A Study on Different Treatments for Knee Osteoarthritis Caused by Damaged Roots of the Medial Meniscus.

Official title

Comparison of Different Treatment Strategies for Root Injury Behind the Medial Meniscus to Delay the Progression of Knee Osteoarthritis: a Prospective Cohort Study

Overview

Medial meniscus posterior root tears (MMPRT) account for 20% or more of all meniscus tears, but the diagnosis and treatment of this condition continues to plague the general population due to the complexity of the diagnosis and uncertainty of the treatment. Early as well as timely diagnosis and treatment is one of the effective ways to avoid accelerated knee degeneration. Based on this study, our team is going to conduct a clinical study on posterior medial meniscus tear, combining Magnetic Resonance Imaging(MRI) to dynamically assess the changes of meniscus and articular cartilage surface after the injury, and selecting a specific patient group to carry out different therapeutic interventions, which mainly include conservative treatment, partial meniscectomy, and meniscal repair, in order to clarify the effects of different treatment modalities on the articular cartilage after the posterior meniscus tear, and to help to delay the degeneration of knee joints. This is to clarify the effects of different treatment modalities on the articular cartilage after posterior medial meniscus tears and to provide appropriate advice for delaying the progression of osteoarthritis of the knee.

Interventions

• Procedure Arthroscopic meniscus surgery
  Comparison of the incidence of osteoarthritis with conservative treatment as well as arthroscopic partial resection as well as arthroscopic repair surgery for a condition known as posterior meniscus root injury.

Primary outcome measures

• the incidence of KOA [Time frame: 30th November 2024 -30th November 2027]

Secondary outcome measures (1)

• Articular cartilage T2-mapping value [Time frame: 30th November 2024 -30th November 2027]

Eligibility criteria

Inclusion criteria

• Clinical diagnosis of posterior root tear of the medial meniscus;
• Patients with K-L classification ≤ grade II;
• The age range of 50-65 years old;
• International Cartilage Repair Society (ICRS) Modified Magnetic Resonance Imaging Grading System ≤ Grade 2;
• International Cartilage Repair Society (ICRS) arthroscopic grading system ≤ grade 2;
• Knee joint mobility ≥90°;
• Inversion deformity ≤10°;
• Must be able to complete follow-up MRI within 2 years after knee meniscus surgery;
• Must be able to complete clinical data;

Exclusion criteria

• Can not participate in this study;
• Patients with concomitant meniscal injuries elsewhere;
• knee joint infection disease;
• Osteoporosis disease;
• Patients with previous history of knee surgery;
• Knee joint instability disease;
• Severe KOA disease;
• Can not cooperate with MRI detection;
• Cannot tolerate the surgery;
• Those who cannot tolerate the arthroscopic knee surgery;
• Neuromuscular system pathology disease;

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Observational model

Cohort

Study locations

Center list to be confirmed — check the primary protocol.

Publications

• Jung YH, Choi NH, Oh JS, Victoroff BN. All-inside repair for a root tear of the medial meniscus using a suture anchor. Am J Sports Med. 2012 Jun;40(6):1406-11. doi: 10.1177/0363546512439181. Epub 2012 Mar 16. PMID 22427620
• Faucett SC, Geisler BP, Chahla J, Krych AJ, Kurzweil PR, Garner AM, Liu S, LaPrade RF, Pietzsch JB. Meniscus Root Repair vs Meniscectomy or Nonoperative Management to Prevent Knee Osteoarthritis After Medial Meniscus Root Tears: Clinical and Economic Effectiveness. Am J Sports Med. 2019 Mar;47(3):762-769. doi: 10.1177/0363546518755754. Epub 2018 Mar 8. PMID 29517925
• Chung KS, Ha JK, Yeom CH, Ra HJ, Jang HS, Choi SH, Kim JG. Comparison of Clinical and Radiologic Results Between Partial Meniscectomy and Refixation of Medial Meniscus Posterior Root Tears: A Minimum 5-Year Follow-up. Arthroscopy. 2015 Oct;31(10):1941-50. doi: 10.1016/j.arthro.2015.03.035. Epub 2015 Jun 18. PMID 26095821
• Allaire R, Muriuki M, Gilbertson L, Harner CD. Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am. 2008 Sep;90(9):1922-31. doi: 10.2106/JBJS.G.00748. PMID 18762653
• Bin SI, Kim JM, Shin SJ. Radial tears of the posterior horn of the medial meniscus. Arthroscopy. 2004 Apr;20(4):373-8. doi: 10.1016/j.arthro.2004.01.004. PMID 15067276
• Ozkoc G, Circi E, Gonc U, Irgit K, Pourbagher A, Tandogan RN. Radial tears in the root of the posterior horn of the medial meniscus. Knee Surg Sports Traumatol Arthrosc. 2008 Sep;16(9):849-54. doi: 10.1007/s00167-008-0569-z. Epub 2008 Jun 7. PMID 18536902
• Nakagawa Y, Mukai S, Sakai S, Nakamura R, Takahashi M, Nakagawa S. Preoperative diagnosis of knee cartilage, meniscal, and ligament injuries by magnetic resonance imaging. J Exp Orthop. 2023 Apr 20;10(1):47. doi: 10.1186/s40634-023-00595-y. PMID 37079120
• Cao G, Gao S, Xiong B. Application of quantitative T1, T2 and T2* mapping magnetic resonance imaging in cartilage degeneration of the shoulder joint. Sci Rep. 2023 Mar 20;13(1):4558. doi: 10.1038/s41598-023-31644-2. PMID 36941288

Identifiers

NCT: NCT06707948 · IIT2024-109

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗