Knee malalignment and laterality influence 2-year meniscus tear repair outcomes: A pilot study.

IF 3.3 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-02-06 DOI:10.1002/ksa.12602

Benjamin Tschopp, Patrick Omoumi, John Nyland, Aziz Chaouch, Valentine Schneebeli, Roland Jakob, Robin Martin

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引用次数: 0

Abstract

Purpose: To analyse biomechanical determinants for radiological and clinical outcomes of posterior horn longitudinal vertical meniscal tear (LVMT) repairs.

Methods: Patients undergoing primary repair of vascular zone traumatic full-thickness posterior horn LVMT were enroled. We hypothesized four potential factors would influence mid-term outcomes: malalignment (varus/valgus ≥5° for medial/lateral tears), meniscal laterality (medial vs. lateral), concomitant anterior cruciate ligament reconstruction (ACLR) and cartilage damage (Outerbridge grade ≥ II). The primary outcome was posterior horn nonhealing rate 6 months postoperatively (T1), evaluated using computed tomography arthrography (CTA) and Henning's criteria. Secondary outcomes were patient-reported outcomes measures (PROMs) assessed at T1 and ≥24 months postoperatively (T2). Univariate and multivariate logistic regression models estimated the marginal relative risk (MRR) of nonhealing for each determinant, while fractional logit regression assessed determinants' impact on PROMs at T1 and T2.

Results: Seventy-eight patients (median age 29 years, interquartile range [IQR]: [21-37]); 76% male), were followed for ≥2 years (median 2.5 years, IQR: [2.1-3.6]). LVMTs extended to the middle horn in 81% and to the anterior horn in 52%. Posterior horn nonhealing rates (53%) were higher than in the middle (35%, p = 0.013) and anterior horn (7%, p < 0.001). Malalignment was present in 14%, medial meniscal involvement in 77%, ACLR in 55% and cartilage damage in 37%. Malalignment (MRR = 1.48, 95% confidence interval (CI): [0.84, 2.09]) and medial laterality (MRR = 1.7, 95% CI: [0.93, 3.6]) were independently identified as potential nonhealing risk factors. But it is the combination of varus malalignment and medial laterality that significantly increased the risk of nonhealing (MRR = 2.54, 95% CI: [1.09, 6.01], p = 0.033) and negatively impacted all Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales and International Knee Documentation Committee (IKDC) score at T1 and/or T2.

Conclusion: Combined varus malalignment and medial meniscus involvement strongly predicted repair nonhealing and poorer outcomes after posterior horn LVMT repair.

Study design: Prospective cohort pilot study.

Level of evidence: Level III.

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膝关节不对准和偏侧影响2年半月板撕裂修复结果：一项初步研究。

目的：分析后角纵向半月板撕裂（lvpt）修复的放射学和临床结果的生物力学决定因素。方法：选择行创伤性后角血管区全层lvpt一期修复术的患者。我们假设有四个潜在因素会影响中期结局：排列不整（内侧/外侧撕裂内翻/外翻≥5°）、半月板侧边（内侧vs外侧）、合并前交叉韧带重建（ACLR）和软骨损伤（Outerbridge分级≥II）。主要结局是术后6个月（T1）后角不愈合率，使用计算机断层关节摄影（CTA）和Henning标准进行评估。次要结局是在术后T1和≥24个月（T2）评估患者报告的结局测量（PROMs）。单变量和多变量logistic回归模型估计了每个决定因素不愈合的边际相对风险（MRR），而分数logit回归评估了决定因素在T1和T2时对PROMs的影响。结果：78例患者（中位年龄29岁，四分位数间距[IQR]: [21-37]）；76%为男性)，随访≥2年（中位2.5年，IQR:[2.1-3.6]）。lvts延伸至中角（81%）和前角（52%）。后角不愈合率（53%）高于中角不愈合率（35%,p = 0.013）和前角不愈合率（7%,p）结论：内翻畸形和内侧半月板受累强烈预测了后角lvpt修复后不愈合和较差的预后。研究设计：前瞻性队列试验研究。证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).