Transtibial pullout repair of medial meniscus posterior root tear restores physiological rotation of the tibia in the knee-flexed position

Yuki Okazaki, Takayuki Furumatsu, Yuya Kodama, Tomohito Hino, Yusuke Kamatsuki, Yoshiki Okazaki, Shin Masuda, Shinichi Miyazawa, Hirosuke Endo, Tomonori Tetsunaga, Kazuki Yamada, Toshihumi Ozaki

Research output: Contribution to journalArticle

Abstract

Background: Medial meniscus posterior root tear (MMPRT) results in joint overloading and degenerative changes in the knee. Favorable clinical outcomes have been reported after transtibial pullout repair of MMPRT. To date, however, in vivo tibial rotational changes before and after root repair remain poorly understood. The purpose of this study was to investigate postoperative changes in tibial rotation following MMPRT pullout repair. Hypothesis: Pathological external rotation of the tibia in the knee-flexed position is caused by MMPRT and is reduced after transtibial pullout repair. Patients and methods: Fifteen patients who underwent MMPRT pullout repair and 7 healthy volunteers were included. Magnetic resonance imaging examinations were performed in the 10° and 90° knee-flexed positions. The angles between the surgical epicondylar axis and a line between the medial border of the patellar tendon and the apex of the medial tibial spine were measured. Baseline was defined as a line lying at a right angle to the other, and a value was positive and negative when the tibia rotated internally and externally, respectively. Results: In the volunteer's normal knees, tibial internal rotation was +1.00° ± 3.27° at 10° flexion and +4.14° ± 3.46° at 90° flexion. In the MMPRT preoperative knees, tibial internal rotation was +1.07° ± 3.01° at 10° flexion and +1.27° ± 2.96° at 90° flexion. In the postoperative knees, tibial internal rotation was +1.60° ± 2.85° at 10° flexion and +4.33° ± 2.89° at 90° flexion. Discussion: This study demonstrates discontinuity of the MM posterior root may induce a pathological external rotation of the tibia during knee flexion and that MMPRT pullout repair reduces the pathological external rotation of the tibia in the knee-flexed position. Level of evidence: III, comparative retrospective study.

Original languageEnglish
JournalOrthopaedics and Traumatology: Surgery and Research
DOIs
Publication statusAccepted/In press - Jan 1 2018

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Tibial Meniscus
Tibia
Tears
Knee
Healthy Volunteers
Patellar Ligament
Spine
Retrospective Studies
Joints
Magnetic Resonance Imaging

Keywords

  • Magnetic resonance imaging
  • Medial meniscus
  • Posterior root tear
  • Tibial rotation
  • Transtibial pullout repair

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{74fcbc229b7e4234b93af784eaecf6c5,
title = "Transtibial pullout repair of medial meniscus posterior root tear restores physiological rotation of the tibia in the knee-flexed position",
abstract = "Background: Medial meniscus posterior root tear (MMPRT) results in joint overloading and degenerative changes in the knee. Favorable clinical outcomes have been reported after transtibial pullout repair of MMPRT. To date, however, in vivo tibial rotational changes before and after root repair remain poorly understood. The purpose of this study was to investigate postoperative changes in tibial rotation following MMPRT pullout repair. Hypothesis: Pathological external rotation of the tibia in the knee-flexed position is caused by MMPRT and is reduced after transtibial pullout repair. Patients and methods: Fifteen patients who underwent MMPRT pullout repair and 7 healthy volunteers were included. Magnetic resonance imaging examinations were performed in the 10° and 90° knee-flexed positions. The angles between the surgical epicondylar axis and a line between the medial border of the patellar tendon and the apex of the medial tibial spine were measured. Baseline was defined as a line lying at a right angle to the other, and a value was positive and negative when the tibia rotated internally and externally, respectively. Results: In the volunteer's normal knees, tibial internal rotation was +1.00° ± 3.27° at 10° flexion and +4.14° ± 3.46° at 90° flexion. In the MMPRT preoperative knees, tibial internal rotation was +1.07° ± 3.01° at 10° flexion and +1.27° ± 2.96° at 90° flexion. In the postoperative knees, tibial internal rotation was +1.60° ± 2.85° at 10° flexion and +4.33° ± 2.89° at 90° flexion. Discussion: This study demonstrates discontinuity of the MM posterior root may induce a pathological external rotation of the tibia during knee flexion and that MMPRT pullout repair reduces the pathological external rotation of the tibia in the knee-flexed position. Level of evidence: III, comparative retrospective study.",
keywords = "Magnetic resonance imaging, Medial meniscus, Posterior root tear, Tibial rotation, Transtibial pullout repair",
author = "Yuki Okazaki and Takayuki Furumatsu and Yuya Kodama and Tomohito Hino and Yusuke Kamatsuki and Yoshiki Okazaki and Shin Masuda and Shinichi Miyazawa and Hirosuke Endo and Tomonori Tetsunaga and Kazuki Yamada and Toshihumi Ozaki",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.otsr.2018.10.005",
language = "English",
journal = "Orthopaedics and Traumatology: Surgery and Research",
issn = "1877-0568",
publisher = "Elsevier Masson",

}

TY - JOUR

T1 - Transtibial pullout repair of medial meniscus posterior root tear restores physiological rotation of the tibia in the knee-flexed position

AU - Okazaki, Yuki

AU - Furumatsu, Takayuki

AU - Kodama, Yuya

AU - Hino, Tomohito

AU - Kamatsuki, Yusuke

AU - Okazaki, Yoshiki

AU - Masuda, Shin

AU - Miyazawa, Shinichi

AU - Endo, Hirosuke

AU - Tetsunaga, Tomonori

AU - Yamada, Kazuki

AU - Ozaki, Toshihumi

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Medial meniscus posterior root tear (MMPRT) results in joint overloading and degenerative changes in the knee. Favorable clinical outcomes have been reported after transtibial pullout repair of MMPRT. To date, however, in vivo tibial rotational changes before and after root repair remain poorly understood. The purpose of this study was to investigate postoperative changes in tibial rotation following MMPRT pullout repair. Hypothesis: Pathological external rotation of the tibia in the knee-flexed position is caused by MMPRT and is reduced after transtibial pullout repair. Patients and methods: Fifteen patients who underwent MMPRT pullout repair and 7 healthy volunteers were included. Magnetic resonance imaging examinations were performed in the 10° and 90° knee-flexed positions. The angles between the surgical epicondylar axis and a line between the medial border of the patellar tendon and the apex of the medial tibial spine were measured. Baseline was defined as a line lying at a right angle to the other, and a value was positive and negative when the tibia rotated internally and externally, respectively. Results: In the volunteer's normal knees, tibial internal rotation was +1.00° ± 3.27° at 10° flexion and +4.14° ± 3.46° at 90° flexion. In the MMPRT preoperative knees, tibial internal rotation was +1.07° ± 3.01° at 10° flexion and +1.27° ± 2.96° at 90° flexion. In the postoperative knees, tibial internal rotation was +1.60° ± 2.85° at 10° flexion and +4.33° ± 2.89° at 90° flexion. Discussion: This study demonstrates discontinuity of the MM posterior root may induce a pathological external rotation of the tibia during knee flexion and that MMPRT pullout repair reduces the pathological external rotation of the tibia in the knee-flexed position. Level of evidence: III, comparative retrospective study.

AB - Background: Medial meniscus posterior root tear (MMPRT) results in joint overloading and degenerative changes in the knee. Favorable clinical outcomes have been reported after transtibial pullout repair of MMPRT. To date, however, in vivo tibial rotational changes before and after root repair remain poorly understood. The purpose of this study was to investigate postoperative changes in tibial rotation following MMPRT pullout repair. Hypothesis: Pathological external rotation of the tibia in the knee-flexed position is caused by MMPRT and is reduced after transtibial pullout repair. Patients and methods: Fifteen patients who underwent MMPRT pullout repair and 7 healthy volunteers were included. Magnetic resonance imaging examinations were performed in the 10° and 90° knee-flexed positions. The angles between the surgical epicondylar axis and a line between the medial border of the patellar tendon and the apex of the medial tibial spine were measured. Baseline was defined as a line lying at a right angle to the other, and a value was positive and negative when the tibia rotated internally and externally, respectively. Results: In the volunteer's normal knees, tibial internal rotation was +1.00° ± 3.27° at 10° flexion and +4.14° ± 3.46° at 90° flexion. In the MMPRT preoperative knees, tibial internal rotation was +1.07° ± 3.01° at 10° flexion and +1.27° ± 2.96° at 90° flexion. In the postoperative knees, tibial internal rotation was +1.60° ± 2.85° at 10° flexion and +4.33° ± 2.89° at 90° flexion. Discussion: This study demonstrates discontinuity of the MM posterior root may induce a pathological external rotation of the tibia during knee flexion and that MMPRT pullout repair reduces the pathological external rotation of the tibia in the knee-flexed position. Level of evidence: III, comparative retrospective study.

KW - Magnetic resonance imaging

KW - Medial meniscus

KW - Posterior root tear

KW - Tibial rotation

KW - Transtibial pullout repair

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SN - 1877-0568

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