Defining Risk Factors for Medial Meniscus Posterior Root Repair Surgical Failure

Abstract

Objectives To evaluate the risk factors for failure of a repair of the posterior root of the medial meniscus, including the patient's preoperative factors, factors related to surgery and rehabilitation, already excluding factors such as uncorrected varus axis deviation and changes advanced degenerative diseases in the medial compartment. Methods Patients who underwent repair of the posterior root of the medial meniscus were evaluated retrospectively, although with prospective data collection. Repair of the meniscal root was performed using an arthroscopic method, using stitches tying the meniscus using high-resistance suture threads or tapes and fixation through one or two transtibial tunnels in the anterior cortex of the tibia with a button or anchor. Results Among the 125 patients evaluated, considering the adopted failure criteria, 28 (22.4%) were considered repair failure and 97 (77.6%) were considered successful. Comparing the groups, patients who were considered to have repair failure presented as pre- and intra-operative factors a greater proportion of female patients (p=0.0004), higher BMI (p=0.0009), greater number of associated procedures at the time of root repair (0.02) and greater number of chondral injuries in the femur (0.0005). Patients who failed the repair underwent surgery with a greater number of stitches (p=0.02), although only repairs with 2 or 3 stitches were included, and had worse compliance with rehabilitation (p=0.0001). Conclusion Repairs of injuries to the posterior root of the medial meniscus with transtibial tunnel have 77.6% good results with an average follow-up of around 4 years. Female gender, high BMI, surgery to correct the axis or treatment of cartilage injury concomitant with root repair, more pronounced chondral injury in the femoral cartilage, repair with 3 stitches instead of 2, and poor patient compliance with rehabilitation were related factors of repair failure.