Evidence map›Paper›PMID 32613338›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021

Intraoperative repair for iatrogenic MCL tear due to medial pie-crusting in TKA yields satisfactory mid-term outcomes.

Mehdi Motififard, Erfan Sheikhbahaei, Mohammadreza Piri Ardakani, Hojat Cheraghsahar, Arvin Shahzamani

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In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Arthroplasty of the Knee: Current Techniques for Implant Alignment.Zeitschrift fur Orthopadie und Unfallchirurgie · 2022
    Article
  5. [Effectiveness analysis of lateral condyle sliding osteotomy in total knee arthroplasty for the treatment of lateral femoral bowing deformity].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2022
    Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Mehdi MotififardOrthopedic Surgery Department, School of Medicine, Kashani University Hospital, Isfahan University of Medical Sciences, Kashani St. Felezi Br., Isfahan, Iran.
Erfan SheikhbahaeiStudent Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Mohammadreza Piri ArdakaniOrthopedic Surgery Department, School of Medicine, Kashani University Hospital, Isfahan University of Medical Sciences, Kashani St. Felezi Br., Isfahan, Iran. mr-piri@edc.mui.ac.ir.
Hojat CheraghsaharOrthopedic Surgery Department, School of Medicine, Kashani University Hospital, Isfahan University of Medical Sciences, Kashani St. Felezi Br., Isfahan, Iran.
Arvin ShahzamaniStudent Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Isfahan University of Medical Sciences · IRKashan University of Medical Sciences · IR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aimed to assess the rate of iatrogenic mid-substance superficial medial collateral ligament (sMCL) tear due to the medial pie-crusting technique during varus deformity total knee arthroplasty and compare the knee society score (KSS), range of motion (ROM), and instability rate of the repaired group to the control group with intact sMCL.

methodsFor this retrospective series of prospectively collected data, the multiple needle puncturing technique was performed for 653 out of the 1768 knees during algorithmic medial soft-tissue release. Iatrogenic tear was observed in 35 knees (5%); hence, repair with running locking nonabsorbable braided suture was performed. Patients were visited and reviewed both clinically and radiographically at 6 weeks, 3 months, 6 months, 12 months, and annually thereafter. Chi-square, ANOVA, Mann-Whitney, independent and paired t test were used to analyze the variables. P value < 0.05 was considered statistically significant.

results85% of the repaired sMCL had stable joints with a mean KSS of 88 ± 3 and a mean ROM of 103 ± 11 degrees (°). The other five patients (15%) with mean KSS of 40 ± 8 and mean ROM of 81° ± 5° had an instability and needed to undergo a revision surgery. The control group had a mean KSS of 86 ± 15 and mean ROM of 107° ± 8°; however, 7 knees had an instability and needed a revision surgery. No significant difference was observed in terms of KSS (P = 0.86) and ROM (P = 0.64) between the control and repaired groups.

conclusionThe mid-substance sMCL tear is an important intraoperative complication of medial pie-crusting. Repairing this iatrogenic tear with nonabsorbable suture had satisfying clinical outcomes regarding the postoperative knee ROM and KSS in comparison to the control group. However, there is a chance of failure, which should be perceived by the surgeons. LEVEL OF EVIDENCE: Therapeutic studies, investigating the results of treatment, Level III.

Indexed as

Arthroplasty, Replacement, KneeMedial Collateral Ligament, KneeHumansIatrogenic DiseaseKnee JointRange of Motion, ArticularRetrospective StudiesArthroplastyInstabilityMedial collateral ligamentPie-crustingTotal knee replacement

Identifiers

PMID32613338
OpenAlexW3038873234

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.