Degenerative medial meniscus posterior root tear and non-root tear do not show differences in joint survival and clinica
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Degenerative medial meniscus posterior root tear and non‑root tear do not show differences in joint survival and clinical outcome after partial meniscectomy Oh‑Jin Kwon1 · Seong‑Il Bin1 · Jong‑Min Kim1 · Bum‑Sik Lee1 · Sang‑Min Lee2 · Jun‑Gu Park1 · Gi‑Woon Yoon1 Received: 17 February 2019 / Accepted: 22 October 2019 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019
Abstract Purpose No comparative studies of outcomes between degenerative medial meniscus posterior root tear (MM PRT) and non-root tear (NRT) have been conducted. This study aimed to compare joint survival and clinical outcome between MM PRT and MM NRT after partial meniscectomy with proper control of confounding factors. Methods One hundred and ten patients each in MM PRT and MM NRT groups who underwent arthroscopic partial meniscectomy were retrospectively evaluated through propensity score matching. Joint survival was assessed on the basis of surgical and radiographic failures. Clinical outcomes were assessed using the Lysholm score. Results The confounding variables were well balanced between the groups, with standardized mean differences of 40 years, (2) follow-up period of > 4 years, and (3) sole operation for degenerative MM tear. The exclusion criteria were as follows: (1) history of prior knee surgery (meniscus, cartilage, or ligament operation) on the affected knee; (2) traumatic tear of the medial meniscus with a recent history of knee trauma; (3) complex tear accompanied by both posterior root tear and non-root tear; (4) concurrent lateral meniscus tear; and (5) additional operative procedures such as chondroplasty, microfracture, and osteochondral autograft transplantation. A total of 453 patients who met the criteria were finally included in the study. The 453 patients were divided into two groups according to the type of meniscus tear, which was confirmed with arthroscopic examination. The arthroscopic findings were recorded in a preformatted electronic document system [39]. Those with degenerative MM PRT with detached posterior root or a complete radial tear within 9 mm from the posterior bony root attachment were defined as the “MM PRT group” [37]. Those with other types of degenerative MM tear with intact posterior root attachment, such as a longitudinal-vertical, horizontal, radial, vertical flap, horizontal flap, or complex tear pattern, according to the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine classification of meniscal tears, were defined as the “MM NRT group” [4]. Thus, 288 patients were divided into the MM PRT group; and 165, into the MM NRT group. To control for potential confounding variables, we matched the patients from the MM PRT and MM NRT groups through propensity score matching. This statistical method allowed us to perform a retrospective study with minimizing the interferences of covariates that mimicked the characteristics of randomized controlled trials [7]. We calculated propensity scores using logistic regression
Knee Surgery, S
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