Abstract
In the absence of effective long-term repair of meniscal injuries, damage to the knee
may lead to the development of osteoarthritis. Recent reports have recommended meniscal
repair to be undertaken in all cases of meniscal tears. However, the most common complication
encountered during repair of the medial meniscus is iatrogenic cartilage and meniscal
injury due to its unclear visualization. The aim of this study is to evaluate the
long-term clinical and radiological results of the pie-crust (PC) technique performed
during the repair of medial meniscal tears. This retrospective study included 86 patients
who underwent arthroscopic medial meniscus repair. PC technique was performed if the
medial joint width was less than 5 mm. The patient population was divided into two
groups as who underwent meniscus repair with PC technique (PC + repair group) or not
(repair group). All patients were evaluated clinically (Kujala score, International
Knee Documentation Committee (IKDC) subjective score, Lysholm score, and Tegner activity
score) and radiologically (medial joint width and valgus laxity angle). When the medial
joint width measurements before the PC technique and at the postoperative first and
sixth months were compared, it was found to be statistically significant (p < 0.05). However, there was no significant difference between the preoperative and
12-month postoperative joint width measurements (p > 0.05). At the 12-month follow-up, no statistically significant difference was determined
for the valgus laxity angle in the PC group compared with preoperative values (p > 0.05). The follow-up Kujala score, IKDC subjective score, Lysholm score, and Tegner
activity score were similar between the groups. The clinical scores in both groups
were determined to have statistically significant increase at 12-month postoperatively
compared with the preoperative values (p < 0.05). The results of this study showed that performing the PC technique prior
to medial meniscal tear repair increase the medial joint visualization safely and
effectively without permanent valgus laxity.
Keywords
pie crust - MCL - release - meniscal tears
