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. 2021 Jan;12(1):62-69.
doi: 10.1177/1947603518809409. Epub 2018 Oct 31.

Safety, Feasibility, and Radiographic Outcomes of the Anterior Meniscal Takedown Technique to Approach Chondral Defects on the Tibia and Posterior Femoral Condyle: A Matched Control Study

Gergo Merkely  1   2 , Tom Minas  1   3 , Takahiro Ogura  1   4 , Jakob Ackermann  1 , Alexandre Barbieri Mestriner  1   5 , Andreas H Gomoll  1   6
Affiliations

Safety, Feasibility, and Radiographic Outcomes of the Anterior Meniscal Takedown Technique to Approach Chondral Defects on the Tibia and Posterior Femoral Condyle: A Matched Control Study

Gergo Merkely et al. Cartilage. 2021 Jan.

Abstract

Objective: Takedown of the anterior meniscus to facilitate exposure of the cartilage defects located on the tibial plateau and/or posterior femoral condyle with subsequent reattachment is being performed clinically; however, clinical evidence is lacking to support the safety of this technique. The aim of this study was therefore to investigate whether meniscal extrusion develops after patients undergo meniscus takedown and transosseous refixation during autologous chondrocyte implantation (ACI).

Design: We analyzed data from 124 patients with a mean follow-up of 6.8 ± 2.5 years. Sixty-two patients who underwent (ACI) with anterior meniscus takedown and refixation by the senior surgeon (TM), were compared with a matched control group of patients who underwent ACI without meniscus takedown. Meniscal extrusion was investigated by measuring the absolute value and the relative percentage of extrusion (RPE) on 1.5-T magnetic resonance images (MRI) at final follow-up. The number of menisci with radial displacement greater or lesser than 3 mm was determined. In cases where a preoperative MRI was available, both pre- and postoperative meniscal extrusion was evaluated (n = 30) in those patients undergoing meniscal takedown.

Results: There was no significant difference in either absolute meniscus extrusion, RPE, or extrusion rate in patients with and without meniscus takedown. Among patients with meniscal takedown and both pre- and postoperative MRI scans, absolute meniscus extrusion, RPE, and extrusion rate showed no significant differences.

Conclusion: Meniscal takedown and subsequent transosseous refixation is a safe and effective technique for exposure of the tibial plateau and posterior femoral condyle.

Keywords: cartilage repair; knee surgery; meniscal extrusion; meniscal repair; surgical exposure.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Perioperative images of a patient who underwent autologous chondrocyte implantation (ACI) for a lateral tibial plateau defect with meniscus takedown and reattachment. (A) Image showing the takedown of the intermeniscal ligament and the anterior horn of the meniscus. (B) Image showing the defect after ACI procedure. (C) Image showing transosseous refixation of the anterior meniscal horn with nonabsorbable sutures and intermeniscal ligament (arrows) repair.
Figure 2.
Figure 2.
Meniscal extrusion (meniscus is contoured by the dashed line) is defined as the greatest distance (a) from the most peripheral aspect of the meniscus to the border of the tibia, excluding any osteophytes on coronal images. PRE is defined as the percentage of the width of extruded menisci (a) compared with the entire meniscal width (b) (RPE = a/b × 100).
See this image and copyright information in PMC

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