Summary

Medial meniscus posterior root repair with transtibial tunnel has 77.6% good results with a mean follow-up of around four years.

Abstract

Introduction

The purpose of this study is to evaluate the risk factors for failure of medial meniscus posterior root repair, including the patient's preoperative factors, factors related to surgery and rehabilitation.

Methods

Patients of any age submitted to reinsertion of the medial meniscus posterior root through a transtibial tunnel with at least 24 months of follow-up and operated from January 2015 to April 2022 were evaluated. The following parameters were collected: age, sex, BMI, time from injury to surgery, follow-up time, previous knee surgery, procedure associated with root repair, Kellgren-Lawrance scale, Outerbridge classification, number and type of sutures used, type of fixation, number of tunnels used, patient's compliance with rehabilitation, and postoperative scales of subjective International Knee Documentation Committee (IKDC) and Lysholm functional scale, Forgotten Joint Score (FJS) and Global Perceived Effect (GPE) and meniscus root repair failure.

Results

One hundred and twenty-five patients were evaluated. Twenty-eight (22.4%) were considered failures. Patients who were considered repair failure presented a higher proportion of female patients (p = 0.0004), higher BMI (p = 0.0009), a greater number of associated procedures at the time of root repair (0.02) and a greater number of femoral chondral injuries (0.0005). Patients with repair failure were submitted to surgery repair with more sutures (p = 0.02) and they also had worse compliance with rehabilitation (p = 0.0001). Patients with repair failure also showed worse results on all functional scales evaluated, including IKDC (p = 0.0001), Lysholm (p < 0.00001), FJS (p < 0.00001), and GPE (p < 0.00001).

Conclusion

Medial meniscus posterior root repair with transtibial tunnel has 77.6% good results with a mean follow-up of around four years. Female sex, high BMI, osteotomies or cartilage procedures concomitant with root repair, more pronounced femoral chondral injury, repair with three sutures instead of two, and poor patient compliance with rehabilitation were factors related to repair failure.