Yuki Okazaki1,2, Takayuki Furumatsu3, Yuya Kodama1,4, Takaaki Hiranaka1, Keisuke Kintaka1, Yusuke Kamatsuki1, Toshifumi Ozaki1. 1. Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan. 2. Department of Orthopaedic Surgery, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama, Okayama, 708-0841, Japan. 3. Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan. matino@md.okayama-u.ac.jp. 4. Department of Orthopaedic Surgery, University of Pittsburgh, 4200 Fifth Avenue, Pittsburgh, PA, 15260, USA.
Abstract
PURPOSE: Medial meniscus (MM) posterior root tears (PRTs) lead to abnormal kinematic changes in the knee and may induce pathological external rotation of the tibia during knee flexion. This study aimed to investigate changes in the length and inclination of the anterior cruciate ligament (ACL) after MM posterior root repair using magnetic resonance imaging (MRI). METHODS: This retrospective study included 44 patients who underwent MM posterior root repair between 2016 and 2019. Clinical outcomes were evaluated before and after surgery. MRI examinations were performed at 10°/90° of knee flexion preoperatively and 3 months postoperatively. The ACL length, proximal angle, and distal angle were determined using the sagittal view. MM extrusion and ACL inclination angle were determined using the coronal view. RESULTS: Clinical outcomes significantly improved 1 year after surgery. The postoperative ACL length (29.7 ± 2.4 mm) and proximal angle (47.0 ± 7.4°) at 90° of knee flexion decreased relative to the preoperative values (31.5 ± 2.3 mm and 51.8 ± 8.7°, P < 0.01). The postoperative ACL inclination (64.9 ± 5.6°) at 10° of knee flexion decreased relative to the preoperative value (69.7 ± 5.6°, P < 0.01). CONCLUSION: Pathologically-stretched linear ACL at 90° of knee flexion and a steep ACL inclination at 10° of knee flexion could be reduced after MM posterior root repair. This suggests that pullout repair could restore MM function as a secondary stabilizer, thereby preventing meniscal and cartilage degeneration.
PURPOSE: Medial meniscus (MM) posterior root tears (PRTs) lead to abnormal kinematic changes in the knee and may induce pathological external rotation of the tibia during knee flexion. This study aimed to investigate changes in the length and inclination of the anterior cruciate ligament (ACL) after MM posterior root repair using magnetic resonance imaging (MRI). METHODS: This retrospective study included 44 patients who underwent MM posterior root repair between 2016 and 2019. Clinical outcomes were evaluated before and after surgery. MRI examinations were performed at 10°/90° of knee flexion preoperatively and 3 months postoperatively. The ACL length, proximal angle, and distal angle were determined using the sagittal view. MM extrusion and ACL inclination angle were determined using the coronal view. RESULTS: Clinical outcomes significantly improved 1 year after surgery. The postoperative ACL length (29.7 ± 2.4 mm) and proximal angle (47.0 ± 7.4°) at 90° of knee flexion decreased relative to the preoperative values (31.5 ± 2.3 mm and 51.8 ± 8.7°, P < 0.01). The postoperative ACL inclination (64.9 ± 5.6°) at 10° of knee flexion decreased relative to the preoperative value (69.7 ± 5.6°, P < 0.01). CONCLUSION: Pathologically-stretched linear ACL at 90° of knee flexion and a steep ACL inclination at 10° of knee flexion could be reduced after MM posterior root repair. This suggests that pullout repair could restore MM function as a secondary stabilizer, thereby preventing meniscal and cartilage degeneration.
Authors: Christopher M LaPrade; Evan W James; Tyler R Cram; John A Feagin; Lars Engebretsen; Robert F LaPrade Journal: Am J Sports Med Date: 2014-12-01 Impact factor: 6.202
Authors: Christopher M LaPrade; Abdullah Foad; Sean D Smith; Travis Lee Turnbull; Grant J Dornan; Lars Engebretsen; Coen A Wijdicks; Robert F LaPrade Journal: Am J Sports Med Date: 2015-01-26 Impact factor: 6.202
Authors: Christopher M LaPrade; Kyle S Jansson; Grant Dornan; Sean D Smith; Coen A Wijdicks; Robert F LaPrade Journal: J Bone Joint Surg Am Date: 2014-03-19 Impact factor: 5.284
Authors: S Masuda; T Furumatsu; Y Okazaki; Y Kodama; T Hino; Y Kamatsuki; S Miyazawa; T Ozaki Journal: Orthop Traumatol Surg Res Date: 2018-04-10 Impact factor: 2.256