Citations

AbstractMedial meniscus posterior root tears (MMPRTs) are a significant source of pain and dysfunction. The purpose of this study was to evaluate changes in the medial compartment of the knee over time following the diagnosis of a MMPRT on MRI. A retrospective review of the institutional database was performed for patients with an initial MRI diagnosis of a MMPRT. Patients were included if they had a subsequent follow-up MRI on the same knee. Patients with surgical intervention, including debridement or repair, were excluded. MRIs were evaluated by two board-certified musculoskeletal radiologists. MMPRTs were defined using the LaPrade classification, and the medial compartment articular cartilage was graded using the modified Outerbridge classification. MRIs were reviewed for meniscus extrusion, subchondral bone edema, and insufficiency fractures. Patients were divided into two groups for the analysis to account for differences in MRI time intervals. Group 1 had a follow-up MRI within 12 months of initial imaging (subacute group) and Group 2 had a follow-up MRI greater than 12 months after initial imaging (chronic group). Forty-one knees and 82 MRIs were analyzed, including 20 knees/40 MRIs (13 females, 7 males) in the subacute group and 21 knees/42 MRIs (14 females, 7 males) in the chronic group. Subacute patients had a mean age of 59.5 ± 8.8 years and a mean interval of 4.8 ± 2.6 months between MRIs compared with 53.6 ± 11.0 years and 38.2 ± 20.8 months, respectively, for the chronic group. Meniscal extrusion, femoral modified Outerbridge grade, and tibial modified Outerbridge grade worsened between initial and final MRI in both groups (p < 0.05). In both groups, there were no significant differences between initial and final MRIs with regard to the LaPrade classification, insufficiency fracture, or subchondral cysts of the tibia. Progressive meniscus extrusion and medial compartment articular cartilage degeneration were seen in patients with MMPRTs within a year from diagnosis.

Purpose To determine the rate of return of young amateur athletes to sport after hip arthroscopy, their clinical outcomes, and pathologic risk factors for worse outcomes 2 years after surgery. Methods This study included all patients between age 13 and 23 who participated in a sport prior to surgery with intent to return who underwent hip arthroscopy after failure of comprehensive nonoperative management for whom 2‐year outcome scores were available. Outcomes collected retrospectively included modified Harris Hip Score (mHHS) and the Hip Outcome Scores (HOS) subscales for activities of daily living (ADL) and sport (HOS Sport). In addition, sport played, return to sport rates, and Tegner Scores were measured preinjury and postoperatively. Descriptive statistics were used to present demographic data. A priori analysis was used to determine the sample size needed to show minimal clinically important differences for mHHS, HOS ADL, and HOS Sport. Results The study population included 50 patients with a mean age of 17.8 years. Athletes returned to sport at a rate of 92% (46/50). At a mean follow‐up of 34 months, the mean mHHS, HOS ADL, and HOS Sport outcome scores were 85, 91, and 80 for the entire study group; 87, 92, and 84 for the group that returned to sport; and 67, 82, and 41 for the group that did not return to sport, respectively. Median preinjury and postoperative Tegner levels were 8 and 7, respectively. Labral takedown and reattachment was associated with lower HOS ADL ( P = .01) and HOS Sport scores ( P = .02). Conclusions Athletes returned to sport at a high rate (92%; 46/50) after hip arthroscopy and perform activities at near preinjury levels. In this group of athletes, arthroscopic labral repair with chondrolabral preservation, which reflected less severe chondrolabral pathology, performed better than labral repair with takedown and reattachment. Level of Evidence Level IV, therapeutic case series.