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KMID : 1037920140010010031
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Arthroscopy and Orthopedic Sports Medicine
2014 Volume.1 No. 1 p.31 ~ p.39
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One-year clinical outcomes of pullout suture repair of medial meniscus posterior root tear using a knotless anchor and a modified Mason-Allen stitch
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Seo Young-Jin
Yoo Yon-Sik
Song Si-Young
Kim In-Sung
Kim Chan-Hyeok
Kim Yoon-Sang
Jang Seong-Wook
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Abstract
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Background: The purpose of the present study was to investigate clinical and radiological outcomes of pullout suture repair of medial meniscus posterior root (MMPR) tear using a knotless anchor and a modified Mason-Allen stitch in terms of physical assessment, functional score and radiological Kellgren-Lawrence grade.
Methods: Eighteen consecutive patients were treated using an arthroscopic meniscal root repair technique. The average follow-up period was 15 ± 6.5 months (range, 13 to 32 months). There were 7 men and 11 women, and their mean age was 52.2 years (range, 43 to 60 years). Under the vision of the posterior trans-septal portal, the modified Mason-Allen stitch was applied to MMPR repair and the limbs of the two separate sutures were secured outside of the joint using knotless anchor. For postoperative clinical evaluation, joint line tenderness test, McMurray test, Lysholm knee scoring scale, Oxford knee score and visual analogue scale (VAS) were used. Radiological evaluation was performed using magnetic resonance imaging (MRI) and the Kellgren-Lawrence grading system.
Results: The tenderness over the medial joint line and positive McMurray test demonstrated in all patients preoperatively were observed in 9 patients (50%) and 5 patients (28%) postoperatively (P = 0.023, P < 0.001, respectively). The average postoperative Lysholm score, Oxford score, VAS score were significantly increased compared to the preoperative values (P < 0.001). Postoperative Kellgren-Lawrence grades showed no significant difference from the preoperative values. Among eight patients in which postoperative MRI was performed, six patients exhibited complete healing and continuity at the previous tear site. Meanwhile, incomplete healing and some continuity within the posterior meniscal root lesion were found in two patients.
Conclusion: Our study demonstrated that pullout repair of MMPR tears using a knotless anchor and a modified Mason-Allen stitch provides a wide field of vision for optimal tibial tunneling without the risk of iatrogenic cartilage damage, facilitates firm and effective fixation, and produces satisfying clinical outcomes.
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KEYWORD
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Medial meniscus: Posterior root, Tear, Pullout suture repair, Mason-Allen stitch
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