Functional outcomes after re-insertion of posterior root tear of medial meniscus using a simple economic technique

Abstract

Background Root avulsions of the meniscus cause loss of hoop stresses and therefore loss of the meniscal function. This in return is associated with increased peak contact stresses and risk of osteoarthritis. Root repair is therefore crucial to preserve normal biomechanics and kinematics. Many techniques have been used and expensive fancy equipment made the procedure easier, however, cost is of great importance. Aim To demonstrate the results and functional outcomes after root re-insertion using simple economic tools. Patients and methods Between March 2022 and May 2023, 25 patients with root tears were operated upon and followed-up for a mean of 12 months. Patients with acute traumatic tears, degenerative tears with grade 1–2 osteoarthritis, associated genu varum less than 5º and a BMI less than or equal to 35 were included in the study. All patients underwent diagnostic arthroscopy as part of the procedure. Pie-crusting of the medial ligament was performed routinely to facilitate visualization and instrumentation in the medial compartment. Bed preparation was performed using a motorized shaver. This was followed by passing polydioxanone suture (PDS) shuttling sutures through a grey cannula and into the posterior root meniscal tissue, this was then used to shuttle heavy poly-braided nonabsorbable suture material. A tunnel was created through the anterior tibial cortex using the anterior cruciate ligament (ACL) guide. The sutures are then tied over a post (4.5 mm screw). Lysholm, International Knee Documentation Committee (IKDC), and Tegner activity scores were used to evaluate the patients at 6 and 12 months. Results The mean Lysholm score improved from 50.16 ± 12.51 preoperative to 82.08 ± 12.90 postoperative. The mean IKDC score improved from 51.24 ± 11.06 to 84.36 ± 10.18. The mean Tegner activity score improved from 3 ± 1.32 ranging from 1 to 5 to 5.20 ± 1.53. Traumatic tears showed greater improvement as compared with degenerative tears. Conclusion Simple outside techniques can be used to perform adequate reliable root repair. This yields comparable results to other techniques described in the literature.