Percutaneous Superficial Medial Collateral Ligament Release Outcomes During Medial Meniscal Arthroscopy: A Systematic Review
Purpose: To systematically review the literature to better understand the technique, outcomes, and complications after percutaneous superficial medial collateral ligament (sMCL) lengthening during knee arthroscopy to address isolated medial meniscal pathology. Methods: A systematic review was conduc...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-04-01
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| Series: | Arthroscopy, Sports Medicine, and Rehabilitation |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666061X19300306 |
| _version_ | 1818437468117008384 |
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| author | Michael A. Gaudiani, B.A. Derrick M. Knapik, M.D. Matthew W. Kaufman, B.A. Michael J. Salata, M.D. James E. Voos, M.D. Michael R. Karns, M.D. |
| author_facet | Michael A. Gaudiani, B.A. Derrick M. Knapik, M.D. Matthew W. Kaufman, B.A. Michael J. Salata, M.D. James E. Voos, M.D. Michael R. Karns, M.D. |
| author_sort | Michael A. Gaudiani, B.A. |
| collection | DOAJ |
| description | Purpose: To systematically review the literature to better understand the technique, outcomes, and complications after percutaneous superficial medial collateral ligament (sMCL) lengthening during knee arthroscopy to address isolated medial meniscal pathology. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using a PRISMA checklist. The inclusion criteria consisted of English-language articles or articles with English-language translations documenting the use of percutaneous sMCL lengthening during arthroscopic knee surgery to treat isolated meniscal pathology (repair vs meniscectomy) with reported postoperative outcomes and complications. Results: Four studies met the inclusion criteria, consisting of a total of 192 patients undergoing percutaneous sMCL lengthening. No perioperative complications related to iatrogenic chondral damage, fracture, or additional meniscal injury were reported. Mild postoperative pain at the medial needle tract site lasting up to 15 days after surgery was reported in 52% of patients (46 of 88). At final follow-up, laxity on valgus stress testing showed a range from 0 to 1.1 mm with a range from –0.3° to 0.9° of radiographic medial joint space widening compared with preoperative radiographs. The length of follow-up ranged from 1.5 to 24 months. Conclusions: The percutaneous “pie-crusting” technique remains the most commonly reported technique to lengthen the sMCL during arthroscopic meniscal surgery. Percutaneous lengthening represents a safe and effective method of increasing medial joint space visualization, with no reported perioperative or postoperative complications and with minimal, likely clinically insignificant residual joint laxity after surgery on valgus stress testing at final follow-up compared with preoperative values. Level of Evidence: Level IV, systematic review of Level IV studies. |
| first_indexed | 2024-12-14T17:25:09Z |
| format | Article |
| id | doaj.art-db98846235004e0b8d16c503f675e759 |
| institution | Directory Open Access Journal |
| issn | 2666-061X |
| language | English |
| last_indexed | 2024-12-14T17:25:09Z |
| publishDate | 2020-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy, Sports Medicine, and Rehabilitation |
| spelling | doaj.art-db98846235004e0b8d16c503f675e7592022-12-21T22:53:14ZengElsevierArthroscopy, Sports Medicine, and Rehabilitation2666-061X2020-04-0122e153e159Percutaneous Superficial Medial Collateral Ligament Release Outcomes During Medial Meniscal Arthroscopy: A Systematic ReviewMichael A. Gaudiani, B.A.0Derrick M. Knapik, M.D.1Matthew W. Kaufman, B.A.2Michael J. Salata, M.D.3James E. Voos, M.D.4Michael R. Karns, M.D.5School of Medicine, Case Western Reserve University, Cleveland, Ohio, U.S.A; Address correspondence to Michael A. Gaudiani, B.A., School of Medicine, Case Western Reserve University, 2109 Adelbert Rd, Cleveland, OH 44106, U.S.A.University Hospitals Sports Medicine Institute, Cleveland, Ohio, U.S.ASchool of Medicine, Case Western Reserve University, Cleveland, Ohio, U.S.AUniversity Hospitals Sports Medicine Institute, Cleveland, Ohio, U.S.AUniversity Hospitals Sports Medicine Institute, Cleveland, Ohio, U.S.AUniversity Hospitals Sports Medicine Institute, Cleveland, Ohio, U.S.APurpose: To systematically review the literature to better understand the technique, outcomes, and complications after percutaneous superficial medial collateral ligament (sMCL) lengthening during knee arthroscopy to address isolated medial meniscal pathology. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using a PRISMA checklist. The inclusion criteria consisted of English-language articles or articles with English-language translations documenting the use of percutaneous sMCL lengthening during arthroscopic knee surgery to treat isolated meniscal pathology (repair vs meniscectomy) with reported postoperative outcomes and complications. Results: Four studies met the inclusion criteria, consisting of a total of 192 patients undergoing percutaneous sMCL lengthening. No perioperative complications related to iatrogenic chondral damage, fracture, or additional meniscal injury were reported. Mild postoperative pain at the medial needle tract site lasting up to 15 days after surgery was reported in 52% of patients (46 of 88). At final follow-up, laxity on valgus stress testing showed a range from 0 to 1.1 mm with a range from –0.3° to 0.9° of radiographic medial joint space widening compared with preoperative radiographs. The length of follow-up ranged from 1.5 to 24 months. Conclusions: The percutaneous “pie-crusting” technique remains the most commonly reported technique to lengthen the sMCL during arthroscopic meniscal surgery. Percutaneous lengthening represents a safe and effective method of increasing medial joint space visualization, with no reported perioperative or postoperative complications and with minimal, likely clinically insignificant residual joint laxity after surgery on valgus stress testing at final follow-up compared with preoperative values. Level of Evidence: Level IV, systematic review of Level IV studies.http://www.sciencedirect.com/science/article/pii/S2666061X19300306 |
| spellingShingle | Michael A. Gaudiani, B.A. Derrick M. Knapik, M.D. Matthew W. Kaufman, B.A. Michael J. Salata, M.D. James E. Voos, M.D. Michael R. Karns, M.D. Percutaneous Superficial Medial Collateral Ligament Release Outcomes During Medial Meniscal Arthroscopy: A Systematic Review Arthroscopy, Sports Medicine, and Rehabilitation |
| title | Percutaneous Superficial Medial Collateral Ligament Release Outcomes During Medial Meniscal Arthroscopy: A Systematic Review |
| title_full | Percutaneous Superficial Medial Collateral Ligament Release Outcomes During Medial Meniscal Arthroscopy: A Systematic Review |
| title_fullStr | Percutaneous Superficial Medial Collateral Ligament Release Outcomes During Medial Meniscal Arthroscopy: A Systematic Review |
| title_full_unstemmed | Percutaneous Superficial Medial Collateral Ligament Release Outcomes During Medial Meniscal Arthroscopy: A Systematic Review |
| title_short | Percutaneous Superficial Medial Collateral Ligament Release Outcomes During Medial Meniscal Arthroscopy: A Systematic Review |
| title_sort | percutaneous superficial medial collateral ligament release outcomes during medial meniscal arthroscopy a systematic review |
| url | http://www.sciencedirect.com/science/article/pii/S2666061X19300306 |
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