SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025
Centralization reduces meniscal extrusion, improves joint mechanics and functional outcomes in patients undergoing meniscus surgery: A systematic review and meta-analysis.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Centralization reduces meniscal extrusion, improves joint mechanics and functional outcomes in patients undergoing meniscus surgery: A systematic review and meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Pooled it
- Meniscal centralization restores meniscus-cartilage contact mechanics after posterior root repair: a biomechanical in-silico study.Journal of orthopaedic surgery and research · 2026Article
- Meniscal Extrusion: A Key Modifiable Driver of Meniscal and Cartilage Degeneration.Current reviews in musculoskeletal medicine · 2026Review
- Medial meniscus posterior root tear repair: An overview of surgical techniques and augmentation strategies.Journal of experimental orthopaedics · 2026Review
- Short-Term Outcomes After Transtibial Repair of Medial Meniscus Posterior Root Tears: A Case Series.Journal of clinical medicine · 2025Article
- High tibial osteotomy with individualised alignment and meniscal centralisation improves KOOS sports and recreation and cartilage status compared to conventional Fujisawa-point alignment without centralisation: A propensity score matching study.Journal of experimental orthopaedics · 2025Article
- Meniscal extrusion: Proposal for a novel qualitative classification.Journal of experimental orthopaedics · 2025Review
- Placing the transtibial centralisation stitch at the posterior horn of the medial meniscus best restores tibiofemoral contact mechanics and extrusion following medial meniscus posterior root tears: An in vitro biomechanical study using porcine knee joints.Journal of experimental orthopaedics · 2025Article
- Transtibial Pull-Out Repair of a Chronic Medial Meniscal Posterior Root Tear With All-Suture Knotless Centralization.Video journal of sports medicineArticle
- Meniscus extrusion after a medial meniscus root repair: Where we are and how can we solve it?Science progressReview
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo perform a systematic review and meta-analysis of the existing literature on meniscal centralisation procedures, analysing its impact on meniscal extrusion, joint biomechanics and clinical and radiological outcome measures.
methodsThe Cochrane Controlled Register of Trials, PubMed (MEDLINE) and Embase were used to perform a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Biomechanical studies on healthy animal or human cadaveric knee joints that assessed meniscal extrusion or tibiofemoral contact mechanics (contact area and pressure) following centralization for meniscal pathologies were included. For clinical studies, those that prospectively or retrospectively assessed patient-reported outcome measures (PROMs), postoperative knee motion, complications and radiological extrusion following centralization for meniscal pathologies were included.
resultsFifteen studies were included in the analysis, comprising eight biomechanical, six clinical and one both. There were 92 knee specimens for biomechanical testing, of which 40 were human cadaveric and 52 porcine models. Biomechanical data revealed centralization to be commonly performed for posterior meniscal root tears and significantly reduced extrusion and contact pressure whilst improving contact area following a tear (p < 0.00001). Centralization restored extrusion to that of the native knee at all flexion angles described (0-90°, p = 0.25) and, compared to the torn state, brought tibiofemoral contact mechanics 3.2-5.0 times closer to the native state. Clinical data showed that 158 patients underwent centralization for extrusion. It improved postoperative Knee Injury and Osteoarthritis Outcome score (KOOS) (p = 0.006) and Lysholm scores (p < 0.00001) at 25.0 months, maintained extrusion reduction at 17.1 months (p < 0.00001) and preserved knee motion.
conclusionCentralisation for various meniscal injuries associated with extrusion can reduce meniscal extrusion and improve joint biomechanics, along with clinical and radiological outcomes. Existing evidence is still scarce and exhibits a notable amount of methodological heterogeneity. LEVEL OF EVIDENCE: Systematic review of Level IV evidence.
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