{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:18:13Z","timestamp":1787761093568,"version":"build-2784847793"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate whether the addition of a meniscal centralization procedure to medial meniscus posterior root (MMPR) repair improves medial meniscus extrusion (MME) and patient\u2010reported outcomes compared with isolated MMPR repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic review and meta\u2010analysis were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses (PRISMA) guidelines. PubMed, Cochrane CENTRAL and Scopus were searched from inception to 28 February 2026. Comparative studies evaluating isolated MMPR repair versus MMPR repair combined with centralization procedure (including transtibial pull\u2010out repair, posteromedial pull\u2010out repair with all\u2010inside sutures and anchor\u2010based techniques) and reporting radiographic extrusion measured by magnetic resonance imaging and\/or patient\u2010reported outcomes were included. Effect estimates were calculated using change scores. Mean differences (MDs) were used for extrusion, and standardized mean differences (SMDs) were used for patient\u2010reported outcomes. Heterogeneity was assessed using the\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistic, and pooled estimates were generated using a random\u2010effects model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six comparative studies (one randomized controlled trial [RCT] and five retrospective cohort studies) comprising 309 patients (167 isolated repair; 142 centralization repair) with a mean follow\u2010up period of 11.2 months (range, 3\u201326.8 months) were included. Participants were predominantly female, with mean age of 50.3\u201366.4 years, body mass index of 22.5\u201329\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and Kellgren\u2013Lawrence\u2009\u2264\u20092. The overall pooled analysis demonstrated no significant difference in MME reduction between centralization and isolated repair (MD 0.4\u2009mm; 95% confidence interval [CI] \u22120.34 to 1.22;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.27;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2\u2009<\/jats:sup>\n                      =\u200989%). Although post\u2010operative MME was lower in the centralization group (3.3 vs. 3.8\u2009mm), the absolute difference between groups was only 0.6\u2009mm, suggesting limited clinical relevance. No significant differences were observed between groups in Lysholm (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.93), International Knee Documentation Committee (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.13) or visual analogue scale pain scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.10). Reporting of complications was inconsistent, with no conversions to total knee arthroplasty during follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The addition of a meniscal centralization to MMPR repair does not demonstrate a consistent reduction in meniscal extrusion or improvement in patient\u2010reported outcomes compared with isolated MMPR repair. Given the heterogeneity of the current evidence and the predominance of non\u2010randomized studies, further high\u2010quality RCTs are required to clarify its clinical value.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70583","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:20:24Z","timestamp":1787757624000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Medial meniscus posterior root repair with concomitant centralization does not demonstrate superior reduction of meniscal extrusion or improved clinical outcomes compared with isolated repair: A systematic review and meta\u2010analysis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6155-8898","authenticated-orcid":false,"given":"Angelo V.","family":"Vasiliadis","sequence":"first","affiliation":[{"name":"Department of Physical Education and Sports Sciences at Serres Aristotle University of Thessaloniki Agios Ioannis\u2010Serres Greece"},{"name":"Department of Orthopaedic Surgery St. Luke's Hospital Panorama, Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0368-0465","authenticated-orcid":false,"given":"Nifon K.","family":"Gkekas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery School of Health Sciences, Faculty of Medicine University of Thessaly Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandros","family":"Maris","sequence":"additional","affiliation":[{"name":"Joint Reconstruction Unit Royal National Orthopaedic Hospital Stanmore UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0682-4420","authenticated-orcid":false,"given":"Nicholas","family":"Colyvas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California\u2010San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9494-6048","authenticated-orcid":false,"given":"Michael","family":"Hantes","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery School of Health Sciences, Faculty of Medicine University of Thessaly Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2023.04.009"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12683"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12410"},{"issue":"11","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","DOI":"10.1177\/23259671251365977","article-title":"Minimum 5\u2010year outcomes, complication rates, and conversion to total knee arthroplasty following isolated medial meniscus posterior root repair","volume":"13","author":"Chahla J","year":"2025","journal-title":"Orthop J Sports 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of all\u2010inside sutures to the posteromedial capsule in medial meniscus posterior root repair: findings from a retrospective three\u2010dimensional magnetic resonance imaging study","volume":"16","author":"Okazaki Y","year":"2024","journal-title":"Cureus"},{"issue":"4","key":"e_1_2_12_18_1","first-page":"603","article-title":"Degenerative meniscus in knee osteoarthritis: from pathology to treatment","volume":"12","author":"Ozeki N","year":"2022","journal-title":"Life 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