Arthroscopic Repair of Posterior Meniscal Root Tears

Abstract

Objectives:The purpose of this study was to compare subjective clinical outcomes in patients requiring arthroscopic transtibial pullout repair for posterior meniscus root tears of the medial and lateral menisci. We hypothesized that improvement in function and activity level would be similar among patients undergoing lateral and medial meniscal root repairs.Methods:This study was IRB approved. All patients who underwent posterior meniscal root repair by a single orthopaedic surgeon were included in this study. Detailed operative data were documented at surgery. Patients completed a subjective questionnaire, including Lysholm score, Tegner activity scale, WOMAC, SF-12 and patient satisfaction with outcome, which were collected preoperatively and at a minimum of two years postoperatively. Failure was defined as any patient who underwent revision meniscal root repair or partial meniscectomy following the index surgery.Results:There were 50 patients (16 females, 34 males) with a mean age of 37.8 years (range, 16.6-65.7) and a mean BMI of 27.3 (range, 20.5-49.2) included in this study. Fifteen patients underwent lateral meniscus root repair and 35 patients underwent medial meniscus root repair. Three patients who underwent lateral meniscus root repair required revision meniscus root repair surgery, while no patients who underwent medial meniscus root repair required revision surgery (p=0.26). There was a significant difference in preoperative and postoperative Lysholm score (53 vs. 78) (p<0.001), Tegner activity scale (2.0 vs. 4.0) (p=0.03), SF-12 physical component subscale (38 vs. 50) (p=0.001) and WOMAC (36 vs. 8) (p<0.001) for the total population. Median patient satisfaction with outcome was 9 (range, 1-10). There was no significant difference in mean age between lateral and medial root repair groups (32 vs. 40) (p=0.12) or gender (p=0.19). There was no significant difference in gender between lateral and medial root repair groups (p=0.95). There was a significant difference in concurrent ACL reconstructions between lateral versus medial root repair groups (67% vs. 17%) (p<0.001). There was no significant difference in average postoperative Lysholm score (75 vs. 80) (p=0.31), IKDC (72 vs. 71) (p=0.23), SF-12 physical component subscale (48.4 vs. 51.0) (p=0.85) or WOMAC score (2.7 vs. 1.7) (p=0.80) for lateral versus medial meniscus root repairs. There was no significant difference in median postoperative Tegner activity scale for lateral versus medial meniscus root repairs (4 vs. 4) (p=0.88) or in median patient satisfaction with outcome for lateral versus medial meniscus root repairs (9 vs. 9) (p=0.61).Conclusion:There were no differences in outcomes between patients who underwent medial versus lateral arthroscopic meniscus root repair surgery. All patients who underwent arthroscopic repair of medial or lateral meniscus root tears demonstrated a significant improvement in function and activity level at a minimum two year follow-up. Overall, patients were highly satisfied with their outcomes.