Two-Year Outcomes After Meniscoplasty by Capsular Advancement With the Application of Arthroscopic Centralization Technique for Lateral Compartment Knee Osteoarthritis

2020 ◽  
Vol 48 (13) ◽  
pp. 3154-3162
Author(s):  
Hideyuki Koga ◽  
Tomomasa Nakamura ◽  
Hiroki Katagiri ◽  
Yusuke Nakagawa ◽  
Nobutake Ozeki ◽  
...  
Keyword(s):  
Joint Space Width ◽  
Lateral Compartment ◽  
Joint Space ◽  
Lysholm Score ◽  
Sports Performance ◽  
Resonance Imaging ◽  
Meniscal Extrusion ◽  
Radiographic Outcomes ◽  
Subjective Score ◽  
Space Width

Background: A high prevalence of osteoarthritis (OA) progression in patients with lateral meniscal defects has been reported. However, optimal management techniques for active patients remain ill-defined. Hypothesis: Meniscoplasty by capsular advancement with the application of the centralization technique would improve clinical and radiological outcomes in patients with lateral compartment OA attributed to lateral meniscal defects. Study Design: Case series; Level of evidence, 4. Methods: A total of 27 patients were enrolled who had undergone meniscoplasty by capsular advancement for lateral compartment OA attributed to lateral meniscal defects. In these patients, the meniscotibial capsule was released from the tibia and advanced with the remaining meniscus onto the rim of the tibial plateau to reform a meniscus-like configuration. Measures of clinical outcomes included clinical examination, Lysholm score, International Knee Documentation Committee (IKDC) subjective score, Knee injury and Osteoarthritis Outcome Score (KOOS), subjective rating scales regarding recovery of the operated knee, and sports performance level. Measures of radiographic outcomes included meniscal extrusion width or regeneration of the meniscus-like tissue on magnetic resonance imaging and lateral joint space width on standing extension anteroposterior and Rosenberg views. All clinical and radiographic outcomes were reported preoperatively and 2 years postoperatively, except magnetic resonance imaging findings, which were reported preoperatively and 1 year postoperatively. Results: The clinical outcomes were significantly improved 2 years postoperatively as compared with baseline: Lysholm score, IKDC subjective score, and KOOS subscores (all P < .0001). The patients’ subjective recovery ( P < .0001) and sports performance level ( P < .0001) were also improved. One year postoperatively, 10 of 11 patients who had no meniscus remaining at the middle segment showed more than one-third the volume of meniscal tissue–like regeneration, and meniscal extrusion width was significantly reduced as compared with baseline in the remaining 16 patients ( P = .0006). Joint space width increased at 2 years on the standing anteroposterior view ( P < .0001) and the Rosenberg view ( P = .0001). Conclusion: Meniscoplasty of the lateral meniscus by capsular advancement improved clinical and radiographic outcomes at 2-year follow-up in patients with lateral compartment OA attributed to lateral meniscal defects.

scholarly journals Knee Osteoarthritis Revisited; But Only After KL Grading Is Tested: A Retrospective Analysis

2019 ◽  
pp. 9-13
Author(s):  
Victoria David Kuttan ◽  
Deepak Anap ◽  
Sushil Kachevar
Keyword(s):  
Knee Joint ◽  
Disease Progression ◽  
Joint Space Width ◽  
Lateral Compartment ◽  
Exercise Programme ◽  
Joint Space ◽  
Osteoarthritis Of The Knee ◽  
Tibiofemoral Joint ◽  
Keywords Osteoarthritis ◽  
Space Width

Background: Osteoarthritis (OA) of the knee is one of the major causes in musculoskeletal condition leading to functional loss in patients. Determining the progression of the disease is a useful tool which will help in the planning of the exercise programme to slow or halt the disease progression. Measuring the joint space width of the tibiofemoral joint is one of the best options for knowing the disease progression and helps in designing an exercise programme. Aim: Retrospective measurement of joint space width in patients with bilateral tibiofemoral osteoarthritis of the knee joint. Methodology: Data was retrieved from the picture archiving and communication system (PACS) from 1st of February to 22nd of June 2018. Radiographs that were showing OA knee features by using Kellegren Lawrence (KL) grading system were considered and the joint space between the tibial and femoral compartment was measured. Result: The joint space width showed more reduction in the medial compartment of the joint as compared to the lateral compartment. Conclusion: In the rural population of Maharashtra the medial joint space is markedly decreased as compared to the lateral compartment of the tibiofemoral joint and as the KL grade increases the joint space width decreased. Keywords: Osteoarthritis; Knee; Joint space width; Rural Maharashtra.

scholarly journals Is it possible to use stress radiographs as a tool to diagnose medial meniscus posterior root tears?

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0007
Author(s):  
Ali Engin Daştan ◽  
Elcil Kaya Biçer ◽  
Hüseyin Kaya ◽  
Emin Taşkıran
Keyword(s):  
Medial Meniscus ◽  
Weight Bearing ◽  
Joint Space Width ◽  
Joint Space ◽  
X Rays ◽  
Meniscal Extrusion ◽  
Valgus Stress ◽  
Varus Stress ◽  
The Difference ◽  
Space Width

Aim: Medial meniscus posterior root tear (MMPRT) causes meniscal extrusion, loss of meniscus function, arthritic changes. Clinical history, physical examination and magnetic resonance imaging (MRI) findings are useful for the diagnosis of MMPRT. The aim of this study is to evaluate the utility of stress X-rays in the diagnosis of MMPRT. Methods: Twenty patients who had undergone high tibial osteotomy between March 2015 and May 2016 and whose preoperative bilateral varus and valgus stress x-rays (Telos device) along with weight bearing x-rays were available were included. These patients were grouped into two according to integrity of posterior roots of their medial menisci; there were ten patients both in the study and control groups. Lateral joint space width (LJW) on varus stress x-rays, medial joint space width (MJW) on valgus stress x-rays as well as LJW and MJW on weight bearing x-rays were measured bilaterally. Intragroup comparisons of joint space widths between index and opposite knees were performed. Differences of MJW and LJW between index and opposite knees were calculated. Differences of joint space widths between stress x-rays and weight bearing x-rays were also calculated. The changes in joint space widths between the two groups were compared. Statistical analyses were performed utilizing SPSS 18.0. Significance level was set at 0.05. Results: In MMPRT group, opening of LJ space of index knees under varus stress was greater than that of opposite knees (Index: (mean±SD) 10,27±1,17 mm, opposite: 8,61±1,37 mm; p<0,0001). In the control group the difference was not significant (Index: 9,29±2,55 mm, opposite: 9,68±1,44 mm; p=0,566). The difference in the opening of LJW (under varus stress) between index and opposite knees was significantly greater in the study group (p=0,013). The difference between LJW under weight-bearing and varus stress conditions was significantly greater in the study group. (Study: 3,64±0.217 mm, control:2,28±0,182 mm, p=0.018). Conclusions: The findings of this study showed that in patients who had MMPRTs, an increased opening in the LJW was observed under varus stress conditions. This may be relevant with the fact that when varus stress is applied, meniscal extrusion is increased in case of a MMPRT. Stress x-rays could be a useful tool in the diagnosis of MMPRTs. Further studies are needed to determine the sensitivity and specificity of this diagnostic tool.

scholarly journals Differences in the Lateral Compartment Joint Space Width After Anterior Cruciate Ligament Reconstruction: Data From the MOON Onsite Cohort

2018 ◽  
Vol 46 (4) ◽  
pp. 876-882 ◽  
Author(s):  
Morgan H. Jones ◽  
Kurt P. Spindler ◽  
Jack T. Andrish ◽  
Charles L. Cox ◽  
Warren R. Dunn ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Joint Space Width ◽  
Lateral Compartment ◽  
Joint Space ◽  
Activity Score ◽  
Lateral Meniscectomy ◽  
Anterior Cruciate ◽  
Reconstructed Knee ◽  
Space Width

Background: Anterior cruciate ligament (ACL) reconstruction can effectively return athletes to the playing field, but they are still at risk of developing posttraumatic osteoarthritis (PTOA). No studies have used multivariable analysis to evaluate the predictors of radiographic PTOA in the lateral compartment of the knee at short-term follow-up after ACL reconstruction. Purpose: To determine the predictors of radiographic joint space narrowing in the lateral compartment 2 to 3 years after ACL reconstruction in a young, active cohort. Study Design: Cohort study; Level of evidence, 2. Methods: A nested cohort of 358 patients from the Multicenter Orthopaedic Outcomes Network (MOON) prospective cohort who were aged ≤33 years, were injured playing a sport, and had never undergone surgery on the contralateral knee were followed up 2 years after ACL reconstruction with questionnaires and with weightbearing knee radiographs using the metatarsophalangeal (MTP) joint technique. The joint space width in the lateral compartment was measured using a semiautomatic computerized method, and multivariable predictive modeling was used to evaluate the relationship between meniscus treatment, cartilage injury, graft type, and joint space while adjusting for age, sex, body mass index, and Marx activity score. Results: The mean lateral joint space width was 0.11 mm narrower on the ACL-reconstructed knee compared with the contralateral healthy knee (7.69 mm vs 7.80 mm, respectively; P < .01). Statistically significant predictors of a narrower joint space width on the ACL-reconstructed knee included lateral meniscectomy ( P < .001) and a Marx activity score less than 16 points ( P < .001). Conclusion: This study identifies lateral meniscectomy and a lower baseline Marx activity score to be predictors of radiographic joint space narrowing in the lateral compartment 2 to 3 years after ACL reconstruction in young, active patients without a prior knee injury.

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