Location

Knee

Anatomic Structure

Meniscus Medial

Diagnosis / Condition

Tears

Treatment / Technique

Arthroscopy Repair / Reconstruction

Diagnosis Method

MRI

Summary: A novel procedure utilizing meniscoplasty and centralization for degenerative medial meniscus tears with extrusion involves a unique meniscal release technique and has positive initial clinical outcomes.

Introduction

Medial meniscal extrusion occurs when the meniscus protrudes beyond the tibial margin of the knee joint. This displacement away from the natural position can lead to a loss of meniscal mechanical function. Additionally, meniscotibial ligament insufficiency may lead to destabilization and extrusion of the medial meniscus. Medial meniscus extrusion is a risk factor for knee osteoarthritis, and may predispose individuals to medial meniscus posterior root tears. Further, in patients with degenerative medial meniscus tears or prior meniscectomy, part of the meniscus is absent. We describe a novel technique, involving meniscoplasty and centralization, that establishes a new meniscus with advancements, while concomitantly fixing the meniscal extrusion. Ultimately, the goal is to restore meniscal function, position, and stability.

Methods

Through a medial mid arthroscopic portal, an incision was made through the capsule to visualize the anterior medial collateral ligament. A periosteum elevator was passed between the second and third layers of the medial knee, and used to release the capsule from subcutaneous tissue. The elevator was then advanced to the posterior aspect of the posteromedial medial meniscus to check meniscal mobility. Once adequate mobility and centralization were achieved, a rasp was used under the inferior aspect of the meniscus to prepare the tibial metaphysis and meniscotibial ligament just off the edge of the joint surface. Rasping extended from the anterior to posterior extent of the lesion. A grasper was then used to pull the capsule centrally to confirm that the released capsule could be easily advanced to reform a meniscus-like configuration. Capsular advancement was performed using the centralization technique. The released capsule was advanced and centralized onto the rim of the medial tibial plateau to reform a meniscus-like configuration. 3 months post-operatively, patients were asked two questions: Have your symptoms improved compared to before surgery? Would you recommend this surgery to someone else? Pre-operative and post-operative KOOS, IKDC, and Lysholm scores were obtained. A two-tailed distribution paired t-test was used to determine statistical significance (p < 0.05) between pre-operative and post-operative scores.

Results

25 patients were included in an initial cohort of this novel procedure. The average age was 64.96 years. Average follow up was 7.76 months (range 4-16). Initial improvements in pre-operative to post-operative clinical outcomes have been promising. The mean KOOS score significantly increased from 36.25 (SD = 14.48) to 64.76 (SD = 15.13) post-operatively (p = 0.005). The mean IKDC score significantly increased from 34.90 (SD = 14.05) pre-operatively to 65.91 (SD = 13.62) post-operatively (p = 0.0013). The mean Lysholm score significantly increased from 33.13 (SD = 14.52) pre-operatively to 73.13 (SD = 10.41) post-operatively (p = 0.0007).

Conclusion

We describe a novel technique for degenerative medial meniscus tears with extrusion, using meniscoplasty and centralization. This technique involves a release of the meniscus and capsule that is initiated between layers 2 and 3 of the medial knee, facilitating advancement and mobilization of the meniscus inside the joint. Initial clinical outcomes of a small cohort are promising.

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Mid-Term Outcomes And Safety Of Medial Meniscus Allograft Transplantation Using A Bone-Bridge Technique: A Single-Center Experience ePoster Presentation Ilias Fanourgiakis, MD, MSc, FEBOT, GREECE Theodore Balfousias, MD, MSc, FEBOT, GREECE Rainer Siebold, Prof. Dr. med., GERMANY
Cephalic Laxity of the Posterior Root of Lateral Meniscus (CLPRLM) Classification in Associated With Other Arthroscopic Signs of Meniscal Hyper Mobility ePoster Presentation Pablo David Ramos Murillo, MD, SPAIN
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Safety and Efficacy of a Novel Polyglycolic Acid Meniscal Scaffold for Irreparable Meniscal Tear in Human Clinical Trial ePoster Presentation Shuhei Otsuki, MD, JAPAN
Failure And Complication Rates Following Meniscal All-Inside And Inside-Out Repairs: A Meta-Analysis ePoster Presentation Juan Bernardo Villarreal-Espinosa, MD, UNITED STATES Rodrigo Saad Berreta, BA, UNITED STATES Lucas Pallone, MD, BRAZIL Felicitas Allende Figueroa, MD, ARGENTINA Fernando Gómez Verdejo, MD, MEXICO Zeeshan Khan, BA, UNITED STATES Melissa Carpenter, MD, UNITED STATES Sachin Allahabadi, MD, UNITED STATES Jorge Chahla, MD, PhD, UNITED STATES
Magnetic Resonance Imaging at 120° Flexed-Knee Position is a Novel Method for Preoperative Detection of Meniscal Ramp Lesion in Anterior Cruciate Ligament-Injured Knee ePoster Presentation Satoshi Nonaka, MD, JAPAN Kazuhisa Hatayama, MD, PhD, JAPAN Hibiki Kakiage, MD, JAPAN Masanori Terauchi, MD, JAPAN HIrotaka Chikuda, MD, PhD, JAPAN
Age-Dependent Variation In Cytokine Type And Concentration In Knee Synovial Fluid Following Meniscal Injury ePoster Presentation Vishal Sundaram, BA, UNITED STATES Katherine L. Esser, BS, UNITED STATES Luke Schwartz, BS, UNITED STATES Michael Moore, BA, UNITED STATES Larry Chen, BS, UNITED STATES Nathaniel P. Mercer, MD, UNITED STATES Bradley Austin Lezak, MD, MPH, UNITED STATES Heath Patrick Gould, MD, UNITED STATES Eric Strauss, UNITED STATES
Biomechanical Effect Of Location And Number Of Bone Tunnels In Transtibial Pull-Out Repair For Medial Meniscus Posterior Root Tear ePoster Presentation Toshitaka Tsunematsu, MD, JAPAN Tomoki Ohori, MD, PhD, JAPAN Akira Tsujii, MD, PhD, JAPAN Shuto Yamashita, MD, JAPAN Ayaka Tanaka, MD, JAPAN Syunya Otani, MD, PhD, JAPAN Seira Sato, MD, PhD, JAPAN Ken Nakata, MD, PhD, JAPAN Seiji Okada, MD, PhD, Prof., JAPAN
Serial Changes In Muscle Strength And Dynamic Balance After Lateral Meniscal Allograft Transplantation ePoster Presentation Dhong-Won Lee, MD, PhD, KOREA, REPUBLIC OF Jin-Goo Kim, MD, PhD, KOREA, REPUBLIC OF Byeong Sun Park, KOREA, REPUBLIC OF
Diagnosis Of Medial Meniscus Posterior Root Tear On Magnetic Resonance Imaging Using Deep Learning ePoster Presentation Yuta Nakanishi, MD, PhD, JAPAN Takehiko Matsushita, MD, PhD, JAPAN Atsuyuki Inui, MD, PhD, JAPAN Kyohei Nishida , MD, PhD, JAPAN Kanto Nagai, MD, PhD, JAPAN Yuichi Hoshino, MD, PhD, JAPAN Ryosuke Kuroda, MD, PhD, JAPAN
Medial Meniscus Dynamics In Degenerative Meniscus Tears: Analyzing Extrusion And Horn Position Shift In Early Knee Osteoarthritis ePoster Presentation Kentaro Fujita, MD, JAPAN Yasushi Takata, MD, PhD, JAPAN Tomoyuki Kanayama, MD, JAPAN Yoshihiro Ishida, MD, JAPAN Naoki Takemoto, MD, JAPAN Manase Nishimura, MD, JAPAN Takuya Sengoku, PT, PhD, JAPAN Yushin Mizuno, MSc, PT, JAPAN Junsuke Nakase, MD, PhD, JAPAN
Unseen Emissions: The Carbon Footprint Of Knee Arthroscopy ePoster Presentation Shannon Tse, BMBS, UNITED STATES Frank Sierra, BS, UNITED STATES Katherine Guo, BS, UNITED STATES Lydia Mckeithan, MD, UNITED STATES Robin Aldwinckle, BMBS, UNITED STATES Cassandra Lee, MD, UNITED STATES Zachary Lum, DO, UNITED STATES
Association Between Medial Collateral Ligament Injury, Posterior Medial Meniscal Root Injury, And Medial Meniscal Extrusion ePoster Presentation Paulo Vitor Carrijo , MD, BRAZIL Alexandre Zobiole, MD, BRAZIL Davi Casadio, MD, BRAZIL Renan M. Chaim, BRAZIL Moises Cohen, MD, PhD, Prof., BRAZIL Diego Costa Astur, MD, PhD, BRAZIL
The Adequate Volume Of Midbody During The Intraoperative Finding Is 11Mm For Reshaping Surgery Of Discoid Lateral Meniscus ePoster Presentation Yusuke Hashimoto, MD, PhD, JAPAN Yohei Nishida, MD, JAPAN Kazuya Nishino, MD, JAPAN Ken Iida, MD, JAPAN Shuko Tsumoto, MD, JAPAN
Fibrin Clot Augmentation of High-Risk Meniscal Repairs May Result in Clinical Healing in up to 90% of Cases ePoster Presentation Peter T. Myers, AM, MBBS, FRACS, FAOrthA, AUSTRALIA Peter Samuel Edward Davies, MBChB, FRCS, UNITED KINGDOM Michael Goldberg, MBBS, FRACS, AUSTRALIA Jon A. Anderson, BAppSci-HMS, MPhil, MBBS, FRACS, FAOrthA, AUSTRALIA
All Inside Suture For Wide Split Tear Of Lateral Meniscus ePoster Presentation Akihiro Tsuchiya, MD, JAPAN Ichiro Yamaura, MD, JAPAN Kenji Takahashi, MD, PhD, JAPAN Kosuke Hyakutake, MD, JAPAN
Clinical And MRI Outcomes Following Meniscal Repair: A Comparison Between Tear Types ePoster Presentation Elias Ammann, MD, SWITZERLAND Jay R. Ebert, PhD, AUSTRALIA Luke Rao, MD, AUSTRALIA Antony Liddell, FRACS(Orth), FAOrthA, AUSTRALIA Usman Najeeb Bhatty, FRCS, MB ChB, BSc, UNITED KINGDOM Ross Radic, MBBS FRACS (Ortho) FAOrthA, AUSTRALIA
Virtual Computer Vision Based Rehabilitation And In Person Physical Therapy Have Equivalent Outcomes After Knee Arthroscopy ePoster Presentation Katherine L. Esser, BS, UNITED STATES Zachary I Li, BA, UNITED STATES Michael Moore, BA, UNITED STATES Larry Chen, BS, UNITED STATES Isabel Wolfe, BA, UNITED STATES Nathaniel P. Mercer, MD, UNITED STATES Bradley Austin Lezak, MD, MPH, UNITED STATES Heath Patrick Gould, MD, UNITED STATES Laith M. Jazrawi, MD, UNITED STATES Eric Strauss, UNITED STATES Guillem Gonzalez-Lomas, MD, UNITED STATES
Delay in progression of OA, better root healing and extrusion correction is seen in concurrent root repair with high tibial osteotomy (HTO) than isolated root repair for moderate varus aligned knees ePoster Presentation Silvampatti Ramasamy Sundararajan, MS(Orth), INDIA Rajagopalakrishnan Ramakanth, D.ortho, DNB(ortho), D.SICOT, INDIA
Determining The Predictive Value Of A "Pop" For Medial Meniscal Root Tears ePoster Presentation Serafina Faith Zotter, BS, UNITED STATES Brian S Tao, BA, UNITED STATES Naina Ravi Prakash, -, UNITED STATES Amanda Schillinger, BA, UNITED STATES Giovanna Medina, MD, MSc, PhD, UNITED STATES
Pediatric Failed Meniscus Repair In >5000 Arthroscopic Meniscus Repairs ePoster Presentation Keinan Agonias, BS, UNITED STATES Robert Van Pelt, MPH, UNITED STATES Richard E Bowen, MD Charles M. Chan, MD, UNITED STATES Matthew D. Milewski, MD, UNITED STATES Eric Edmonds, UNITED STATES Ben E. Heyworth, MD, UNITED STATES Philip Wilson, MD, UNITED STATES Kevin G. Shea, MD, UNITED STATES Henry B. Ellis, MD, UNITED STATES Members of the SCORE Quality Improvement Registry, -, UNITED STATES
Simulator Wet Knee Joint Model For Arthroscopic Meniscal Repair Training ePoster Presentation Shammas Basheer Muhammed, DNB,D ORTHO , MS ORTHO, INDIA
Clinical And Radiological Outcomes Of Medial Meniscal Allograft Transplantation Combined With High Tibial Osteotomy ePoster Presentation Dhong-Won Lee, MD, PhD, KOREA, REPUBLIC OF Jin-Goo Kim, MD, PhD, KOREA, REPUBLIC OF
Improved Healing Rates Of Meniscal Repair With Concomitant Posterior Cruciate Ligament Reconstruction Compared To Meniscal Repair Alone ePoster Presentation Nathan Varady, MD, MBA, UNITED STATES Suhas Parise, BS, UNITED STATES Riley J. Williams, MD, UNITED STATES
Proof Of Concept Of A Novel Surgical Technique To Improve The Treatment Of Horizontal Cleavage Meniscus Tears: “The Quad Tendon Augmentation Technique”. ePoster Presentation Maximiliano Ibañez, MD, SPAIN Caroline Mouton, PhD, LUXEMBOURG Felix Hoffmann, MD, LUXEMBOURG Romain Seil, MD, Prof., LUXEMBOURG
Early Complications Following Open Parameniscal And Popliteal Cyst Excision Of The Knee ePoster Presentation Marlena Ramanis, BS, BA, UNITED STATES Kory B. Dylan Pasko, BS, UNITED STATES Dean Wang, MD, UNITED STATES

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Meniscoplasty And Centralization For Medial Meniscus Degenerative Tears With Extrusion: A Novel Technique And Initial Clinical Outcomes

Meniscoplasty And Centralization For Medial Meniscus Degenerative Tears With Extrusion: A Novel Technique And Initial Clinical Outcomes

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Conclusion

Knee Meniscus ePosters

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Meniscoplasty And Centralization For Medial Meniscus Degenerative Tears With Extrusion: A Novel Technique And Initial Clinical Outcomes

Meniscoplasty And Centralization For Medial Meniscus Degenerative Tears With Extrusion: A Novel Technique And Initial Clinical Outcomes

Introduction

Methods

Results

Conclusion