Marrow stimulation procedures for high-grade cartilage lesions during surgical repair of medial meniscus root tear yielded suboptimal outcomes, whilst small lesions showed surgical eligibility
Purpose To investigate the surgical outcomes of arthroscopic pull-out repair for medial meniscus root tear (MMRT) combined with the marrow stimulation procedures (MSP) for accompanying high-grade cartilage lesions. Methods Patients who underwent arthroscopic pull-out repair for MMRT between 2010 and...
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2023-12, Vol.31 (12), p.5812-5822 |
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| container_title | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
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| creator | Moon, Hyun-Soo Jung, Min Choi, Chong-Hyuk Yoo, Je-Hyun Nam, Bum-Joon Lee, Seung-Hun Shin, Seung-Hwan Kim, Dong-Ki Kim, Sung-Hwan |
| description | Purpose
To investigate the surgical outcomes of arthroscopic pull-out repair for medial meniscus root tear (MMRT) combined with the marrow stimulation procedures (MSP) for accompanying high-grade cartilage lesions.
Methods
Patients who underwent arthroscopic pull-out repair for MMRT between 2010 and 2019 were retrospectively reviewed. Patients who had at least 3 years of follow-up were included and classified into two groups according to whether MSP (microfracture or microdrilling) were performed on cartilage lesions in the medial tibiofemoral joint (group 1, patients with International Cartilage Repair Society [ICRS] grade 0–3a lesions and did not undergo MSP; group 2, patients with ICRS grade 3b–3d lesions and underwent MSP). Comparative analyses, including non-inferiority trials, were conducted between groups for subjective and objective outcomes. In addition, group 2 was further divided into two subgroups according to cartilage lesion size and compared with group 1 (group S, ≤ 2.0 cm
2
; group L, > 2.0 cm
2
).
Results
A total of 94 patients were included (group 1, 68 patients; group 2, 26 patients). There were no significant differences in clinical scores at postoperative 3 years and final follow-up between groups 1 and 2, but group 2 failed to satisfy the non-inferiority criteria compared to group 1 overall. In objective outcomes, group 2 did not meet the non-inferiority criteria for the rate of osteoarthritis progression compared to group 1, and it also showed a significantly higher proportion of high-grade osteoarthritis at final follow-up (
P
= 0.044) and a higher degree of osteoarthritis progression than group 1 (
P
= 0.03 for pre- to postoperative 3 years, and
P
= 0.006 for pre- to final follow-up). In additional evaluations comparing the subgroups of group 2 and group 1, group S showed relatively favourable results compared to group L in objective outcomes at final follow-up.
Conclusion
Patients who underwent arthroscopic pull-out repair for MMRT combined with MSP for accompanying high-grade cartilage lesions showed suboptimal outcomes compared to those with no or low-grade lesions at mid-term follow-up. High-grade cartilage lesions ≤ 2.0 cm
2
may be candidates for the surgical repair of MMRT if MSP are performed, but those with larger lesions may require alternative treatment strategies.
Level of evidence
III. |
| doi_str_mv | 10.1007/s00167-023-07642-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2887475145</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2887475145</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4266-d90d9250003a4af08b2d0d2eb0d6fc342a1a9e7ae7d71177687e7c46accef36b3</originalsourceid><addsrcrecordid>eNqNkcFu1DAQhiMEokvhBTggS1w4EHBsx064lYoCoogDcLYce5J15cSLnWi1b8ejMdssReKAOFi2Rt8_83v-onha0VcVpep1prSSqqSMl1RJwUp2r9hUgvNScaHuFxvaHou0lmfFo5xvKMWnaB8WZ1y1vOGs2RQ_P5uU4p7k2Y9LMLOPE9mlaMEtCTLpYyJbP2zLIRkHxJo0-2AGIAEyopkg5qeB5CUN3ppAEuyMTyT2ZATnsTDC5LNdMkkxzmQGk8jBQ3DgUNTFHc5FKi6zjSPkl2S_9SHPJGM13E3J27i_FZymQPCD73zw8-Fx8aA3IcOT031efL969-3yQ3n95f3Hy4vr0gomZela6lpW4wq4EaanTcccdQw66mRvuWCmMi0oA8qpqlJKNgqUFdJYCz2XHT8vXqx9cTs_FsizHvFfEIKZIC5Zs6ZRQtWVqBF9_hd6E5c0oTvNWlrhqdmRYitlU8w5Qa93CXeRDrqi-pivXvPVmK--zVczFD07tV46XPCd5HegCLxZgb0PcPiPlvrT14u3VxTNSxTzVZx3x1Qh_TH-D0-_ALu_x2I</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2901290525</pqid></control><display><type>article</type><title>Marrow stimulation procedures for high-grade cartilage lesions during surgical repair of medial meniscus root tear yielded suboptimal outcomes, whilst small lesions showed surgical eligibility</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals</source><creator>Moon, Hyun-Soo ; Jung, Min ; Choi, Chong-Hyuk ; Yoo, Je-Hyun ; Nam, Bum-Joon ; Lee, Seung-Hun ; Shin, Seung-Hwan ; Kim, Dong-Ki ; Kim, Sung-Hwan</creator><creatorcontrib>Moon, Hyun-Soo ; Jung, Min ; Choi, Chong-Hyuk ; Yoo, Je-Hyun ; Nam, Bum-Joon ; Lee, Seung-Hun ; Shin, Seung-Hwan ; Kim, Dong-Ki ; Kim, Sung-Hwan</creatorcontrib><description>Purpose
To investigate the surgical outcomes of arthroscopic pull-out repair for medial meniscus root tear (MMRT) combined with the marrow stimulation procedures (MSP) for accompanying high-grade cartilage lesions.
Methods
Patients who underwent arthroscopic pull-out repair for MMRT between 2010 and 2019 were retrospectively reviewed. Patients who had at least 3 years of follow-up were included and classified into two groups according to whether MSP (microfracture or microdrilling) were performed on cartilage lesions in the medial tibiofemoral joint (group 1, patients with International Cartilage Repair Society [ICRS] grade 0–3a lesions and did not undergo MSP; group 2, patients with ICRS grade 3b–3d lesions and underwent MSP). Comparative analyses, including non-inferiority trials, were conducted between groups for subjective and objective outcomes. In addition, group 2 was further divided into two subgroups according to cartilage lesion size and compared with group 1 (group S, ≤ 2.0 cm
2
; group L, > 2.0 cm
2
).
Results
A total of 94 patients were included (group 1, 68 patients; group 2, 26 patients). There were no significant differences in clinical scores at postoperative 3 years and final follow-up between groups 1 and 2, but group 2 failed to satisfy the non-inferiority criteria compared to group 1 overall. In objective outcomes, group 2 did not meet the non-inferiority criteria for the rate of osteoarthritis progression compared to group 1, and it also showed a significantly higher proportion of high-grade osteoarthritis at final follow-up (
P
= 0.044) and a higher degree of osteoarthritis progression than group 1 (
P
= 0.03 for pre- to postoperative 3 years, and
P
= 0.006 for pre- to final follow-up). In additional evaluations comparing the subgroups of group 2 and group 1, group S showed relatively favourable results compared to group L in objective outcomes at final follow-up.
Conclusion
Patients who underwent arthroscopic pull-out repair for MMRT combined with MSP for accompanying high-grade cartilage lesions showed suboptimal outcomes compared to those with no or low-grade lesions at mid-term follow-up. High-grade cartilage lesions ≤ 2.0 cm
2
may be candidates for the surgical repair of MMRT if MSP are performed, but those with larger lesions may require alternative treatment strategies.
Level of evidence
III.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-023-07642-2</identifier><identifier>PMID: 37938328</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Arthritis ; Arthroscopy - methods ; Bone Marrow - pathology ; Cartilage ; Cartilage diseases ; Cartilage lesion ; Cartilage, Articular - pathology ; Cartilage, Articular - surgery ; Clinical trials ; Comparative analysis ; Criteria ; Humans ; Knee ; Lesions ; Marrow stimulation procedure ; Medial meniscus root tear ; Medicine ; Medicine & Public Health ; Menisci, Tibial - surgery ; Meniscus ; Microdrilling ; Microfracture ; Orthopedics ; Osteoarthritis ; Osteoarthritis - surgery ; Patients ; Pull‐out repair ; Retrospective Studies ; Rupture - pathology ; Sports Medicine ; Stimulation ; Subgroups ; Treatment Outcome</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023-12, Vol.31 (12), p.5812-5822</ispartof><rights>The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023 European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA)</rights><rights>2023. The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4266-d90d9250003a4af08b2d0d2eb0d6fc342a1a9e7ae7d71177687e7c46accef36b3</citedby><cites>FETCH-LOGICAL-c4266-d90d9250003a4af08b2d0d2eb0d6fc342a1a9e7ae7d71177687e7c46accef36b3</cites><orcidid>0000-0001-5743-6241</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-023-07642-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-023-07642-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,41469,42538,45555,45556,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37938328$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moon, Hyun-Soo</creatorcontrib><creatorcontrib>Jung, Min</creatorcontrib><creatorcontrib>Choi, Chong-Hyuk</creatorcontrib><creatorcontrib>Yoo, Je-Hyun</creatorcontrib><creatorcontrib>Nam, Bum-Joon</creatorcontrib><creatorcontrib>Lee, Seung-Hun</creatorcontrib><creatorcontrib>Shin, Seung-Hwan</creatorcontrib><creatorcontrib>Kim, Dong-Ki</creatorcontrib><creatorcontrib>Kim, Sung-Hwan</creatorcontrib><title>Marrow stimulation procedures for high-grade cartilage lesions during surgical repair of medial meniscus root tear yielded suboptimal outcomes, whilst small lesions showed surgical eligibility</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
To investigate the surgical outcomes of arthroscopic pull-out repair for medial meniscus root tear (MMRT) combined with the marrow stimulation procedures (MSP) for accompanying high-grade cartilage lesions.
Methods
Patients who underwent arthroscopic pull-out repair for MMRT between 2010 and 2019 were retrospectively reviewed. Patients who had at least 3 years of follow-up were included and classified into two groups according to whether MSP (microfracture or microdrilling) were performed on cartilage lesions in the medial tibiofemoral joint (group 1, patients with International Cartilage Repair Society [ICRS] grade 0–3a lesions and did not undergo MSP; group 2, patients with ICRS grade 3b–3d lesions and underwent MSP). Comparative analyses, including non-inferiority trials, were conducted between groups for subjective and objective outcomes. In addition, group 2 was further divided into two subgroups according to cartilage lesion size and compared with group 1 (group S, ≤ 2.0 cm
2
; group L, > 2.0 cm
2
).
Results
A total of 94 patients were included (group 1, 68 patients; group 2, 26 patients). There were no significant differences in clinical scores at postoperative 3 years and final follow-up between groups 1 and 2, but group 2 failed to satisfy the non-inferiority criteria compared to group 1 overall. In objective outcomes, group 2 did not meet the non-inferiority criteria for the rate of osteoarthritis progression compared to group 1, and it also showed a significantly higher proportion of high-grade osteoarthritis at final follow-up (
P
= 0.044) and a higher degree of osteoarthritis progression than group 1 (
P
= 0.03 for pre- to postoperative 3 years, and
P
= 0.006 for pre- to final follow-up). In additional evaluations comparing the subgroups of group 2 and group 1, group S showed relatively favourable results compared to group L in objective outcomes at final follow-up.
Conclusion
Patients who underwent arthroscopic pull-out repair for MMRT combined with MSP for accompanying high-grade cartilage lesions showed suboptimal outcomes compared to those with no or low-grade lesions at mid-term follow-up. High-grade cartilage lesions ≤ 2.0 cm
2
may be candidates for the surgical repair of MMRT if MSP are performed, but those with larger lesions may require alternative treatment strategies.
Level of evidence
III.</description><subject>Arthritis</subject><subject>Arthroscopy - methods</subject><subject>Bone Marrow - pathology</subject><subject>Cartilage</subject><subject>Cartilage diseases</subject><subject>Cartilage lesion</subject><subject>Cartilage, Articular - pathology</subject><subject>Cartilage, Articular - surgery</subject><subject>Clinical trials</subject><subject>Comparative analysis</subject><subject>Criteria</subject><subject>Humans</subject><subject>Knee</subject><subject>Lesions</subject><subject>Marrow stimulation procedure</subject><subject>Medial meniscus root tear</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Menisci, Tibial - surgery</subject><subject>Meniscus</subject><subject>Microdrilling</subject><subject>Microfracture</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Osteoarthritis - surgery</subject><subject>Patients</subject><subject>Pull‐out repair</subject><subject>Retrospective Studies</subject><subject>Rupture - pathology</subject><subject>Sports Medicine</subject><subject>Stimulation</subject><subject>Subgroups</subject><subject>Treatment Outcome</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkcFu1DAQhiMEokvhBTggS1w4EHBsx064lYoCoogDcLYce5J15cSLnWi1b8ejMdssReKAOFi2Rt8_83v-onha0VcVpep1prSSqqSMl1RJwUp2r9hUgvNScaHuFxvaHou0lmfFo5xvKMWnaB8WZ1y1vOGs2RQ_P5uU4p7k2Y9LMLOPE9mlaMEtCTLpYyJbP2zLIRkHxJo0-2AGIAEyopkg5qeB5CUN3ppAEuyMTyT2ZATnsTDC5LNdMkkxzmQGk8jBQ3DgUNTFHc5FKi6zjSPkl2S_9SHPJGM13E3J27i_FZymQPCD73zw8-Fx8aA3IcOT031efL969-3yQ3n95f3Hy4vr0gomZela6lpW4wq4EaanTcccdQw66mRvuWCmMi0oA8qpqlJKNgqUFdJYCz2XHT8vXqx9cTs_FsizHvFfEIKZIC5Zs6ZRQtWVqBF9_hd6E5c0oTvNWlrhqdmRYitlU8w5Qa93CXeRDrqi-pivXvPVmK--zVczFD07tV46XPCd5HegCLxZgb0PcPiPlvrT14u3VxTNSxTzVZx3x1Qh_TH-D0-_ALu_x2I</recordid><startdate>202312</startdate><enddate>202312</enddate><creator>Moon, Hyun-Soo</creator><creator>Jung, Min</creator><creator>Choi, Chong-Hyuk</creator><creator>Yoo, Je-Hyun</creator><creator>Nam, Bum-Joon</creator><creator>Lee, Seung-Hun</creator><creator>Shin, Seung-Hwan</creator><creator>Kim, Dong-Ki</creator><creator>Kim, Sung-Hwan</creator><general>Springer Berlin Heidelberg</general><general>Springer‐Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5743-6241</orcidid></search><sort><creationdate>202312</creationdate><title>Marrow stimulation procedures for high-grade cartilage lesions during surgical repair of medial meniscus root tear yielded suboptimal outcomes, whilst small lesions showed surgical eligibility</title><author>Moon, Hyun-Soo ; Jung, Min ; Choi, Chong-Hyuk ; Yoo, Je-Hyun ; Nam, Bum-Joon ; Lee, Seung-Hun ; Shin, Seung-Hwan ; Kim, Dong-Ki ; Kim, Sung-Hwan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4266-d90d9250003a4af08b2d0d2eb0d6fc342a1a9e7ae7d71177687e7c46accef36b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Arthritis</topic><topic>Arthroscopy - methods</topic><topic>Bone Marrow - pathology</topic><topic>Cartilage</topic><topic>Cartilage diseases</topic><topic>Cartilage lesion</topic><topic>Cartilage, Articular - pathology</topic><topic>Cartilage, Articular - surgery</topic><topic>Clinical trials</topic><topic>Comparative analysis</topic><topic>Criteria</topic><topic>Humans</topic><topic>Knee</topic><topic>Lesions</topic><topic>Marrow stimulation procedure</topic><topic>Medial meniscus root tear</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Menisci, Tibial - surgery</topic><topic>Meniscus</topic><topic>Microdrilling</topic><topic>Microfracture</topic><topic>Orthopedics</topic><topic>Osteoarthritis</topic><topic>Osteoarthritis - surgery</topic><topic>Patients</topic><topic>Pull‐out repair</topic><topic>Retrospective Studies</topic><topic>Rupture - pathology</topic><topic>Sports Medicine</topic><topic>Stimulation</topic><topic>Subgroups</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moon, Hyun-Soo</creatorcontrib><creatorcontrib>Jung, Min</creatorcontrib><creatorcontrib>Choi, Chong-Hyuk</creatorcontrib><creatorcontrib>Yoo, Je-Hyun</creatorcontrib><creatorcontrib>Nam, Bum-Joon</creatorcontrib><creatorcontrib>Lee, Seung-Hun</creatorcontrib><creatorcontrib>Shin, Seung-Hwan</creatorcontrib><creatorcontrib>Kim, Dong-Ki</creatorcontrib><creatorcontrib>Kim, Sung-Hwan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moon, Hyun-Soo</au><au>Jung, Min</au><au>Choi, Chong-Hyuk</au><au>Yoo, Je-Hyun</au><au>Nam, Bum-Joon</au><au>Lee, Seung-Hun</au><au>Shin, Seung-Hwan</au><au>Kim, Dong-Ki</au><au>Kim, Sung-Hwan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Marrow stimulation procedures for high-grade cartilage lesions during surgical repair of medial meniscus root tear yielded suboptimal outcomes, whilst small lesions showed surgical eligibility</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2023-12</date><risdate>2023</risdate><volume>31</volume><issue>12</issue><spage>5812</spage><epage>5822</epage><pages>5812-5822</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
To investigate the surgical outcomes of arthroscopic pull-out repair for medial meniscus root tear (MMRT) combined with the marrow stimulation procedures (MSP) for accompanying high-grade cartilage lesions.
Methods
Patients who underwent arthroscopic pull-out repair for MMRT between 2010 and 2019 were retrospectively reviewed. Patients who had at least 3 years of follow-up were included and classified into two groups according to whether MSP (microfracture or microdrilling) were performed on cartilage lesions in the medial tibiofemoral joint (group 1, patients with International Cartilage Repair Society [ICRS] grade 0–3a lesions and did not undergo MSP; group 2, patients with ICRS grade 3b–3d lesions and underwent MSP). Comparative analyses, including non-inferiority trials, were conducted between groups for subjective and objective outcomes. In addition, group 2 was further divided into two subgroups according to cartilage lesion size and compared with group 1 (group S, ≤ 2.0 cm
2
; group L, > 2.0 cm
2
).
Results
A total of 94 patients were included (group 1, 68 patients; group 2, 26 patients). There were no significant differences in clinical scores at postoperative 3 years and final follow-up between groups 1 and 2, but group 2 failed to satisfy the non-inferiority criteria compared to group 1 overall. In objective outcomes, group 2 did not meet the non-inferiority criteria for the rate of osteoarthritis progression compared to group 1, and it also showed a significantly higher proportion of high-grade osteoarthritis at final follow-up (
P
= 0.044) and a higher degree of osteoarthritis progression than group 1 (
P
= 0.03 for pre- to postoperative 3 years, and
P
= 0.006 for pre- to final follow-up). In additional evaluations comparing the subgroups of group 2 and group 1, group S showed relatively favourable results compared to group L in objective outcomes at final follow-up.
Conclusion
Patients who underwent arthroscopic pull-out repair for MMRT combined with MSP for accompanying high-grade cartilage lesions showed suboptimal outcomes compared to those with no or low-grade lesions at mid-term follow-up. High-grade cartilage lesions ≤ 2.0 cm
2
may be candidates for the surgical repair of MMRT if MSP are performed, but those with larger lesions may require alternative treatment strategies.
Level of evidence
III.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37938328</pmid><doi>10.1007/s00167-023-07642-2</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-5743-6241</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0942-2056 |
| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023-12, Vol.31 (12), p.5812-5822 |
| issn | 0942-2056 1433-7347 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2887475145 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SpringerLink Journals |
| subjects | Arthritis Arthroscopy - methods Bone Marrow - pathology Cartilage Cartilage diseases Cartilage lesion Cartilage, Articular - pathology Cartilage, Articular - surgery Clinical trials Comparative analysis Criteria Humans Knee Lesions Marrow stimulation procedure Medial meniscus root tear Medicine Medicine & Public Health Menisci, Tibial - surgery Meniscus Microdrilling Microfracture Orthopedics Osteoarthritis Osteoarthritis - surgery Patients Pull‐out repair Retrospective Studies Rupture - pathology Sports Medicine Stimulation Subgroups Treatment Outcome |
| title | Marrow stimulation procedures for high-grade cartilage lesions during surgical repair of medial meniscus root tear yielded suboptimal outcomes, whilst small lesions showed surgical eligibility |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T10%3A00%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Marrow%20stimulation%20procedures%20for%20high-grade%20cartilage%20lesions%20during%20surgical%20repair%20of%20medial%20meniscus%20root%20tear%20yielded%20suboptimal%20outcomes,%20whilst%20small%20lesions%20showed%20surgical%20eligibility&rft.jtitle=Knee%20surgery,%20sports%20traumatology,%20arthroscopy%20:%20official%20journal%20of%20the%20ESSKA&rft.au=Moon,%20Hyun-Soo&rft.date=2023-12&rft.volume=31&rft.issue=12&rft.spage=5812&rft.epage=5822&rft.pages=5812-5822&rft.issn=0942-2056&rft.eissn=1433-7347&rft_id=info:doi/10.1007/s00167-023-07642-2&rft_dat=%3Cproquest_cross%3E2887475145%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2901290525&rft_id=info:pmid/37938328&rfr_iscdi=true |