Clinical and Radiological Results with Second-Look Arthroscopic Findings after Open Wedge High Tibial Osteotomy without Arthroscopic Procedures for Medial Meniscal Root Tears
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: To identify the structural integrity of the healing site after medial open wedge high tibial osteotomy (MOWHTO) in patients with a posterior root tear of the medial meniscus (PRTMM) and chondral lesion by second-look arthroscopy and to determine the clinical and radiological findings. Materials and Methods: From August 2010 to June 2016, 52 consecutive patients underwent MOWHTO and arthroscopic examination without a chondral resurfacing procedure and meniscal treatment for PRTMM. Twenty-four patients were available for second-look arthroscopic evaluation. The mean follow-up period was 19.5 months (range, 5 to 46 months). Clinical evaluation was based on the Lysholm knee scores and Hospital for Special Surgery (HSS) scores. Results: There were 5 lax healing, 6 scar tissue, 13 failed healing of PRTMM. Definite change of chondral lesion was not observed. The Kellgren- Lawrence grade did not improve according to the follow-up plain radiograph. The mean Lysholm score improved from 34.7 preoperatively to 77.1 at the last follow-up, and the mean HSS score significantly increased from 36.5 to 82.4. Conclusions: This study revealed a low rate of healing potency of PRTMM and chondral lesion after MOWHTO without any attempt for meniscal treatment or chondral resurfacing. The cartilage and healing status of PRTMM was not associated with improved clinical outcomes and radiological findings.
Abstract
Purpose: To identify the structural integrity of the healing site after medial open wedge high tibial osteotomy (MOWHTO) in patients with a posterior root tear of the medial meniscus (PRTMM) and chondral lesion by second-look arthroscopy and to determine the clinical and radiological findings. Materials and Methods: From August 2010 to June 2016, 52 consecutive patients underwent MOWHTO and arthroscopic examination without a chondral resurfacing procedure and meniscal treatment for PRTMM. Twenty-four patients were available for second-look arthroscopic evaluation. The mean follow-up period was 19.5 months (range, 5 to 46 months). Clinical evaluation was based on the Lysholm knee scores and Hospital for Special Surgery (HSS) scores. Results: There were 5 lax healing, 6 scar tissue, 13 failed healing of PRTMM. Definite change of chondral lesion was not observed. The Kellgren- Lawrence grade did not improve according to the follow-up plain radiograph. The mean Lysholm score improved from 34.7 preoperatively to 77.1 at the last follow-up, and the mean HSS score significantly increased from 36.5 to 82.4. Conclusions: This study revealed a low rate of healing potency of PRTMM and chondral lesion after MOWHTO without any attempt for meniscal treatment or chondral resurfacing. The cartilage and healing status of PRTMM was not associated with improved clinical outcomes and radiological findings.
참고문헌 (22)
- Villegas DF, "A quantitative study of the microstructure and biochemistry of the medial meniscal horn attachments", Ann Biomed Eng, 36, pp.123~131 (2008)[DOI]
- Ozkoc G, "Radial tears in the root of the posterior horn of the medial meniscus", Knee Surg Sports Traumatol Arthrosc, 16, pp.849~854 (2008)[DOI]
- Koenig JH, "Meniscal root tears: diagnosis and treatment", Arthroscopy, 25, pp.1025~1032 (2009)[DOI]
- Allaire R, "Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy", J Bone Joint Surg Am, 90, pp.1922~1931 (2008)[DOI]
- Bin SI, "Radial tears of the posterior horn of the medial meniscus", Arthroscopy, 20, pp.373~378 (2004)[DOI]
- Harner CD, "Biomechanical consequences of a tear of the posterior root of the medial meniscus: surgical technique", J Bone Joint Surg Am, 91(Suppl 2), pp.257~270 (2009)
- Jones AO, "Medial meniscus posterior root attachment injury and degeneration: MRI findings", Australas Radiol, 50, pp.306~313 (2006)[DOI]
- Lerer DB, "The role of meniscal root pathology and radial meniscal tear in medial meniscal extrusion", Skeletal Radiol, 33, pp.569~574 (2004)
- Seo HS, "Second-look arthroscopic findings after repairs of posterior root tears of the medial meniscus", Am J Sports Med, 39, pp.99~107 (2011)[DOI]
- Kanamiya T, "The influences of biomechanical factors on cartilage regeneration after high tibial osteotomy for knees with medial compartment osteoarthritis: clinical and arthroscopic observations", Arthroscopy, 18, pp.725~729 (2002)[DOI]
- Choi NH, "Arthroscopic all-inside repair for a tear of posterior root of the medial meniscus: a technical note", Knee Surg Sports Traumatol Arthrosc, 16, pp.891~893 (2008)[DOI]
- Kim SB, "Medial meniscus root tear refixation: comparison of clinical, radiologic, and arthroscopic findings with medial meniscectomy", Arthroscopy, 27, pp.346~354 (2011)[DOI]
- Lee JH, "Arthroscopic pullout suture repair of posterior root tear of the medial meniscus: radiographic and clinical results with a 2-year followup", Arthroscopy, 25, pp.951~958 (2009)[DOI]
- Nha KW, "Posterior reattachment of a radial tear in the posterior root of the medial meniscus", Orthopedics, 34, pp.276~280 (2011)[DOI]
- Park YS, "Arthroscopic pullout repair of posterior root tear of the medial meniscus: the anterior approach using medial collateral ligament pie-crusting release", Knee Surg Sports Traumatol Arthrosc, 19, pp.1334~1336 (2011)[DOI]
- Seo JH, "Effect of repair of radial tears at the root of the posterior horn of the medial meniscus with the pullout suture technique: a biomechanical study using porcine knees", Arthroscopy, 25, pp.1281~1287 (2009)[DOI]
- Sterett WI, "Chondral resurfacing and high tibial osteotomy in the varus knee: survivorship analysis", Am J Sports Med, 38, pp.1420~1424 (2010)[DOI]
- Bergenudd H, "The articular cartilage after osteotomy for medial gonarthrosis: biopsies after 2 years in 19 cases", Acta Orthop Scand, 63, pp.413~416 (1992)[DOI]
- Nha KW, "Second-look arthroscopic findings after open-wedge high tibia osteotomy focusing on the posterior root tears of the medial meniscus", Arthroscopy, 29, pp.226~231 (2013)[DOI]
- 이동원, "Medial Meniscus Posterior Root Tear: A Comprehensive Review", Knee Surgery and Related Research, 26(3), pp.125~134 (2014), 대한슬관절학회
- Kfuri M, "High tibial osteotomy for the correction of varus knee deformity", J Knee Surg, 30, pp.409~420 (2017)[DOI]
- Akizuki S, "Does arthroscopic abrasion arthroplasty promote cartilage regeneration in osteoarthritic knees with eburnation? A prospective study of high tibial osteotomy with abrasion arthroplasty versus high tibial osteotomy alone", Arthroscopy, 13, pp.9~17 (1997)[DOI]