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The percutaneous pie-crusting medial release during arthroscopic procedures of the medial meniscus does neither affect valgus laxity nor clinical outcome

  • Jeon, Sang-Woo1, 2
  • Jung, Min1, 2
  • Chun, Yong-Min1, 2
  • Lee, Su-Keon3
  • Jung, Woo Seok1
  • Choi, Chong Hyuk1, 2
  • Kim, Sung-Jae4
  • Kim, Sung-Hwan1, 2, 5
  • 1 Yonsei University College of Medicine, Department of Orthopedic Surgery, Seoul, Republic of Korea , Seoul (South Korea)
  • 2 Yonsei University Health System, Department of Arthroscopy, Joint Research Institute, Seoul, Republic of Korea , Seoul (South Korea)
  • 3 Gwangmyeong Sungae Hospital, Department of Orthopaedic Surgery, Gyeonggi-do, Republic of Korea , Gyeonggi-do (South Korea)
  • 4 Yonsesarang Hospital, Department of Orthopedic Surgery, Seoul, Republic of Korea , Seoul (South Korea)
  • 5 Gangnam Severance Hospital, Department of Orthopedic Surgery, 211 Eonju-ro, Gangnam-gu, Seoul, 06237, Republic of Korea , Seoul (South Korea)
Published Article
Knee Surgery Sports Traumatology Arthroscopy
Publication Date
Dec 28, 2017
DOI: 10.1007/s00167-017-4827-9
Springer Nature


PurposeTo analyze the effect of percutaneous pie-crusting medial release on valgus laxity before and after surgery and on clinical outcomes.MethodsEight-hundred fourteen consecutive patients who underwent an arthroscopic procedure for the medial compartment of the knee were evaluated retrospectively. Sex, age, type of operation (meniscectomy, meniscal repair, and posterior root repair), type of accompanying surgery (none, cartilage procedure, ligament procedure and osteotomy) were documented. Sixty-four patients who underwent percutaneous pie-crusting medial release (release group) and 64 who did not undergo medial release (non-release group) were matched using the propensity score method. Each patient was evaluated for the following variables: degree of valgus laxity on stress radiographs, Lysholm knee score, visual analog scale score, and International Knee Documentation Committee knee score and grade.ResultsAt the 24-month follow-up, no significant increase in side-to-side differences in the valgus gap was observed in comparison to the preoperative value in the release group [preoperative, − 0.1 ± 1.3 mm; follow-up, − 0.1 ± 1.4 mm; (n.s.)]. The follow-up Lysholm score, visual analog scale score and International Knee Documentation Committee knee score and grade were similar between the two groups.ConclusionsPercutaneous pie-crusting medial release is an additional procedure that can be performed during arthroscopic surgery for patients with a narrow medial joint space of the knee. Percutaneous pie-crusting medial release reduces iatrogenic injury to the cartilage and does not produce any residual valgus laxity of the knee.Level of evidenceIV.

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