TY - JOUR
T1 - Medial Meniscus Posterior Root Tear Treatment
T2 - A Matched Cohort Comparison of Nonoperative Management, Partial Meniscectomy, and Repair
AU - Bernard, Christopher D
AU - Kennedy, Nicholas I
AU - Tagliero, Adam J
AU - Camp, Christopher L
AU - Saris, Daniel B F
AU - Levy, Bruce A
AU - Stuart, Michael J
AU - Krych, Aaron J
N1 - Funding Information:
Meniscus root repair leads to significantly less arthritis progression and subsequent knee arthroplasty compared with nonoperative management and partial meniscectomy in a matched cohort based on patient characteristics. medial meniscus posterior root tear root tear meniscus matched cohort root repair edited-state corrected-proof Submitted April 1, 2019; accepted September 26, 2019. One or more of the authors has declared the following potential conflict of interest or source of funding: C.L.C. has received general payments from Arthrex Inc (travel and lodging, education) and Zimmer Biomet Holdings Inc (travel and lodging). M.J.S. has received research support from Arthrex and Stryker; IP royalties from Arthrex; consulting fees from Arthrex; and hospitality payments from Gemini Medical LLC. B.A.L. has received IP royalties from Arthrex and VOT Solutions; consulting fees from Arthrex; and speaking fees from Linvatec and Smith & Nephew. D.B.F.S. has received consulting fees from Smith & Nephew, Genzyme, and Tigenix; and speaker fees from Smith & Nephew. A.J.K. has received research support from Aesculap/B. Braun, Arthritis Foundation, Ceterix, and Histogenics; consulting fees from Arthrex Inc, Vericel, and DePuy; IP royalties from Arthrex Inc; a grant from Exactech; and honoraria from Vericel and Musculoskeletal Transplant Foundation. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
Publisher Copyright:
© 2019 The Author(s).
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - BACKGROUND: There are limited data comparing the outcomes of similarly matched patients with a medial meniscus posterior root tear (MMPRT) treated with nonoperative management, partial meniscectomy, or repair.PURPOSE/HYPOTHESIS: The purpose was to compare treatment failure, clinical outcome scores, and radiographic findings for a matched cohort of patients who underwent either nonoperative management, partial meniscectomy, or transtibial pull-through repair for an MMPRT. We hypothesized that patients who underwent meniscus root repair will have lower rates of progression to arthroplasty than patients who were treated with nonoperative management or partial meniscectomy.STUDY DESIGN: Cohort study; Level of evidence, 3.METHODS: Patients who underwent transtibial medial meniscus posterior horn root repair were matched by meniscal laterality, age, sex, and Kellgren-Lawrence (K-L) grades to patients treated nonoperatively or with a partial meniscectomy. Progression to arthroplasty rates, International Knee Documentation Committee and Tegner scores, and radiographic outcomes were analyzed between groups.RESULTS: Forty-five patients were included in this study (15 nonoperative, 15 partial meniscectomy, 15 root repair). Progression to arthroplasty demonstrated significant differences among treatment groups at a mean of 74 months (nonoperative, 4/15; partial meniscectomy, 9/15; meniscal repair, 0/15; P = .0003). The meniscus root repair group had significantly less arthritic progression, as measured by change in K-L grade from pre- to postoperatively (nonoperative, 1.0; partial meniscectomy, 1.1; meniscal repair, 0.1; P = .001).CONCLUSION: Meniscus root repair leads to significantly less arthritis progression and subsequent knee arthroplasty compared with nonoperative management and partial meniscectomy in a matched cohort based on patient characteristics.
AB - BACKGROUND: There are limited data comparing the outcomes of similarly matched patients with a medial meniscus posterior root tear (MMPRT) treated with nonoperative management, partial meniscectomy, or repair.PURPOSE/HYPOTHESIS: The purpose was to compare treatment failure, clinical outcome scores, and radiographic findings for a matched cohort of patients who underwent either nonoperative management, partial meniscectomy, or transtibial pull-through repair for an MMPRT. We hypothesized that patients who underwent meniscus root repair will have lower rates of progression to arthroplasty than patients who were treated with nonoperative management or partial meniscectomy.STUDY DESIGN: Cohort study; Level of evidence, 3.METHODS: Patients who underwent transtibial medial meniscus posterior horn root repair were matched by meniscal laterality, age, sex, and Kellgren-Lawrence (K-L) grades to patients treated nonoperatively or with a partial meniscectomy. Progression to arthroplasty rates, International Knee Documentation Committee and Tegner scores, and radiographic outcomes were analyzed between groups.RESULTS: Forty-five patients were included in this study (15 nonoperative, 15 partial meniscectomy, 15 root repair). Progression to arthroplasty demonstrated significant differences among treatment groups at a mean of 74 months (nonoperative, 4/15; partial meniscectomy, 9/15; meniscal repair, 0/15; P = .0003). The meniscus root repair group had significantly less arthritic progression, as measured by change in K-L grade from pre- to postoperatively (nonoperative, 1.0; partial meniscectomy, 1.1; meniscal repair, 0.1; P = .001).CONCLUSION: Meniscus root repair leads to significantly less arthritis progression and subsequent knee arthroplasty compared with nonoperative management and partial meniscectomy in a matched cohort based on patient characteristics.
KW - Arthroplasty, Replacement, Knee/statistics & numerical data
KW - Cohort Studies
KW - Female
KW - Humans
KW - Knee Joint/surgery
KW - Male
KW - Meniscectomy/methods
KW - Menisci, Tibial/surgery
KW - Middle Aged
KW - Postoperative Period
KW - Retrospective Studies
KW - Rupture/surgery
KW - Tibial Meniscus Injuries/surgery
UR - http://www.scopus.com/inward/record.url?scp=85075498905&partnerID=8YFLogxK
U2 - 10.1177/0363546519888212
DO - 10.1177/0363546519888212
M3 - Article
C2 - 31765234
SN - 0363-5465
VL - 48
SP - 128
EP - 132
JO - American Journal of Sports Medicine
JF - American Journal of Sports Medicine
IS - 1
ER -