Short Term Clinical Outcome After Medial Meniscus Posterior Root Tear Repair


Ingebjørg L. Strand MD, Steinar Johansen MD, Christian Owesen MD PhD

Lovisenberg Diaconal Hospital, Oslo, Norway

Introduction

Medial meniscus root tear (MMRT) can be compared to total meniscectomy biomechanically. A meniscectomised knee, has an increased risk of developing ostearthritis (OA). In the treatment of MMRT, expectance or meniscectomy have shown poor clinical results, and often rapid progression of OA. There are promising results of the repair of MMRT with pull-out technique. Other authors have published an improvement in clinical scores and less progression of OA. Information regarding early clinical outcome is scarce.

Methods

Since June 2018, patients who underwent surgical treatment for MMRT with transtibial pull-out repair, have been evaluated with Tegner, Lysholm and Cincinnati Knee Score preoperatively, after 3, 6 and 12 months.

Results

23 knees (20 women/3 men) with MMRT underwent transtibial pull-out repair from June 2018 to January 2021. Patients with preoperative Kellgren-Lawrence 3 and 4 were excluded. Median age and BMI were 55 years (range 44-72) and 29,4 (range 20,3-42) respectively. Mean Tegner was 2,4 preoperatively, 2,4 at 3 months and 3,7 at 12 months. Mean Lysholm was 49,7 (SD±17,4) preoperatively and increased significantly after 3 months to 77,3 (SD±14,3) (p<0,001) and 85,1 (SD±13,3) at 1 year (p=0,001). Mean Cincinnati Knee Score was 42,2 (SD±18,7) preoperatively, and had also a significant improvement to 67 (SD±10,0) at 3 months (p<0,001) and 82,1 (SD±14,2) after 1 year (p<0,001). We had no complications.

Conclusion

Surgical treatment of symptomatic MMRT with transtibial pull-out technique, improves knee function and reduces pain significantly already after 3 months. This significant improvement in Tegner, Lysholm and Cincinnati Knee Score, continues during the first year.

Clinical Relevance: MMRT repair has good clinical outcomes and few complications at short term follow-up.