AMR Sign - An Arthroscopic S-shaped Fold Signifying Adequate Medial Meniscus Repair
https://doi.org/10.5704/MOJ.2307.003
- Author:
Rajani AM
1
;
Shah UA
2
;
Mittal ARS
3
;
Gupta S
4
;
Garg R
5
;
Rajani AA
6
;
Punamiya M
7
;
Singhal R
8
Author Information
1. Department of Orthopaedics, Breach Candy Hospital Trust, Mumbai, India
2. Department of Orthopaedics, Surgikids Hospital, Ahmedabad, India
3. Department of Orthopaedics, Orthopaedic Arthroscopy Knee and Shoulder Clinic, Mumbai, India
4. Department of Orthopaedics, Galaxy Hospital, Bhopal, India
5. Department of Orthopaedics, Canadian Specialist Hospital, Dubai, United Arab Emirates
6. Department of Radiology, Orthopaedic Arthroscopy Knee and Shoulder Clinic, Mumbai, India
7. Department of Physiotherapy, Orthopaedic Arthroscopy Knee and Shoulder Clinic, Mumbai, India
8. Department of Biostatistics, Orthopaedic Arthroscopy Knee and Shoulder Clinic, Mumbai, India
- Publication Type:Journal Article
- Keywords:
AMR sign, Medial meniscus tear, arthroscopic repair, all inside, adequate repair
- From:Malaysian Orthopaedic Journal
2023;17(No.2):13-20
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: The preferred management of medial
meniscus tears has notably moved from meniscectomies
towards repair. With a higher volume of meniscal repairs
being done all across the world with every passing day, the
lack of an objective and definitive sign suggesting the
adequacy of its repair is daunting. The purpose of our study
was to introduce a unique and novel arthroscopic sign
formed after adequate repair of the medial meniscus, the
AMR (Adequacy of Medial meniscus Repair) sign. We
hypothesised that it is not only the objective end point for
repair, but can also form the indicator for excellent clinical,
functional, and radiological outcome even in the long term.
Materials and methods: This was a multicentric,
prospective study initiated by the corresponding author, and
the findings validated subsequently by the other authors.
Overall, it included 804 patients of isolated medial meniscus
tear operated with arthroscopic all-inside technique between
January 2014 and December 2017. Patients were segregated
into three groups based on whether an S-shaped curve in the
free, inner edge of the medial meniscus sign was formed
post-repair, lost after further tightening, or not formed upon
subjective completion of repair. All the patients were
followed-up and evaluated based of medial joint line
tenderness, McMurray’s test for medial meniscus, IKDC
score, WOMET score, and radiologically using an MRI at
the terminal follow-up.
Results: The mean terminal follow-up was 42.34±4.54
months. There was significant (p<0.01) improvement in all
patients at the terminal follow-up post-surgery, irrespective
of the group. The group in which AMR sign was formed and
maintained showed a significantly better functional outcome
on terminal follow-up as well as lower failure rates
compared to the other two groups.
Conclusion: AMR sign is an S-shaped fold at the inner, free
edge of medial meniscus, formed after an adequate repair of
isolated medial meniscus tear, as viewed on arthroscopy. It is
an objective sign denoting regained integrity of the collagen
architecture of the medial meniscus following repair. It is
also a reliable indicator of excellent long term functional,
clinical, and radiological outcome and also lower failure
rates in patients after arthroscopic medial meniscus repair.
- Full text:16.2023my1314.pdf
