2017 ISAKOS Biennial Congress ePoster #1328
Clinical and Radiologic Outcomes Following Surgical Treatment for Medial Meniscus Root Tear in the Middle Age (Meniscus Repair Vs Subtotal Meniscectomy)
Chong Hyuk Choi, MD, Seoul KOREA, REPUBLIC OF
Ki Joon Jang, MD, Seoul KOREA, REPUBLIC OF
Gil Sung Yoon, MD, Seoul KOREA, REPUBLIC OF
Jun-Sik Kim, MD, Seoul, Ganseo-gu KOREA, REPUBLIC OF
Yoo Chul Jeong, MD, Seoul, Seodaemungu KOREA, REPUBLIC OF
Tae-Hwan Yoon, MD, Seoul KOREA, REPUBLIC OF
Yonsei University College of Medicine, Severance Hospital, Seoul, KOREA, REPUBLIC OF
FDA Status Not Applicable
Summary
In surgical treatment of medial meniscus root tear, meniscus repair is more effective than subtotal meniscectomy in the middle age to delay of arthritic change.
Abstract
Purpose
This study is to compare the clinical and radiologic outcomes of meniscal repair group with meniscal resection group for medial meniscus root tear (MRT) in the middle age
Materials And Methods
This study enrolled patients in their fifties with medial MRT who underwent meniscal repair (A group, n=47) or meniscal resection (B group, n=45) between April 2011 and May 2013. Minimum follow-up duration was 24 months and patients who have other concomitant ligament injury and grade IV cartilage damage, K-L grade IV, malalignment beyond 3` genu varum were excluded. Total 92 patients were enrolled in this study. A group was done meniscus repair using pull out technique(Reverse modified Mason Allen technique) and B group was done subtotal meniscectomy from body to posterior horn. We compared clinical and radiologic outcomes A group with B group. Clinical assessments parameters were the International Knee Documentation Committee (IKDC) subjective knee score, Lysholm score and radiologic assessment parameters were medial joint space width, and Kellgren-Lawrence grade
Results
There were no differences in demographic, clinical data and pre-op medial femoral condylar cartilage damage degree between the two groups. Lysholm and IKDC scores improved significantly in both groups (P<0.05). A group had better Lysholm and IKDC scores, but it was not statistically significant(P=0.12). There were no differences in pre-op mean medial joint space width(A group=6.53, B group=6.34), but post-op mean joint space narrowing was 0.26mm in A group, 0.73mm in B group. It was statistically significant(P<0.05). Progression of the Kellgren-Lawrence grade was 7 in 47 patients in A group, 23 in 47 patients in A group. It was statistically significant between two groups(P<0.05)
Conclusions
Both meniscus repair and subtotal meniscectomy gave significantly good clinical result in medial MRT. A group showed less medial joint space narrowing, K-L grade progression than B group, but both groups showed medial joint space narrowing and K-L grade progression. So in surgical treatment of medial MRT, meniscus repair is more effective than subtotal meniscectomy in the middle age to delay of arthritic change.
Keywords
Medial meniscus, root tear, repair, subtotal meniscectomy