2025 ISAKOS Congress in Munich, Germany

2025 ISAKOS Biennial Congress Paper


Age and Postoperative Meniscal Extrusion as Predictors of Patient-perceived Substantial Clinical Improvement 5 Years after Medial Meniscus Root Repair

Hyun-Soo Moon, MD, PhD, Seoul KOREA, REPUBLIC OF
Min Jung, MD, PhD, Seoul KOREA, REPUBLIC OF
Se-Han Jung, MD, Seoul KOREA, REPUBLIC OF
Junwoo Byun, MD, Seoul KOREA, REPUBLIC OF
Sung Chul Shin, MD, Seoul KOREA, REPUBLIC OF
Sung-Hwan Kim, MD, PhD, Seoul KOREA, REPUBLIC OF

Severance Hospital, Yonsei University College of Medicine, Seoul, KOREA, REPUBLIC OF

FDA Status Not Applicable

Summary

The number of patients who perceived substantial clinical improvement 5 years after surgical repair for MMRT was relatively few, especially among those who were older than 56 years or had increased MME of 4.5mm at 1 year postoperatively.

Abstract

Purpose

This study aimed to analyze the factors influencing the achievement of mid-term substantial clinical improvement as perceived by patients after surgical repair for medial meniscus root tears (MMRT).

Methods

The medical records of patients who underwent arthroscopic pull-out repair for MMRT from 2010 to 2018 were retrospectively reviewed, and those with a follow-up period of over 5 years were included. Patients were then classified into 2 groups based on the achievement of substantial clinical improvement at 5 years postoperatively compared to preoperative status: group 1 (improvement beyond respective substantial clinical benefit [SCB] values in both IKDC subjective and Lysholm scores) and group 2 (did not achieve improvement in either score). To identify factors affecting outcomes, comparative analyses of demographic, intra-operative, radiological, and clinical data were conducted, followed by regression analysis.

Results

Sixty-four patients were included (group 1: 22; group 2: 42). Patients in group 2 were significantly older than those in group 1 (P = 0.004). Radiologically, group 2 had higher postoperative medial meniscus extrusion (MME) at 1 year after surgery and ΔMME (P = 0.012 and P = 0.047, respectively). Group 2 also exhibited higher Kellgren-Lawrence grades and their progression than group 1 at 5 years postoperatively (P = 0.003 and P = 0.015, respectively). Subsequent regression analysis identified age and postoperative MME as independent factors influencing the achievement of mid-term clinical improvement after surgical repair of MMRT (P = 0.011 and P = 0.027, respectively). Cut-off points were 56 years for age and 4.5mm for postoperative MME.

Conclusion

The number of patients who perceived substantial clinical improvement 5 years after surgical repair for MMRT was relatively few. Notably, patients who were older or had increased MME at 1 year postoperatively, with cut-off values of age 56 years and MME of 4.5mm, may not achieve patient-perceived substantial clinical improvement at mid-term.