{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T00:24:09Z","timestamp":1794011049666,"version":"4.8.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82472410"],"award-info":[{"award-number":["82472410"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare clinical and radiologic outcomes after transtibial pull\u2010out repair for medial meniscus posterior root tears (MMPRTs) between patients with acute and insidious symptom onset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent transtibial pull\u2010out repair for MMPRTs between March 2022 and December 2023 and had a minimum 2\u2010year follow\u2010up were retrospectively reviewed. Patients were classified into an acute\u2010onset group, defined by abrupt symptom onset during or immediately after a clear inciting knee incident, or an insidious\u2010onset group, defined by gradually progressive symptoms without a definite precipitating event. Outcomes included patient\u2010reported outcome measures (PROMs) and radiologic parameters. PROMs comprised the International Knee Documentation Committee (IKDC) and Lysholm scores, with minimal clinically important difference (MCID) achievement also assessed. Radiologic outcomes included Kellgren\u2013Lawrence (KL) grade progression, meniscal extrusion and magnetic resonance imaging (MRI) healing status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 49 patients were included (28 acute\u2010onset, 21 insidious\u2010onset). Both groups showed significant improvement in IKDC and Lysholm scores, with similar MCID achievement rates. At final follow\u2010up, the Acute Group had higher median IKDC scores than the Insidious Group (73.0 [66.8\u201379.0] vs. 67.0 [62.0\u201369.0];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) and Lysholm scores (76.0 [73.0\u201378.0] vs. 71.0 [70.0\u201374.0];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). KL\u2010grade progression was less frequent in the Acute Group (1\/28 [3.6%] vs. 8\/21 [38.1%];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Meniscal extrusion was also lower (3.3 [2.9\u20133.5] vs. 3.9 [3.1\u20134.0] mm;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), although the absolute difference was small. MRI healing status did not differ between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Acute\u2010onset MMPRTs were associated with better postoperative functional outcomes and less radiologic progression than insidious\u2010onset MMPRTs, although the clinical relevance of the small difference in meniscal extrusion remains uncertain. Therefore, symptom\u2010onset pattern may provide potentially useful information for preoperative prognostic counselling, but this association should be interpreted cautiously and confirmed in prospective studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70948","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:55:47Z","timestamp":1791582947000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute rather than insidious symptom onset is associated with better postoperative outcomes after transtibial pull\u2010out repair for medial meniscus posterior root tears"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0294-7110","authenticated-orcid":false,"given":"Zheng\u2010Zheng","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Sports Medicine, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu\u2010Yang","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Nan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Hao","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Long","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing\u2010Song","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"He","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010Ping","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2024.100998"},{"issue":"7","key":"e_1_2_12_3_1","article-title":"Establishing the minimal clinically important difference and patient acceptable symptom state after isolated arthroscopic posterior medial meniscal root repair","volume":"13","author":"Allende F","year":"2025","journal-title":"Arthrosc Sports Med 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