La réparation par fixation transtibiale de la rupture de la racine postérieure du ménisque latéral associée à la reconstruction du ligament croisé antérieur réduit l’extrusion du ménisque latéral : Étude rétrospective avec évaluation par IRM

Abstract

BackgroundLateral meniscus (LM) posterior root tears (PRT) are often associated with anterior cruciate ligament (ACL) injury and can result in rotational instability, joint overloading, and degenerative changes in the knee. Improved rotational stability and kinematics have been reported after LMPRT repair. However, it is unclear which repair technique can achieve the greatest reduction in lateral meniscus extrusion (LME). HypothesisWe hypothesized that transtibial pullout repair would decrease LME to a greater extent than other repair techniques. Patients and methodsSeventeen patients with ACL injury but complete LM posterior root were evaluated. Nine underwent ACL reconstruction (ACLR) and transtibial pullout repair, and eight underwent ACLR and other repairs such as inside-out suturing. Double-bundle ACLR was performed using hamstring tendons, and LMPRT pullout was performed through the bone tunnel for the PL bundle. Magnetic resonance imaging was performed immediately preoperatively and at >6months postoperatively, and LME was measured from coronal images only. ResultsA significantly greater decrease in the size of LME from pre- to postoperative measurement was observed in the transtibial pullout repair group (−0,5±0,7mm) than in the other-repair group (1,0±0,9mm, p<0,01). Pre- and postoperative LME measurements were not significantly different between the two groups. DiscussionThe most important finding of this study is that transtibial pullout repair results in a greater decrease in LME than other repair techniques in patients with ACL injury and LMPRT. This technique might be useful for restoring hoop tension by decreasing LME. Level of evidenceIII comparative retrospective study.