Purpose
To compare radiologic and clinical outcomes between patients who underwent medial
meniscus posterior root tear (MMPRT) repair and were subsequently classified as having
lax healing based on second-look arthroscopy and patients who underwent subtotal meniscectomy
for an MMPRT.
Methods
The patients who received pullout repair or subtotal meniscectomy due to MMPRT between
January 2011 and December 2014 were retrospectively reviewed. Among the patients who
underwent MMPRT repair, those whose lax healing of the repair site was confirmed by
second-look arthroscopy (repair/lax healing group) and among the patients who received
subtotal meniscectomy, those who have varus deformity of <5° and a Kellgren–Lawrence
grade of ≤2 (meniscectomy group) were included in the study population. Medial joint
space width, Kellgren–Lawrence grade, International Knee Documentation Committee Subjective
Knee Evaluation Form score, and Lysholm Knee score were used for radiologic and clinical
assessment.
Results
The meniscectomy group included 24 patients (average follow-up, 37.2 months), and
the repair/lax healing group included 21 patients (average follow-up, 39.2 months).
The 2 groups showed improved patient-reported outcomes postoperatively (P < .001). However, medial joint space width (P < .001) became narrow and Kellgren–Lawrence grade (P = .002 and P = .005, respectively) worsened. Comparison of the radiologic outcomes between the
2 groups revealed that the repair/lax healing group had less Kellgren–Lawrence grade
progression than the meniscectomy group (P = .014). The grade progressed by ≥2 grades in 4 patients (16.7%) and 0 patients in
the meniscectomy and repair/lax healing groups, respectively (P < .001).
Conclusions
Although the repair/lax healing group showed improved functional outcomes on short-term
follow-up, arthritic change progressed radiologically. Nevertheless, the repair/lax
healing group showed better radiologic outcomes than the meniscectomy group, despite
lax healing of the repair site. However, because of the small number of cases in this
study, the results of this study could be associated with potential for type II or
β errors.
Level of Evidence
Level III, retrospective comparative study.
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Article info
Publication history
Published online: October 16, 2019
Accepted:
May 23,
2019
Received:
January 11,
2019
Footnotes
The authors report the following potential conflicts of interest or sources of funding: This work was supported by a grant from Inje University in research year 2014 (No. 20140528). Full ICMJE author disclosure forms are available for this article online, as supplementary material.
See commentary on page 3087
Identification
Copyright
© 2019 Published by Elsevier on behalf of the Arthroscopy Association of North America
ScienceDirect
Access this article on ScienceDirectLinked Article
- Editorial Commentary: Failure With Continuity: Redefining Healing With Meniscal Root RepairArthroscopyVol. 35Issue 11
- PreviewThe importance of the medial meniscus posterior root for preserving knee joint kinematics, joint contact pressures, and articular cartilage integrity is well recognized. Medial meniscus root repair generally is associated with favorable clinical outcomes and radiographic changes compared with conservative treatment or subtotal meniscectomy; however, second-look arthroscopy often reveals some laxity at the repair site. Even in this latter situation of “failure with continuity” of the meniscus root repair, there may be benefit in delaying progression of radiographic degeneration changes.
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