Summary: This study assesses the implications of demographic variables and coronal plane alignment on outcomes of meniscal root repair and provides additional guidelines to the literature to appropriately identify proper surgical candidates.

Objectives: Meniscal root tears, defined as a radial tear occurring within 1 cm of meniscal attachment or an avulsion of the meniscus attachment site to bone, comprise up to 20% of meniscal injuries. Previous studies have identified patient demographics such as Body Mass Index (BMI), age, sex and lower extremity coronal plane alignment as important factors that can impact clinical outcomes after meniscal root repairs. However, there is no standardized set of guidelines to identify proper surgical candidates for meniscal root repair based on coronal plane alignment. The purpose of this study was to evaluate the impact of coronal plane alignment on outcomes of root repair. We hypothesized that patients with lateral root repairs performed in a valgus knee or medial root repairs performed in a varus knee (“at-risk” group) would report worse patient-reported outcomes.

Methods

Patient demographic and surgical data were retrieved from chart review of all meniscus repairs performed at an academic center between 2006 and 2018. Patients between 18 and 65 years old with adequate full length weight bearing radiographs for measuring the mechanical axis were included. Patients were contacted to complete patient-reported outcome measures (PROM): Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee subjective score (IKDC). Patients with varus alignment (> 3 degrees) and a medial root repair, or valgus alignment (>3 degrees) and a lateral root repair were considered “at-risk”. PROMs were compared between at-risk groups versus patients within 3 degrees of neutral mechanical axis. Independent t-tests for continuous variables and chi-squared test for categorical variables were utilized to analyze relationships among body mass index subgroups, level of malalignment, PROMs, and complications.

Results

A total of 62 patients who underwent transtibial meniscus root repair were identified. Twenty patients met inclusion criteria, of which 9 patients (45%) were considered “at-risk” with varus-aligned knees with medial root tears. Patients at-risk of failure had a greater absolute mean mechanical axis (-6.8 degrees) when compared to patients not at-risk of failure (-0.091 degrees) (p< 0.001). Additionally, patients at-risk of failure had a shorter length of mean follow-up time (13.0 months) when compared to patients not at-risk of failure (15.3 months) (p=0.005). No significant differences were noted between the groups in patient age, sex, BMI, or PROMs (Table 1).

Conclusion

This study assesses the implications of demographic variables and coronal plane alignment on outcomes of meniscal root repair and provides additional guidelines to the literature to appropriately identify proper surgical candidates. Although more studies are needed to confirm these findings, this study demonstrates no associated differences in outcome of root repair based on coronal plane alignment.

Outcomes of Arthroscopic All-Inside Repair are Improved Compared to Transtibial Pull-Out Repair of Medial Meniscus Posterior Root Tears ePoster Presentation Kyoung Ho Yoon, MD, PhD, Prof., KOREA, REPUBLIC OF Jae-Young Park, MD, KOREA, REPUBLIC OF Cheol Hee Park, MD, PhD, KOREA, REPUBLIC OF Sang-Gyun Kim, MD, PhD, KOREA, REPUBLIC OF Yoon-Seok Kim, MD, KOREA, REPUBLIC OF Hee Sung Lee, MD, KOREA, REPUBLIC OF Sung Hyun Hwang, MD, KOREA, REPUBLIC OF Dae Keun Suh, MD, PhD, KOREA, REPUBLIC OF Bo Seung Bae, MD, KOREA, REPUBLIC OF
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Delaying ACL Reconstruction Increases the Risk of Medial Meniscal Tear ePoster Presentation Julien Erard, MD, FRANCE Nicolas Cance, MD, FRANCE Jobe Shatrov, MD, AUSTRALIA Gaspard Fournier, MD, FRANCE Stanislas Gunst, MD, FRANCE Gianluca Ciolli, MD, ITALY Pasquale Porcelli, MD, ITALY Sebastien Lustig, MD, PhD, Prof., FRANCE Elvire Servien, MD, PhD, Prof., FRANCE
Comparing the Risk of Iatrogenic Peroneal Nerve Injury in All-inside Lateral Meniscus Repair between Preoperative and Real Arthroscopic Position MRIs ePoster Presentation Chaiwat Chuaychoosakoon, MD, THAILAND Wachiraphan Parinyakhup, MD, THAILAND Tanarat Boonriong, Principal, THAILAND
Etiology of Posterior Meniscus Root Tears: Medial vs. Lateral ePoster Presentation Katrin Karpinski, MD, GERMANY Philipp Forkel, MD, GERMANY Martin Häner, MD, GERMANY Wolf Petersen, MD, Prof, GERMANY
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Risk Factors Affecting the Survival Rate of Collagen Meniscus Implant (CMI) For Partial Meniscus Deficiency. An Analysis Of 156 Consecutive Cases at A Mean 10 Years of Follow-Up ePoster Presentation Gian Andrea Lucidi, MD, ITALY Alberto Grassi, PhD, ITALY Piero Agostinone, MD, QATAR Stefano Di Paolo, Eng, PhD, ITALY Giacomo Dal Fabbro, MD, AUSTRALIA Nicola Pizza, MD, ITALY Stefano Zaffagnini, MD, Prof., ITALY
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Good Clinical Results And Patient Satisfaction After Arthroscopic Repair of Large Meniscus Bucket Handle Tears of the Knee ePoster Presentation Johannes Pawelczyk, cand. med., GERMANY Rainer Siebold, Prof. Dr. med., GERMANY
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Determinants of Radiologic and Functional Outcomes after Meniscal Repair of Longitudinal Vertical Tears. A Prospective Cohort Study of 78 patients. ePoster Presentation Benjamin Tschopp, MD, SWITZERLAND Robin Martin, MD, SWITZERLAND
Less Than 10% Failure Rate in Patients with Bucket-Handle Meniscal Tear Repair After 4 Years Follow-Up ePoster Presentation Tomas Alfredo Esteves, MD, ARGENTINA Ignacio Astore, MD, ARGENTINA Carlos H. Yacuzzi, MD, ARGENTINA Matias Costa-Paz, MD, PhD, ARGENTINA Juan Pablo Zicaro, MD, ARGENTINA
Biomechanics Comparison Between Transtibial Pullout, Suture Anchor And All-Suture Anchor Technique For Posterior Medial Meniscal Repair ePoster Presentation Nadhaporn Saengpetch, MD, THAILAND Napat Prasitmeeboon, MD, THAILAND Tanapol Janyawongchot, MD, THAILAND Sorawut Thamyongkit , MD, THAILAND
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Bone Bridge Technique For Lateral Meniscal Allograft Transplantation – No Difference In Clinical Outcome Compared To The Soft Tissue Technique ePoster Presentation Rahul Bhattacharyya, MBCHB (Hons), MD (Res), FRCS (Orth), MSc, MRCS, UNITED KINGDOM Harry Krishnan, FRCS(Tr&Orth),MEd(ULT), MBBS, BSc (Hons), UNITED KINGDOM Nicole Bausch, MSc physiotherapy and education, UNITED KINGDOM Adam Richard Pilarski, MBBS, MRCS, MBA, BA (hons), UNITED KINGDOM Niall McGoldrick, MB MCh FRCS (Tr & Orth), IRELAND Peter Thompson, MBChB, UNITED KINGDOM Andrew Metcalfe, PhD, UNITED KINGDOM Tim Spalding, FRCS(Orth), UNITED KINGDOM
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Posterior Cruciate Buckling Angle Variations are Associated With Different Patterns of Medial Meniscus Tears in Anterior Cruciate Deficient Knees: Results of a Prospective Comparative Magnetic Imaging Resonance Study ePoster Presentation Simone Cerciello , DR, ITALY Gianluca Ciolli, MD, ITALY Dario Candura, ITALY Michele Mercurio, Prof., MD, ITALY Fabrizio Mocini, MD, ITALY Lorenzo Proietti, MD, ITALY
Continuous Vertical Inside-Out Versus Traditional Vertical Inside-Out Meniscal Repair: A Biomechanical Comparison ePoster Presentation José Leonardo Rocha De Faria , MD, MSc, BRAZIL Arthur Paiva Grimaldi Santos, M.Sc., BRAZIL Douglas Mello Pavão, MD, MSc, PhD, BRAZIL Mariana Radulski, Medical Student, BRAZIL Ana Carolina Leal, PhD, BRAZIL Ari Digiácomo Ocampo Moré, PhD, BRAZIL Alan de Paula Mozella, PhD, Prof., BRAZIL Joao ANTONIO MATHEUS GUIMARAES, BRAZIL Robert F. LaPrade, MD, PhD, UNITED STATES Carlos Rodrigo De Mello Roesler, PhD, BRAZIL Rodrigo Salim, MD,PhD, BRAZIL
Meniscus Transplants Delay Arthroplasty in Patients Over 50 Years of Age ePoster Presentation Kevin R. Stone, MD, UNITED STATES Ann W. Walgenbach, RN, NP, MSN, UNITED STATES Shadera Slatter, MS, UNITED STATES Thomas J. Turek, PhD, UNITED STATES Caroline Ferguson-Dryden, BA, UNITED STATES Marie Dicker, BASc, UNITED STATES Emma Miltenberger, BS, UNITED STATES Riley Horn, BS, UNITED STATES Haley Cowles, BA, UNITED STATES Vivian Liu, BA, UNITED STATES Stephanie Wu, BS, UNITED STATES Mani Vessal, MA, PhD, UNITED STATES
Medial Meniscus Repair only Partially Restores In-Vivo Knee Kinematics after ACL Reconstruction ePoster Presentation Alberto Grassi, PhD, ITALY Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, ITALY Gian Andrea Lucidi, MD, ITALY Erika Pinelli, MsC, ITALY Gregorio Marchiori, MD, ITALY Marco Bontempi, PhD, ITALY Laura Bragonzoni, Prof., ITALY Stefano Zaffagnini, MD, Prof., ITALY
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Biomechanical Effect of Unstable Meniscal Injury on Gait in ACL-Deficient and -Reconstructed Knees ePoster Presentation Kengo Harato, MD, PhD, JAPAN Kohei Nishizawa, PhD, JAPAN Shu Kobayashi, MD, PhD, JAPAN Yasuo Niki, MD, PhD, JAPAN Takeo Nagura, MD, JAPAN
Lateral Meniscus Root Tear in ACL-Injured Patients Results In High-Grade Rotatory Knee Laxity: A Quantitative Pivot Shift Analysis ePoster Presentation Bálint Zsidai, MD, SWEDEN Gian Andrea Lucidi, MD, ITALY Ryosuke Kuroda, MD, PhD, JAPAN James J. Irrgang, PT, PhD, FAPTA, UNITED STATES Kristian Samuelsson, Prof, MD, PhD, MSc, SWEDEN Stefano Zaffagnini, MD, Prof., ITALY Volker Musahl, MD, Prof., UNITED STATES
Good Clinical Results After Combined Arthroscopic Meniscal Allograft Transplantation and Autologous Chondrocyte Implantation Using Chondrospheres ePoster Presentation Rainer Siebold, Prof. Dr. med., GERMANY Johannes Pawelczyk, cand. med., GERMANY
The High Prevalence of Spin Reporting Bias in Meniscal Allograft Transplant Abstracts: A Qualitative Assessment Of Systematic Reviews and Meta-Analyses ePoster Presentation Matthew T Gulbrandsen, MD, UNITED STATES Mustafa Hashimi, BS, UNITED STATES Taha Taka, BS, UNITED STATES Trevor Gulbrandsen, MD, UNITED STATES Anthony Essilfie, MD, UNITED STATES Anikar Chhabra, MD, MS, UNITED STATES Seth L. Sherman, MD, UNITED STATES
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Concomitant Medial Meniscal Ramp Lesions and Lateral Meniscal Tears with Anterior Cruciate Ligament Injuries are Associated with Anterior Tibial Subluxation in Knee Extension ePoster Presentation Hibiki Kakiage, MD, JAPAN Kazuhisa Hatayama, MD, PhD, JAPAN Satoshi Nonaka, MD, JAPAN Masanori Terauchi, MD, JAPAN Atsufumi Oshima, MD, JAPAN HIrotaka Chikuda, MD, PhD, JAPAN
Large Posterolateral Cartilage Slope Is a Risk Factor for Noncontact ACL Injury ePoster Presentation Kensuke Hotta, MD, JAPAN Mitsuru Hanada, MD, PhD, JAPAN Kazuki Nomoto, MD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Evolution in the Indication of Surgical Treatment on Repairable Meniscal Tears and Their Treatment in the Last 20 Years ePoster Presentation Alejandro Espejo-Reina, MD, MSc, SPAIN Enrique Sevillano-Perez, MD, SPAIN María Josea Espejo-Reina, MD, SPAIN Maximiano Lombardo-Torre, SPAIN Miguel Verdejo-Parrilla, MD, MSc, SPAIN Alejandro Espejo-Baena, MD, SPAIN
Biological Augmentation May Play A Role In Obtaining Superior Clinical Outcomes In Meniscal Root Repair With Concomitant Anterior Cruciate Ligament Reconstruction ePoster Presentation Lika Dzidzishvili, MD, PhD, SPAIN Irene Isabel López-Torres, MD, PhD, SPAIN David Sáez, MD, SPAIN Antonio Hernández Diez, MD, SPAIN Emilio Calvo, MD, PhD, MBA, SPAIN
Clinical Outcomes After the Repair of Isolated Full Radial Tear at Midbody of Lateral Meniscus - All-Inside Suture Repair vs Trans-Capsular Suture Repair - ePoster Presentation Ryohei Uchida, MD, PhD, JAPAN Shuji Horibe, MD, PhD, JAPAN Yoshinari Tanaka, MD, PhD, JAPAN Kazutaka Kinugasa, MD, PhD, JAPAN Yuta Tachibana, M.D., Ph.D., JAPAN Akira Tsujii, MD, PhD, JAPAN Konsei Shino, MD, PhD, JAPAN
Comparison Of Resultant Force Through The Repaired Lateral Meniscus With Between Inside-Out And All-Inside-Suture Techniques ePoster Presentation Takehito Hirose, MD, PhD, JAPAN Tatsuo Mae, MD, PhD, JAPAN Satoshi Yamakawa, PhD, JAPAN Issei Ogasawara, PhD, JAPAN Shoji Konda, PhD, JAPAN Yasuhiro Take, MD, PhD, JAPAN Ken Nakata, MD, PhD, JAPAN
Mid-Term Clinical And Radiological Outcomes of Lateral Meniscal Allograft Transplantation With Suture-Only Fixation Plus Capsulodesis ePoster Presentation Àngel Masferrer-Pino, MD PhD, SPAIN Rodolfo Morales-Avalos, MD, PhD., MEXICO Maximiliano Ibañez, MD, SPAIN Simone Perelli, MD,PhD, SPAIN Pablo E. Gelber, MD, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Cross-Sectional Effects of Isolated Meniscal Tears on In Vivo Biomechanics of the Knee: A Systematic Review Of Motion Analysis Studies ePoster Presentation Enzo Salviato Mameri, MD, MSc, BRAZIL Garrett Jackson, MD, UNITED STATES Harkirat Jawanda, BS, UNITED STATES Jonathan A Gustafson, PhD, UNITED STATES Leonardo Metsavaht, MD PhD, BRAZIL Jorge Chahla, MD, PhD, UNITED STATES
Non-Extruded Grafts Result in Better Cartilage Quality after Lateral Meniscal Allograft Transplantation: Quantitative 3-T MRI T2 Mapping ePoster Presentation Seong-Il Bin, MD, PhD, KOREA, REPUBLIC OF Jong-Min Kim, MD, PhD, KOREA, REPUBLIC OF Bum-Sik Lee, MD, KOREA, REPUBLIC OF Hyo Yeol Lee, MD, PhD, KOREA, REPUBLIC OF Ju-Ho Song, MD, KOREA, REPUBLIC OF Ho Yeon Kim, MD, KOREA, REPUBLIC OF Jaejung Ryu, MD, KOREA, REPUBLIC OF
Postoperative Subjective Evaluation after Meniscectomy in Patients Older than 70 Years: A Local Retrospective Study ePoster Presentation Ignacio Fernández, Md, CHILE Francesca Castelletto, MD, CHILE Enrique Sebastián Rubio, Md, CHILE Rodrigo Humberto Garcia, MD, CHILE Roberto Cisternas, md, CHILE Ignacio Lopez, CHILE

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Increased Mechanical Axis Malalignment Does Not Lead to Worse Outcomes Following Transtibial Meniscus Root Repair

Increased Mechanical Axis Malalignment Does Not Lead to Worse Outcomes Following Transtibial Meniscus Root Repair

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Increased Mechanical Axis Malalignment Does Not Lead to Worse Outcomes Following Transtibial Meniscus Root Repair

Increased Mechanical Axis Malalignment Does Not Lead to Worse Outcomes Following Transtibial Meniscus Root Repair

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