Increased quadriceps muscle strength after medial meniscus posterior root repair is associated with decreased medial meniscus extrusion progression.
Clinical score
Medial meniscus
Medial meniscus extrusion
Muscle strength
Posterior root tear
Quadriceps
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
12 Sep 2023
12 Sep 2023
Historique:
received:
22
05
2023
accepted:
06
09
2023
medline:
14
9
2023
pubmed:
13
9
2023
entrez:
12
9
2023
Statut:
epublish
Résumé
This study aimed to assess quadriceps muscle strength after medial meniscus (MM) posterior root repair and determine its relationship with clinical scores and MM extrusion (MME). Thirty patients who underwent pullout repair for MM posterior root tear and were evaluated for quadriceps muscle strength preoperatively and at 1 year postoperatively were included in this study. Quadriceps muscle strength was measured using the Locomo Scan-II instrument (ALCARE, Tokyo, Japan). MME and clinical scores (i.e., Knee Injury and Osteoarthritis Outcome Score [KOOS], International Knee Documentation Committee score, Lysholm score, Tegner score, and visual analog scale pain score) were evaluated preoperatively and at 1 year postoperatively, and second-look arthroscopy was performed at 1 year postoperatively. Wilcoxon's signed-rank test was used to compare each measure pre- and postoperatively. Pearson's correlation coefficient was used to assess the correlation with quadriceps muscle strength values. Multiple regression analysis was performed to identify factors associated with the change in MME (ΔMME). Second-look arthroscopy confirmed continuity of the posterior root in all patients. The quadriceps muscle strength measured at 1 year postoperatively (355.1 ± 116.2 N) indicated significant improvement relative to the quadriceps muscle strength measured preoperatively (271.9 ± 97.4 N, p < 0.001). The MME at 1 year postoperatively (4.59 ± 1.24 mm) had progressed significantly relative to the MME preoperatively (3.63 ± 1.01 mm, p < 0.001). The clinical scores at 1 year postoperatively were improved significantly relative to the scores preoperatively (p < 0.001). The postoperative quadriceps muscle strength was correlated with ΔMME (correlation coefficient = -0.398, p = 0.030), and the change in quadriceps muscle strength was correlated with the KOOS-Quality of Life (correlation coefficient = 0.430, p = 0.018). Multiple regression analysis showed that the postoperative quadriceps muscle strength had a significant effect on ΔMME even when the body mass index and time from injury to surgery were included. After MM posterior root repair, patients with greater quadriceps muscle strength showed less MME progression. In addition, patients with greater improvement in quadriceps muscle strength had better clinical scores; therefore, continued rehabilitation aimed at improving quadriceps muscle strength after MM posterior root repair is recommended. IV.
Sections du résumé
BACKGROUND
BACKGROUND
This study aimed to assess quadriceps muscle strength after medial meniscus (MM) posterior root repair and determine its relationship with clinical scores and MM extrusion (MME).
METHODS
METHODS
Thirty patients who underwent pullout repair for MM posterior root tear and were evaluated for quadriceps muscle strength preoperatively and at 1 year postoperatively were included in this study. Quadriceps muscle strength was measured using the Locomo Scan-II instrument (ALCARE, Tokyo, Japan). MME and clinical scores (i.e., Knee Injury and Osteoarthritis Outcome Score [KOOS], International Knee Documentation Committee score, Lysholm score, Tegner score, and visual analog scale pain score) were evaluated preoperatively and at 1 year postoperatively, and second-look arthroscopy was performed at 1 year postoperatively. Wilcoxon's signed-rank test was used to compare each measure pre- and postoperatively. Pearson's correlation coefficient was used to assess the correlation with quadriceps muscle strength values. Multiple regression analysis was performed to identify factors associated with the change in MME (ΔMME).
RESULTS
RESULTS
Second-look arthroscopy confirmed continuity of the posterior root in all patients. The quadriceps muscle strength measured at 1 year postoperatively (355.1 ± 116.2 N) indicated significant improvement relative to the quadriceps muscle strength measured preoperatively (271.9 ± 97.4 N, p < 0.001). The MME at 1 year postoperatively (4.59 ± 1.24 mm) had progressed significantly relative to the MME preoperatively (3.63 ± 1.01 mm, p < 0.001). The clinical scores at 1 year postoperatively were improved significantly relative to the scores preoperatively (p < 0.001). The postoperative quadriceps muscle strength was correlated with ΔMME (correlation coefficient = -0.398, p = 0.030), and the change in quadriceps muscle strength was correlated with the KOOS-Quality of Life (correlation coefficient = 0.430, p = 0.018). Multiple regression analysis showed that the postoperative quadriceps muscle strength had a significant effect on ΔMME even when the body mass index and time from injury to surgery were included.
CONCLUSIONS
CONCLUSIONS
After MM posterior root repair, patients with greater quadriceps muscle strength showed less MME progression. In addition, patients with greater improvement in quadriceps muscle strength had better clinical scores; therefore, continued rehabilitation aimed at improving quadriceps muscle strength after MM posterior root repair is recommended.
LEVEL OF EVIDENCE
METHODS
IV.
Identifiants
pubmed: 37700279
doi: 10.1186/s12891-023-06858-0
pii: 10.1186/s12891-023-06858-0
pmc: PMC10496236
doi:
Substances chimiques
MME
78185-58-7
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
727Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Allaire R, Muriuki M, Gilbertson L, Harner CD. Biomechanical consequences of a tear of the posterior root of the medial meniscus similar to total meniscectomy. J Bone Joint Surg Am. 2008;90:1922–31.
doi: 10.2106/JBJS.G.00748
pubmed: 18762653
Marzo JM, Gurske-DePerio J. Effects of medial meniscus posterior horn avulsion and repair on tibiofemoral contact area and peak contact pressure with clinical implications. Am J Sports Med. 2009;37:124–9.
doi: 10.1177/0363546508323254
pubmed: 18815238
Krych AJ, Johnson NR, Mohan R, Dahm DL, Levy BA, Stuart MJ. Partial meniscectomy provides no benefit for symptomatic degenerative medial meniscus posterior root tears. Knee Surg Sports Traumatol Arthrosc. 2018;26:1117–22.
pubmed: 28184957
Krych AJ, Reardon PJ, Johnson NR, Mohan R, Peter L, Levy BA, et al. Non-operative management of medial meniscus posterior horn root tears is associated with worsening arthritis and poor clinical outcome at 5-year follow-up. Knee Surg Sports Traumatol Arthrosc. 2017;25:383–9.
doi: 10.1007/s00167-016-4359-8
pubmed: 27761625
Kawada K, Furumatsu T, Tamura M, Xue H, Higashihara N, Kintaka K, et al. Medial joint space narrowing progresses after pullout repair of medial meniscus posterior root tear. Int Orthop. 2023. https://doi.org/10.1007/s00264-023-05701-4 .
doi: 10.1007/s00264-023-05701-4
pubmed: 36715713
Culvenor AG, Ruhdorfer A, Juhl C, Eckstein F, Øiestad BE. Knee extensor strength and risk of structural, symptomatic, and functional decline in knee osteoarthritis: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2017;69:649–58.
doi: 10.1002/acr.23005
pubmed: 27563843
Øiestad BE, Juhl CB, Eitzen I, Thorlund JB. Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis. A systematic review and meta-analysis. Osteoarthritis Cartilage. 2015;23:171–7.
doi: 10.1016/j.joca.2014.10.008
pubmed: 25450853
Omori G, Narumi K, Nishino K, Nawata A, Watanabe H, Tanaka M, et al. Association of mechanical factors with medial knee osteoarthritis: a cross-sectional study from Matsudai Knee Osteoarthritis Survey. J Orthop Sci. 2016;21:463–8.
doi: 10.1016/j.jos.2016.03.006
pubmed: 27151074
Schmitt LC, Rudolph KS. Muscle stabilization strategies in people with medial knee osteoarthritis: the effect of instability. J Orthop Res. 2008;26:1180–5.
doi: 10.1002/jor.20619
pubmed: 18404657
pmcid: 3112363
Sturnieks DL, Besier TF, Lloyd DG. Muscle activations to stabilize the knee following arthroscopic partial meniscectomy. Clin Biomech (Bristol, Avon). 2011;26:292–7.
doi: 10.1016/j.clinbiomech.2010.11.003
pubmed: 21146908
Mikesky AE, Meyer A, Thompson KL. Relationship between quadriceps strength and rate of loading during gait in women. J Orthop Res. 2000;18:171–5.
doi: 10.1002/jor.1100180202
pubmed: 10815815
Ericsson YB, Roos EM, Owman H, Dahlberg LE. Association between thigh muscle strength four years after partial meniscectomy and radiographic features of osteoarthritis 11 years later. BMC Musculoskelet Disord. 2019;20:512.
doi: 10.1186/s12891-019-2875-7
pubmed: 31679520
pmcid: 6827177
Hipsley A, Hall M, Saxby DJ, Bennell KL, Wang X, Bryant AL. Quadriceps muscle strength at 2 years following anterior cruciate ligament reconstruction is associated with tibiofemoral joint cartilage volume. Knee Surg Sports Traumatol Arthrosc. 2022;30:1949–57.
doi: 10.1007/s00167-021-06853-9
pubmed: 34997247
LaPrade CM, James EW, Cram TR, Feagin JA, Engebretsen L, LaPrade RF. Meniscal root tears: a classification system based on tear morphology. Am J Sports Med. 2015;43:363–9.
doi: 10.1177/0363546514559684
pubmed: 25451789
Narumi K, Funaki Y, Yoshimura N, Muraki S, Omori G, Nawata A, et al. Quadriceps muscle strength reference value as index for functional deterioration of locomotive organs: data from 3617 men and women in Japan. J Orthop Sci. 2017;22:765–70.
doi: 10.1016/j.jos.2017.03.012
pubmed: 28408156
Nie S, Li H, Liao X, Liu Q, Lan M. Younger patients, lower BMI, complete meniscus root healing, lower HKA degree and shorter preoperative symptom duration were the independent risk factors correlated with the good correction of MME in patients with repaired MMPRTs. Knee Surg Sports Traumatol Arthrosc. 2023;31:3775–83.
doi: 10.1007/s00167-023-07330-1
pubmed: 36790456
Moon HS, Choi CH, Jung M, Lee DY, Hong SP, Kim SH. Early surgical repair of medial meniscus posterior root tear minimizes the progression of meniscal extrusion: 2-year follow-up of clinical and radiographic parameters after arthroscopic transtibial pull-out repair. Am J Sports Med. 2020;48:2692–702.
doi: 10.1177/0363546520940715
pubmed: 32730732
Chang PS, Radtke L, Ward P, Brophy RH. Midterm Outcomes of posterior medial meniscus root tear repair: a systematic review. Am J Sports Med. 2022;50:545–53.
doi: 10.1177/0363546521998297
pubmed: 33780278
Tahami M, Vaziri AS, Tahmasebi MN, Ahmadi MA, Akbarzadeh A, Vosoughi F. The functional impact of home-based self-rehabilitation following arthroscopic meniscus root repair. BMC Musculoskelet Disord. 2022;23:753.
doi: 10.1186/s12891-022-05662-6
pubmed: 35932028
pmcid: 9354278
Meadows KD, Peloquin JM, Markhali MI, Zgonis MH, Schaer TP, Mauck RL, et al. Acute repair of meniscus root tear partially restores joint displacements as measured with magnetic resonance images and loading in a cadaveric porcine knee. J Biomech Eng. 2023;145:081002.
doi: 10.1115/1.4062524
pubmed: 37255448
Steineman BD, LaPrade RF, Haut Donahue TL. Loosening of posteromedial meniscal root repairs affects knee mechanics: a finite element study. J Biomech Eng. 2022;144:051003.
doi: 10.1115/1.4053100
pubmed: 34817052