PMID- 26142540
OWN - NLM
STAT- MEDLINE
DCOM- 20160316
LR  - 20220408
IS  - 1434-3916 (Electronic)
IS  - 0936-8051 (Linking)
VI  - 135
IP  - 9
DP  - 2015 Sep
TI  - Comparison between conservative treatment and arthroscopic pull-out repair of the 
      medial meniscus root tear and analysis of prognostic factors for the 
      determination of repair indication.
PG  - 1265-76
LID - 10.1007/s00402-015-2269-8 [doi]
AB  - INTRODUCTION: This study was undertaken to compare the clinical outcomes between 
      the conservative treatment and pull-out repair of the medial meniscus root tear 
      (MMRT), and to analyze the prognostic factors of the MMRT repair for the 
      determination of repair indication. MATERIALS AND METHODS: 38 patients, diagnosed 
      with a MMRT between August 2010 and February 2012, were retrospectively 
      evaluated. Among these patients, 25 patients (pull-out repair group) underwent 
      arthroscopic pull-out repair and the remaining 13 patients (conservative 
      treatment group) underwent conservative management. Two groups were compared 
      using the final clinical outcomes (using Tegner and Lysholm activity scale, IKDC 
      subjective score). For the analysis of prognostic factors of the pull-out repair, 
      patients' factors, radiologic, and magnetic resonance imaging factors were 
      evaluated. Degrees of varus alignment (>/=5 degrees ) and cartilage status (>/=outerbridge 
      III) were employed as a cut-off value in comparing the final clinical outcomes 
      among the subgroups. RESULTS: In the final clinical results, the MMRT pull-out 
      repair group had better IKDC subjective scores (p < 0.001), Tegner and Lysholm 
      activity scale (p = 0.017). In the MMRT pull-out repair group, mild varus knee 
      patient achieved better clinical outcome than the severe varus knee patient (p = 
      0.006). And the mild cartilage degenerative patient group achieved better 
      outcomes than the severe cartilage degenerative patient group (p = 0.009). 
      However, there was no significant difference between the severe varus alignment 
      group and conservative treatment group (p = 0.487). Severe cartilage changes also 
      show no significant difference (p = 0.643). CONCLUSIONS: The MMRT pull-out repair 
      group had better clinical results than that the conservative treatment group. 
      However, severe varus alignment and severe degeneration of cartilage status were 
      a poor prognostic factor, and there was no significant difference between the 
      severe varus alignment or severe cartilage change and the conservative treatment 
      group in the clinical results. The other optional treatment could be recommended 
      for patients who have MMRT with a severe varus knee alignment or severe 
      cartilage.
FAU - Ahn, Jin Hwan
AU  - Ahn JH
AD  - Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan 
      University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 110-746, 
      Republic of Korea, jha3535@naver.com.
FAU - Jeong, Hwa Jae
AU  - Jeong HJ
FAU - Lee, Yong Seuk
AU  - Lee YS
FAU - Park, Jai Hyung
AU  - Park JH
FAU - Lee, Jae Wook
AU  - Lee JW
FAU - Park, Jong-Hyon
AU  - Park JH
FAU - Ko, Taeg Su
AU  - Ko TS
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20150705
PL  - Germany
TA  - Arch Orthop Trauma Surg
JT  - Archives of orthopaedic and trauma surgery
JID - 9011043
SB  - IM
MH  - Adult
MH  - Aged
MH  - Arthroscopy/*methods
MH  - Cartilage, Articular/pathology
MH  - Female
MH  - Humans
MH  - Knee Injuries/*therapy
MH  - Lysholm Knee Score
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Menisci, Tibial/*surgery
MH  - Middle Aged
MH  - *Patient Outcome Assessment
MH  - Physical Therapy Modalities
MH  - Prognosis
MH  - Retrospective Studies
MH  - Tibial Meniscus Injuries
EDAT- 2015/07/06 06:00
MHDA- 2016/03/17 06:00
CRDT- 2015/07/06 06:00
PHST- 2014/11/07 00:00 [received]
PHST- 2015/07/06 06:00 [entrez]
PHST- 2015/07/06 06:00 [pubmed]
PHST- 2016/03/17 06:00 [medline]
AID - 10.1007/s00402-015-2269-8 [doi]
PST - ppublish
SO  - Arch Orthop Trauma Surg. 2015 Sep;135(9):1265-76. doi: 10.1007/s00402-015-2269-8. 
      Epub 2015 Jul 5.