Degenerative Medial Meniscus Tear With a Displaced Flap Into the Meniscotibial Recess and Tibial Peripheral Reactive Bone Edema Presents Good Results With Arthroscopic Surgical Treatment

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art_HELITO_Degenerative_Medial_Meniscus_Tear_With_a_Displaced_Flap_2021.PDF (1.15 MB)
Citações na Scopus
4
Tipo de produção
article
Data de publicação
2021
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
W B SAUNDERS CO-ELSEVIER INC
Autores
BERG, Bruno Vande
Citação
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, v.37, n.11, p.3307-3315, 2021
Projetos de Pesquisa
Unidades Organizacionais
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Resumo
Purpose: To report the arthroscopic treatment results of a degenerative medial meniscus tear with a displaced flap into the meniscotibial recess, tibial peripheral reactive bone edema, and focal knee medial pain. As a secondary objective, we propose to identify possible factors associated with a good or poor prognosis of the surgical treatment of this lesion. Methods: From 2012 to 2018, patients who had this specific meniscus pathology and underwent arthroscopic surgical treatment were retrospectively evaluated. Patients with Kellgren-Lawrence (KL) classification greater than 2 were excluded. KL classification, the presence of an Outerbridge grade III/V chondral lesion of the medial compartment, limb alignment, body mass index, and smoking were evaluated. The subjective outcomes included the International Knee Documentation Committee score, improvement in the pain reported by patients, and the Global Perceived Effect (GPE) scale score. Results: A total of 69 patients were evaluated. The mean age was 58.6 +/- 7.1 years. The follow-up time was 48.7 +/- 20.8 months. Fifty-five (79.7%) patients reported pain improvement. The postoperative International Knee Documentation Committee was 62.6 +/- 15.4, and the mean GPE was 2.3 +/- 2.6. Fourteen patients (20.3%) showed no improvement in pain, and 7 patients (10.2%) presented complications. Groups that improved (GPE 0) and did not improve (GPE < 0) did not present differences regarding age, sex, follow-up time, chondral lesions, or body mass index. Patients without improvement had a greater incidence of smoking (P = .001), varus alignment (P = .008), and more advanced KL classification (P < .001). In the multivariate analysis based on the GPE score, KL classification (P = .038) and smoking (P = .003) were significant. Conclusions: Arthroscopic surgical treatment of degenerative medial meniscal tears with a meniscal flap displaced into the meniscotibial recess and adjacent focal bone edema in the tibia shows good results in approximately 80% of cases. Smoking and KL grade 2 were factors associated with poor prognosis of surgical treatment.
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URI
https://observatorio.fm.usp.br/handle/OPI/44214
Referências
  1. Basques BA, 2015, AM J SPORT MED, V43, P169, DOI 10.1177/0363546514551923
  2. Bassett AJ, 2019, ARTHROSC TEC, V8, pE727, DOI 10.1016/j.eats.2019.03.008
  3. Bernard CD, 2020, AM J SPORT MED, V48, P128, DOI 10.1177/0363546519888212
  4. Bonadio MB, 2017, MAGN RESON INSIGHTS, V10, P1, DOI 10.1177/1178623X17703382
  5. Chang EY, 2014, SKELETAL RADIOL, V43, P1403, DOI 10.1007/s00256-014-1958-7
  6. Cole BJ, 2019, ARTHROSCOPY, V35, P1160, DOI 10.1016/j.arthro.2018.12.019
  7. Essilfie A, 2019, ARTHROSCOPY, V35, P1152, DOI 10.1016/j.arthro.2018.10.152
  8. Helito CP, 2020, ARTHROSC TEC, V9, pE1017, DOI 10.1016/j.eats.2020.03.023
  9. Herschmiller TA, 2015, ORTHOP J SPORTS MED, V3, DOI 10.1177/2325967115583954
  10. Heyer Jessica H, 2020, Eur J Orthop Surg Traumatol, V30, P329, DOI 10.1007/s00590-019-02577-2
  11. Hohmann E, 2020, ARTHROSCOPY, V36, P501, DOI 10.1016/j.arthro.2019.08.014
  12. Hohmann E, 2018, ARTHROSCOPY, V34, P2699, DOI 10.1016/j.arthro.2018.04.018
  13. Johnson Daniel J, 2019, J Surg Orthop Adv, V28, P272
  14. Jung M, 2018, BIOMED RES INT, V2018, DOI 10.1155/2018/5941057
  15. Kamper SJ, 2010, J CLIN EPIDEMIOL, V63, P760, DOI 10.1016/j.jclinepi.2009.09.009
  16. Karpinski K, 2019, KNEE SURG SPORT TR A, V27, P782, DOI 10.1007/s00167-018-5086-0
  17. Kartus JT, 2018, ARTHROSCOPY, V34, P2711, DOI 10.1016/j.arthro.2018.06.013
  18. Katz JN, 2020, ARTHROSCOPY, V36, P513, DOI 10.1016/j.arthro.2019.10.026
  19. Khan I, 2020, SKELETAL RADIOL, V49, P823, DOI 10.1007/s00256-020-03379-y
  20. Kon E, 2016, KNEE SURG SPORT TR A, V24, P1797, DOI 10.1007/s00167-016-4113-2
  21. Krych AJ, 2020, J KNEE SURG, V33, P659, DOI 10.1055/s-0039-1683938
  22. Krych AJ, 2018, KNEE SURG SPORT TR A, V26, P1117, DOI 10.1007/s00167-017-4454-5
  23. Lecas LK, 2000, AM J ROENTGENOL, V174, P161, DOI 10.2214/ajr.174.1.1740161
  24. Lecouvet F, 2018, DIAGN INTERV IMAG, V99, P55, DOI 10.1016/j.diii.2017.12.005
  25. Lizaur-Utrilla A, 2019, AM J SPORT MED, V47, P2412, DOI 10.1177/0363546519857589
  26. Lubowitz JH, 2020, ARTHROSCOPY, V36, P327, DOI 10.1016/j.arthro.2019.11.128
  27. Marcillaud G., 2013, REV CHIR ORTHOP TRAU, V99, pS60
  28. Moran TE, 2020, ARTHROSC TEC, V9, pE393, DOI 10.1016/j.eats.2019.11.008
  29. Salem HS, 2018, ORTHOPEDICS, V41, pE442, DOI 10.3928/01477447-20180501-01
  30. Sihvonen R, 2018, ANN RHEUM DIS, V77, P188, DOI 10.1136/annrheumdis-2017-211172
  31. Sihvonen R, 2013, NEW ENGL J MED, V369, P2515, DOI 10.1056/NEJMoa1305189

Coleções
Artigos e Materiais de Revistas Científicas - HC/IOT
Artigos e Materiais de Revistas Científicas - LIM/41