UJCR; 2024, Vol. 4, Issue 3

Тема статьи

Optimization of medial meniscus mobility: personalized approach and arthroscopic repair (12-15)

Авторы

Mamatkulov KM¹, Abdusamatov ShN², Kholikulov MT²

Учреждение

Samarkand State Medical University

Аннотация

Abstract Medial meniscus hypermobility is a common cause of pain and discomfort in the knee joint, particularly among athletes and active individuals. Despite extensive research on meniscal tears, hypermobility remains an underexplored issue. Arthroscopic techniques offer minimally invasive solutions, but there is still no clear treatment protocol for patients with this pathology.Objective: To evaluate the effectiveness of the «all-inside» arthroscopic method combined with a personalized approach for treating medial meniscus hypermobility and improving clinical outcomes in patients with different knee injuries. Methods: The study included 34 patients who underwent arthroscopic medial meniscus reconstruction using the «all-inside» technique from January 2021 to September 2023. Patients were divided into groups based on the presence or absence of anterior cruciate ligament (ACL) injuries. Clinical outcomes were assessed using the IKDC scale before and after surgery. Results: Patients showed significant improvements in subjective IKDC scores, from 54.11 to 84.56 (p < 0.005). In 85% of cases, only one segment of the meniscus was affected, enabling successful repair without further interventions. The main complications were restricted joint mobility and prolonged pain syndrome in a few patients. Conclusion: The arthroscopic method for treating medial meniscus hypermobility with a personalized approach demonstrated high clinical efficacy. However, further research is needed to identify factors influencing outcomes to minimize complications.

Ключевые слова

medial meniscus hypermobility, arthroscopy, meniscus reconstruction, anterior cruciate ligament, personalized approach

Литературы

1. Faizan A, Goldstein J, Edelman S, et al. Comparison of post-operative knee stability and return to sports outcomes between all-inside and transportal ACLR. Sports Health. 2020;12(2):184-190. doi:10.1177/1941738119875243. 2. Foster BD, Munns C, Smith BT, et al. All-inside versus transportal ACL reconstruction: a meta-analysis of patientreported outcomes and complications. Am J Sports Med. 2021;49(1):144-150. doi:10.1177/0363546520949391. 3. Gualtieri D, Monaco E, De Carli A, et al. Long-term clinical and radiographic results after all-inside ACL reconstruction. J Knee Surg. 2021;34(4):329-337. doi:10.1055/s-0039-1700882. 4. Hamill J, Murphy I, Whelan D, et al. The clinical efficacy of transportal and all-inside ACL reconstruction: a metaanalysis. BMC Musculoskelet Disord. 2021;22:267. doi:10.1186/s12891-021-04122-0. 5. Hewison C, England A, Haskell A. All-inside ACL reconstruction technique: patient outcomes and complications. Orthop J Sports Med. 2020;8(2):3235. doi:10.1177/2325967119896942. 6. Karimov MY, Tolochko KP, Mamatkulov KM. Anterior knee pain syndrome. J Adv Med Med Res. 2019;30(3):1-8. doi:10.9734/JAMMR/2019/v30i330178. 7. Karimov MY, Tolochko KP, Mamatkulov KM. Anterior knee pain syndrome. Vestnik Tashkentskoi Meditsinskoi Akademii. 2017;(5):9-13. (In Russ.) 8. Karimov MY, Tolochko KP, Mamatkulov KM. Kujala questionnaire for patients with anterior knee pain. Uzbek Tibbiiyot Zhurnali. 2019;(2):111-113. (In Russ.) 9. Kim SH, Lee SH, Kim JH, et al. Minimally invasive all-inside ACL reconstruction technique: a comparative study of patient outcomes. J Korean Orthop Assoc. 2020;55(2):101-107. doi:10.4055/jkoa.2020.55.2.101. 10. Kouloumentas P, Kouloumentas P, Papadopoulos G, et al. Long-term outcomes of all-inside versus full tibial tunnel ACL reconstruction. Arthroscopy. 2021;37(1):45-53. doi:10.1016/j.arthro.2020.06.039. 11. Koutras G, Papavasileiou X, Tsagkozis P, et al. Systematic review comparing the outcomes of ACL reconstruction using transportal and all-inside techniques. Clin Orthop Relat Res. 2021;79(9):2055-2064. doi:10.1097/01. blo.0000717856.65871.6d. 12. Kraus T, Heidari N, Švehlík M, Schneider F, Sperl M, Linhart W. Outcome of repaired unstable meniscal tears in children and adolescents. Acta Orthop. 2012;83(3):261-266. 13. Lemanek NJ, Huber K, Fraga J, et al. Patient satisfaction after all-inside ACL reconstruction: A two-year follow-up. Clin J Sport Med. 2021;31(1) 14. Lu G, Li X, Zhang J, et al. Arthroscopic all-inside versus conventional ACL reconstruction: a prospective comparative study. BMC Musculoskelet Disord. 2021;22:555. doi:10.1186/s12891-021-04232-7. 15. Lv Y, Qiu J, Wang J, et al. Is all-inside with suspensory cortical button fixation a superior technique for anterior cruciate ligament reconstruction surgery? A systematic review and meta-analysis. BMC Musculoskelet Disord. 2020;21:450. doi:10.1186/s12891-020-03352-4. 16. Lyle NJ, Sampson MA, Barrett DS. MRI of intermittent meniscal dislocation in the knee. Br J Radiol. 2009;82:374-379. 17. Mahmud MR, Karim MB, Rahman MS. Comparison of surgical outcomes between all-inside and full tibial tunnel techniques in ACL reconstruction. Arch Orthop Trauma Surg. 2020;140(5):673-680. doi:10.1007/s00402-020-03342-1. 18. Mamatkulov K, Kholkhudjayev F, et al. Our experience of plastic surgery of the anterior cruciate ligament using the «All Inside» method with the tendons of the popliteal flexors or the tendon of the long fibular muscle. Pol J Sci. 2021;45(1):42-44. 19. Mamatkulov KM, Xolxo’jayev FI, Rakhmonov SH. Reconstruction of the anterior cruciate ligament with popliteal flexor tendons or the tendon of the long fibular muscle. Zhurnal Akademicheskikh Issledovanii i Nauk. 2021;2(2):1214- 1219. doi:10.24411/2181-1385-2021-00326. (In Russ.) 20. Mamatkulov KM, Xolxo’jayev FI. Arthroscopic restoration of the anterior cruciate ligament using the «All Inside» method with popliteal flexor tendons or long fibular muscle tendon. Problemy Biologii i Meditsiny. 2023. (In Russ.) 21. Monaco E, Fabbri M, Redler A, et al. All-inside technique for ACL reconstruction with augmentation: long-term follow-up. J Knee Surg. 2021;34(3):210-217. doi:10.1055/s-0039-1694010. 22. Monaco E, Redler A, De Carli A, et al. Long-term outcomes of anterior cruciate ligament reconstruction using the all-inside technique. J Orthop Sports Phys Ther. 2020;50(8):374-380. doi:10.2519/jospt.2020.9367. 23. Morrison JB, Tuck KL, Lee J, et al. Comparative outcomes of all-inside versus conventional ACL reconstruction: a multicenter randomized controlled trial. Arthroscopy. 2020;36(7):1938-1946. doi:10.1016/j.arthro.2020.02.029. 24. Muaidi QI, Hegazy FA, Ahmed AF, et al. Effect of all-inside anterior cruciate ligament reconstruction on postoperative outcomes. Saudi J Sports Med. 2021;9(2):152-160. doi:10.4103/sjsm.sjsm_79_20. 25. Orr R, Fox A, Hughson RL, et al. Transportal versus all-inside ACL reconstruction: a comparative study of biomechanical and functional outcomes. J Orthop Surg Res. 2021;16:87. doi:10.1186/s13018-020-02135-8. 26. Pace V, Adams RD, Tofts L, Munns CF, Nicholson LL. Proprioceptive acuity into knee hypermobile range in children with joint hypermobility syndrome. Pediatr Rheumatol. 2014;12:408. 27. Park YB, Ha JK, Kim SW, et al. Biomechanical comparison between transportal and all-inside techniques in ACL reconstruction. Clin Orthop Surg. 2020;12(3):352-360. doi:10.4055/cios2020.12.3.352. 28. Song EK, Kim SK, Yoo JH, et al. All-inside technique versus conventional ACL reconstruction with a hamstring autograft: A retrospective comparative study. Knee Surg Sports Traumatol Arthrosc. 2020;28(2):502-509. doi:10.1007/ s00167-019-05589-0. 29. Söylev S, Pınar İH. Results of meniscus repair for the hypermobile medial meniscus. Dokuz Eylul Univ, Dep Orthop Traumatol, Izmir, Turkey; Ata Sağlık Hospital, Clinic of Orthopaedics and Traumatology, Izmir, Turkey. 30. Thomeé R, Karlsson J, Holmgren K, et al. Functional outcomes and return to sport after all-inside ACL reconstruction. Orthop J Sports Med. 2020;8(5):253. doi:10.1177/2325967119900814.