{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:40:36Z","timestamp":1792194036436,"version":"4.4.0"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"13","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study aimed to evaluate the progression of medial meniscus (MM) extrusion (MME) volume (MMEV) at knee joint extension\/flexion up to 3 years after pullout repair of MM posterior root tears (MMPRT) and to assess its relationship with clinical outcomes. A retrospective analysis was conducted in 15 patients who underwent pullout repair of unilateral MMPRT and open magnetic resonance imaging (MRI) examination preoperatively and at 1 and 3 years postoperatively. An open MRI was performed at knee joint extension and flexion. MME and MMEV at knee joint extension, MM posterior extrusion (MMPE), and MMEV at knee joint flexion were evaluated. Clinical scores were recorded preoperatively and at 1 and 3 years postoperatively. The correlations between changes in MME, MMPE, and MMEV from the preoperative period to 3 years postoperatively (\u0394MMEV) and clinical scores from the preoperative period to 3 years postoperatively were evaluated. MME and MMEV at knee joint extension increased significantly from preoperatively to 1 year (p\u2009=\u20090.001 and p\u2009=\u20090.016) and to 3 years (p\u2009&lt;\u20090.001 and p\u2009=\u20090.010), with no significant change from 1 to 3 years (p\u2009=\u20090.319 and p\u2009=\u20090.840). MMPE at knee joint flexion decreased significantly from preoperatively to 1 year (p\u2009=\u20090.007) and to 3 years (p\u2009=\u20090.002), whereas no difference was observed from 1 to 3 years (p\u2009=\u20090.672). MMEV at knee joint flexion showed no significant longitudinal changes (all p\u2009&gt;\u20090.644). After false discovery rate (FDR) adjustment, all clinical outcomes, except the pain visual analog scale, demonstrated significant time effects. No significant correlation was observed between \u0394MME, \u0394MMPE, and \u0394MMEV at knee joint extension and clinical outcomes before\/after FDR adjustment. Although moderate correlations between \u0394MMEV at knee joint flexion and clinical outcomes were observed before adjustment, none remained significant after FDR correction. Three years after transtibial pullout repair for MMPRT, MMPE at knee joint flexion significantly improved, maintaining MMEV at knee joint flexion without deterioration. \u0394MMEV at knee joint flexion may correlate with clinical score improvement; however, further research is required.<\/jats:p>","DOI":"10.1055\/a-2824-8786","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:04:21Z","timestamp":1773792261000},"page":"711-721","source":"Crossref","is-referenced-by-count":0,"title":["Medial Meniscus Extrusion Volume in the Knee Flexion Position Does Not Worsen after Transtibial Pullout Repair for Medial Meniscus Posterior Root Tears: A 3-year Follow-up"],"prefix":"10.1055","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8209-1927","authenticated-orcid":false,"given":"Koki","family":"Kawada","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6591-5100","authenticated-orcid":false,"given":"Yuki","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1761-2287","authenticated-orcid":false,"given":"Masanori","family":"Tamura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshifumi","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5094-813X","authenticated-orcid":false,"given":"Takayuki","family":"Furumatsu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan"},{"name":"Department of Orthopaedic Surgery, Japanese Red Cross Okayama Hospital, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"issue":"10","key":"ref1","doi-asserted-by":"crossref","first-page":"4492","DOI":"10.1007\/s00167-023-07444-6","article-title":"Subchondral insufficiency fracture is a predictive factor of osteoarthritis progression and conversion to arthroplasty in non-surgically treated medial meniscus root tear","volume":"31","author":"B S Choi","year":"2023","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"10","key":"ref2","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1177\/03635465231185132","article-title":"Nonoperative management of degenerative medial meniscus posterior root tears: Poor outcomes at a minimum 10-year follow-up","volume":"51","author":"A J Krych","year":"2023","journal-title":"Am J Sports Med"},{"issue":"11","key":"ref3","doi-asserted-by":"crossref","first-page":"2959","DOI":"10.1002\/ksa.12321","article-title":"Clinical outcomes following transtibial medial meniscal root repair are maintained at long-term follow-up","volume":"32","author":"M Moore","year":"2024","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"2021","DOI":"10.1007\/s00590-024-03889-8","article-title":"Longitudinal changes in medial meniscus extrusion and clinical outcomes following pullout repair for medial meniscus posterior root tears: A 3-year evaluation","volume":"34","author":"K Kawada","year":"2024","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"e70262","DOI":"10.1002\/jeo2.70262","article-title":"Clinical outcomes following medial meniscus posterior root repairs: A minimum of 5-year follow-up study","volume":"12","author":"Y Okazaki","year":"2025","journal-title":"J Exp Orthop"},{"issue":"12","key":"ref6","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.1016\/j.arthro.2010.05.004","article-title":"Magnetic resonance imaging evidence of meniscal extrusion in medial meniscus posterior root tear","volume":"26","author":"C J Choi","year":"2010","journal-title":"Arthroscopy"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s00402-022-04347-y","article-title":"Etiology of posterior meniscus root tears: Medial vs. lateral","volume":"143","author":"K Karpinski","year":"2023","journal-title":"Arch Orthop Trauma Surg"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1007\/s00402-023-05068-6","article-title":"Ultrasonographic diagnosis of medial meniscus posterior root tear in early knee osteoarthritis: A comparative study","volume":"144","author":"K Shimozaki","year":"2024","journal-title":"Arch Orthop Trauma Surg"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1186\/s12891-023-06807-x","article-title":"Extrusion of the medial meniscus under a weight-loading condition in early knee osteoarthritis: An investigation using special upright magnetic resonance imaging","volume":"24","author":"K Shimozaki","year":"2023","journal-title":"BMC Musculoskelet Disord"},{"issue":"10","key":"ref10","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.1007\/s43465-023-00987-3","article-title":"Time-dependent increase in medial meniscus extrusion predicts the need for meniscal repair in patients with partial medial meniscus posterior root tears: A case-control study","volume":"57","author":"K Kawada","year":"2023","journal-title":"Indian J Orthop"},{"issue":"09","key":"ref11","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1002\/ksa.12245","article-title":"Meniscal healing status after medial meniscus posterior root repair negatively correlates with a 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Arthrosc"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1177\/036354659101900302","article-title":"Tibial meniscal dynamics using three-dimensional reconstruction of magnetic resonance images","volume":"19","author":"W O Thompson","year":"1991","journal-title":"Am J Sports Med"},{"issue":"11","key":"ref15","doi-asserted-by":"crossref","first-page":"3405","DOI":"10.1007\/s00167-019-05580-6","article-title":"Medial meniscus posterior root tear causes swelling of the medial meniscus and expansion of the extruded meniscus: a comparative analysis between 2D and 3D MRI","volume":"28","author":"Y Okazaki","year":"2020","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"04","key":"ref16","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.otsr.2018.02.012","article-title":"Medial meniscus posterior root tear induces pathological posterior extrusion of the meniscus in the knee-flexed position: An open magnetic resonance imaging analysis","volume":"104","author":"S Masuda","year":"2018","journal-title":"Orthop Traumatol Surg Res"},{"issue":"11","key":"ref17","doi-asserted-by":"crossref","first-page":"3435","DOI":"10.1007\/s00167-020-05953-2","article-title":"Medial meniscus posterior root repair restores the intra-articular volume of the medial meniscus by decreasing posteromedial extrusion at knee flexion","volume":"28","author":"Y Okazaki","year":"2020","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"05","key":"ref18","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/j.otsr.2020.02.020","article-title":"Volumetric assessment of extrusion in medial meniscus posterior root tears through semi-automatic segmentation on 3-Tesla magnetic resonance images","volume":"106","author":"C Kim","year":"2020","journal-title":"Orthop Traumatol Surg Res"},{"issue":"10","key":"ref19","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1007\/s00264-022-05660-2","article-title":"Concomitant posterior anchoring further reduces posterior meniscal extrusion during pullout repair of medial meniscus posterior root tears: A retrospective study","volume":"47","author":"H Xue","year":"2023","journal-title":"Int Orthop"},{"issue":"05","key":"ref20","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1002\/mrm.22380","article-title":"A three-dimensional quantitative method to measure meniscus shape, position, and signal intensity using MR images: A pilot study and preliminary results in knee osteoarthritis","volume":"63","author":"W Wirth","year":"2010","journal-title":"Magn Reson Med"},{"issue":"11","key":"ref21","doi-asserted-by":"crossref","first-page":"2692","DOI":"10.1177\/0363546520940715","article-title":"Early surgical repair of medial meniscus posterior root tear minimizes the progression of meniscal extrusion: 2-year follow-up of clinical and radiographic parameters after arthroscopic transtibial pull-out repair","volume":"48","author":"H S Moon","year":"2020","journal-title":"Am J Sports Med"},{"issue":"09","key":"ref22","doi-asserted-by":"crossref","first-page":"3775","DOI":"10.1007\/s00167-023-07330-1","article-title":"Younger patients, lower BMI, complete meniscus root healing, lower HKA degree and shorter preoperative symptom duration were the independent risk factors correlated with the good correction of MME in patients with repaired MMPRTs","volume":"31","author":"S Nie","year":"2023","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"12","key":"ref23","doi-asserted-by":"crossref","first-page":"4205","DOI":"10.1007\/s00167-021-06505-y","article-title":"Medial meniscus posterior root repair reduces the extruded meniscus volume during knee flexion with favorable clinical outcome","volume":"29","author":"X Zhang","year":"2021","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"04","key":"ref24","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1007\/s00167-020-06070-w","article-title":"Placement of an anatomic tibial tunnel significantly improves the medial meniscus posterior extrusion at 90\u00b0 of knee flexion following medial meniscus posterior root pullout repair","volume":"29","author":"Y Kamatsuki","year":"2021","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"04","key":"ref25","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1177\/03635465231157758","article-title":"A systematic review of adverse events and complications after isolated posterior medial meniscus root repairs","volume":"52","author":"G R Jackson","year":"2024","journal-title":"Am J Sports Med"},{"issue":"07","key":"ref26","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1177\/03635465211017514","article-title":"Comparison of long-term radiographic outcomes and rate and time for conversion to total knee arthroplasty between repair and meniscectomy for medial meniscus posterior root tears: A systematic review and meta-analysis","volume":"50","author":"L M Krivicich","year":"2022","journal-title":"Am J Sports Med"},{"issue":"04","key":"ref28","doi-asserted-by":"crossref","first-page":"e70057","DOI":"10.1002\/jeo2.70057","article-title":"Quadriceps muscle strength of the affected limb in medial meniscus posterior root tears is negatively correlated with the progression of postoperative medial joint space narrowing","volume":"11","author":"K Kawada","year":"2024","journal-title":"J Exp Orthop"},{"issue":"08","key":"ref29","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1002\/ksa.12229","article-title":"Accurate tibial tunnel position in transtibial pullout repair for medial meniscus posterior root tears delays the progression of medial joint space narrowing","volume":"32","author":"K Kawada","year":"2024","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"01","key":"ref30","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1002\/ksa.12037","article-title":"Weight loss enhances meniscal healing following transtibial pullout repair for medial meniscus posterior root tears","volume":"32","author":"T Hiranaka","year":"2024","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"08","key":"ref31","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1007\/s43465-022-00650-3","article-title":"Prognostic factors and midterm clinical outcome of transtibial pullout and partial meniscectomy for medial meniscus posterior root tears in middle-aged patients","volume":"56","author":"L Dzidzishvili","year":"2022","journal-title":"Indian J Orthop"}],"container-title":["The Journal of Knee Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2824-8786.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:44:23Z","timestamp":1792190663000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2824-8786"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":30,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2026,10,16]]},"published-print":{"date-parts":[[2026,11]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2824-8786","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1538-8506","1938-2480"],"issn-type":[{"value":"1538-8506","type":"print"},{"value":"1938-2480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]}}}