Transtibial pullout repair techniques using two simple stitches for medial meniscus posterior root tear can prevent the progression of medial meniscus extrusion and obtain successful outcomes

doi:10.1007/s00590-021-03035-8

. 2022 Jul;32(5):795-802.

doi: 10.1007/s00590-021-03035-8. Epub 2021 Jun 17.

Transtibial pullout repair techniques using two simple stitches for medial meniscus posterior root tear can prevent the progression of medial meniscus extrusion and obtain successful outcomes

Takaaki Hiranaka¹, Takayuki Furumatsu², Shinichi Miyazawa¹, Yuki Okazaki¹, Keisuke Kintaka¹, Yuya Kodama¹, Yusuke Kamatsuki¹, Toshifumi Ozaki¹

Affiliations

¹ Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
² Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan. matino@md.okayama-u.ac.jp.

PMID: 34137941
DOI: 10.1007/s00590-021-03035-8

Transtibial pullout repair techniques using two simple stitches for medial meniscus posterior root tear can prevent the progression of medial meniscus extrusion and obtain successful outcomes

Takaaki Hiranaka et al. Eur J Orthop Surg Traumatol. 2022 Jul.

. 2022 Jul;32(5):795-802.

doi: 10.1007/s00590-021-03035-8. Epub 2021 Jun 17.

Authors

Takaaki Hiranaka¹, Takayuki Furumatsu², Shinichi Miyazawa¹, Yuki Okazaki¹, Keisuke Kintaka¹, Yuya Kodama¹, Yusuke Kamatsuki¹, Toshifumi Ozaki¹

Affiliations

¹ Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
² Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan. matino@md.okayama-u.ac.jp.

PMID: 34137941
DOI: 10.1007/s00590-021-03035-8

Abstract

Purpose: Transtibial pullout repairs using two simple stitches (TSS) and a combination of TSS with posteromedial pullout repair (TSS + PMP) using an all-inside meniscal repair device have been reported previously for the treatment of medial meniscus (MM) posterior root tears. This study aimed to investigate the postoperative clinical outcomes of these techniques including MM extrusion (MME).

Methods: Fifty-two patients who underwent transtibial pullout repair were investigated and divided into TSS (n = 27) and TSS + PMP (n = 25) groups. The clinical outcomes were assessed using the Lysholm knee score and Knee Injury and Osteoarthritis Outcome Score 1 year postoperatively and compared between two groups. MME was measured using magnetic resonance imaging at 1 year postoperatively and compared between two groups.

Results: A significant improvement in each clinical score was observed in both groups, and no significant difference was seen in clinical outcomes. Moreover, no significant difference in postoperative MME was observed in both groups (TSS and TSS + PMP: 3.5 mm and 3.8 mm, respectively). Though no significant progression of MME was observed in TSS group, a significant progression of it was observed in TSS + PMP group postoperatively.

Conclusions: This study demonstrated that both techniques improved clinical outcomes in the short-term postoperative period. However, MME was progressed significantly in TSS + PMP group 1 year postoperatively, which indicated that PMP might not be a useful additional procedure for reducing the postoperative MME.

Keywords: Arthroscopy; Clinical outcome; Medial meniscus; Posterior root tear; Pullout repair.

PubMed Disclaimer

Cited by

Accuracy of the newly developed Zimmer Biomet Root Aiming guide in tibial tunnel creation compared with that of conventional guides.
Hiranaka T, Furumatsu T, Okazaki Y, Kintaka K, Higashihara N, Tamura M, Nakata E, Ozaki T. Hiranaka T, et al. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2023 Apr 6;32:1-6. doi: 10.1016/j.asmart.2023.03.001. eCollection 2023 Apr. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2023. PMID: 37092123 Free PMC article.
ICRS scores worsen between 2-year short term and 5-year mid-term follow-up after transtibial medial meniscus root repair despite maintained functional outcomes.
Kaplan DJ, Bloom D, Alaia EF, Walter WR, Meislin RJ, Strauss EJ, Jazrawi LM, Alaia MJ. Kaplan DJ, et al. Knee Surg Sports Traumatol Arthrosc. 2022 Jul;30(7):2235-2243. doi: 10.1007/s00167-021-06747-w. Epub 2021 Oct 15. Knee Surg Sports Traumatol Arthrosc. 2022. PMID: 34652498
The preoperative flexion tear gap affects postoperative meniscus stability after pullout repair for medial meniscus posterior root tear.
Tamura M, Furumatsu T, Kitayama T, Yokoyama Y, Okazaki Y, Kawada K, Ozaki T. Tamura M, et al. Knee Surg Relat Res. 2025 Apr 3;37(1):16. doi: 10.1186/s43019-025-00264-7. Knee Surg Relat Res. 2025. PMID: 40181486 Free PMC article.
Patient-reported Outcomes After Medial Meniscus Root Tear Repair Versus Other Medial Meniscus Repairs: An Exploratory Meta-analysis of Single-arm Cohorts.
Gurba JE, Weiss-Laxer NS, Haider MN, Marzo JM. Gurba JE, et al. J Am Acad Orthop Surg Glob Res Rev. 2024 Sep 25;8(9):e23.00293. doi: 10.5435/JAAOSGlobal-D-23-00293. eCollection 2024 Sep 1. J Am Acad Orthop Surg Glob Res Rev. 2024. PMID: 39321043 Free PMC article.
Favorable clinical outcomes are achieved in both male and female following medial meniscus posterior root repair.
Katayama H, Furumatsu T, Okazaki Y, Higashihara N, Yokoyama Y, Tamura M, Kawada K, Hasegawa T, Kohara T, Ozaki T. Katayama H, et al. Eur J Orthop Surg Traumatol. 2025 Jun 14;35(1):245. doi: 10.1007/s00590-025-04344-y. Eur J Orthop Surg Traumatol. 2025. PMID: 40515764 Free PMC article.

References

1. Padalecki JR, Jansson KS, Smith SD, Dornan GJ, Pierce CM, Wijdicks CA, Laprade RF (2014) Biomechanical consequences of a complete radial tear adjacent to the medial meniscus posterior root attachment site: in situ pull-out repair restores derangement of joint mechanics. Am J Sports Med 42(3):699–707. https://doi.org/10.1177/0363546513499314 - DOI - PubMed
1. Allaire R, Muriuki M, Gilbertson L, Harner CD (2008) Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Jt Surg Am 90(9):1922–1931. https://doi.org/10.2106/JBJS.G.00748 - DOI
1. Bloecker K, Guermazi A, Wirth W, Benichou O, Kwoh CK, Hunter DJ, Englund M, Resch H, Eckstein F, Investigators OAI (2013) Tibial coverage, meniscus position, size and damage in knees discordant for joint space narrowing–data from the osteoarthritis initiative. Osteoarthr Cartil 21(3):419–427. https://doi.org/10.1016/j.joca.2012.11.015 - DOI
1. Kawaguchi K, Enokida M, Otsuki R, Teshima R (2012) Ultrasonographic evaluation of medial radial displacement of the medial meniscus in knee osteoarthritis. Arthr Rheum 64(1):173–180. https://doi.org/10.1002/art.33319 - DOI
1. Chung KS, Ha JK, Ra HJ, Nam GW, Kim JG (2017) Pullout fixation of posterior medial meniscus root tears: correlation between meniscus extrusion and midterm clinical results. Am J Sports Med 45(1):42–49. https://doi.org/10.1177/0363546516662445 - DOI - PubMed

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- Springer
Medical
- MedlinePlus Health Information
Miscellaneous
- NCI CPTAC Assay Portal

[1] Padalecki JR, Jansson KS, Smith SD, Dornan GJ, Pierce CM, Wijdicks CA, Laprade RF (2014) Biomechanical consequences of a complete radial tear adjacent to the medial meniscus posterior root attachment site: in situ pull-out repair restores derangement of joint mechanics. Am J Sports Med 42(3):699–707. https://doi.org/10.1177/0363546513499314 - DOI - PubMed

[2] Padalecki JR, Jansson KS, Smith SD, Dornan GJ, Pierce CM, Wijdicks CA, Laprade RF (2014) Biomechanical consequences of a complete radial tear adjacent to the medial meniscus posterior root attachment site: in situ pull-out repair restores derangement of joint mechanics. Am J Sports Med 42(3):699–707. https://doi.org/10.1177/0363546513499314 - DOI - PubMed

[3] Allaire R, Muriuki M, Gilbertson L, Harner CD (2008) Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Jt Surg Am 90(9):1922–1931. https://doi.org/10.2106/JBJS.G.00748 - DOI

[4] Allaire R, Muriuki M, Gilbertson L, Harner CD (2008) Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Jt Surg Am 90(9):1922–1931. https://doi.org/10.2106/JBJS.G.00748 - DOI

[5] Bloecker K, Guermazi A, Wirth W, Benichou O, Kwoh CK, Hunter DJ, Englund M, Resch H, Eckstein F, Investigators OAI (2013) Tibial coverage, meniscus position, size and damage in knees discordant for joint space narrowing–data from the osteoarthritis initiative. Osteoarthr Cartil 21(3):419–427. https://doi.org/10.1016/j.joca.2012.11.015 - DOI

[6] Bloecker K, Guermazi A, Wirth W, Benichou O, Kwoh CK, Hunter DJ, Englund M, Resch H, Eckstein F, Investigators OAI (2013) Tibial coverage, meniscus position, size and damage in knees discordant for joint space narrowing–data from the osteoarthritis initiative. Osteoarthr Cartil 21(3):419–427. https://doi.org/10.1016/j.joca.2012.11.015 - DOI

[7] Kawaguchi K, Enokida M, Otsuki R, Teshima R (2012) Ultrasonographic evaluation of medial radial displacement of the medial meniscus in knee osteoarthritis. Arthr Rheum 64(1):173–180. https://doi.org/10.1002/art.33319 - DOI

[8] Kawaguchi K, Enokida M, Otsuki R, Teshima R (2012) Ultrasonographic evaluation of medial radial displacement of the medial meniscus in knee osteoarthritis. Arthr Rheum 64(1):173–180. https://doi.org/10.1002/art.33319 - DOI

[9] Chung KS, Ha JK, Ra HJ, Nam GW, Kim JG (2017) Pullout fixation of posterior medial meniscus root tears: correlation between meniscus extrusion and midterm clinical results. Am J Sports Med 45(1):42–49. https://doi.org/10.1177/0363546516662445 - DOI - PubMed

[10] Chung KS, Ha JK, Ra HJ, Nam GW, Kim JG (2017) Pullout fixation of posterior medial meniscus root tears: correlation between meniscus extrusion and midterm clinical results. Am J Sports Med 45(1):42–49. https://doi.org/10.1177/0363546516662445 - DOI - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Transtibial pullout repair techniques using two simple stitches for medial meniscus posterior root tear can prevent the progression of medial meniscus extrusion and obtain successful outcomes

Affiliations

Transtibial pullout repair techniques using two simple stitches for medial meniscus posterior root tear can prevent the progression of medial meniscus extrusion and obtain successful outcomes

Authors

Affiliations

Abstract

Similar articles

Cited by

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous

Abstract

Similar articles

Cited by

References

MeSH terms

Related information

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous