Meniscal repair concurrent with anterior cruciate ligament reconstruction restores posterior shift of the medial meniscus in the knee-flexed position
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The purpose of this study was to evaluate the shape and shift of the medial meniscus before and after meniscal repair concurrent with anterior cruciate ligament (ACL) reconstruction using magnetic resonance imaging (MRI) at 90° of knee flexion.
This study included 18 patients with ACL-deficient knees without meniscus tears (group A), 11 patients with medial meniscus tears alone (group M), and 15 patients with ACL-deficient knees complicated with medial meniscus tears (group AM). The posterior segment shape was evaluated using open MRI at 90° of knee flexion preoperatively and at 3 months postoperatively. The length, height, width, and posterior extrusion of the medial meniscus and posterior tibiofemoral distance were measured. These measurements were compared between the three groups.
On preoperative MRI, a significant difference was observed in the posterior extrusion of the medial meniscus (group A, 1.2 ± 0.5 mm; group M, 1.7 ± 0.3 mm; group AM, 4.1 ± 1.5 mm, p < 0.001). All parameters did not differ between the three groups on postoperative MRI. In addition, the posterior width and extrusion of the medial meniscus were decreased significantly after meniscal repair concurrent with ACL reconstruction.
This study demonstrated that the medial meniscus shifted posteriorly at 90° of knee flexion in ACL-deficient knees complicated with medial meniscus tears. Medial meniscal repair concurrent with ACL reconstruction improved the deformed morphology and posterior extrusion. MRI measurements of the posterior extrusion at the knee-flexed position may be clinically useful to assess the functional improvement of the medial meniscus following meniscal repair combined with ACL reconstruction.
Level of evidence
KeywordsMedial meniscus Posterior shift Anterior cruciate ligament reconstruction Meniscal repair Open magnetic resonance imaging Flexed-knee position
This study was supported by radiologic technologists in our university for taking accurate MRI and Ms. Ami Maehara for preparing schematic illustrations. Further, we would like to thank Editage (http://www.editage.jp) for English language editing.
YO, YK, TH, and TO measured the MRI-based parameters. TF and SM carried out the arthroscopic surgery. TF designed this study. YO and SM compiled the data. YO and TF prepared the manuscript, tables, and figures. All authors have approved the final manuscript.
No funding was required.
Compliance with ethical standards
Conflict of interest
The authors report no conflicts of interest.
The Institutional Review Board (Okayama University Graduate School, Okayama, Japan) approved this study.
Informed consent was obtained from all patients in this study.
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