The distance between the tibial tunnel aperture and meniscal root attachment is correlated with meniscal healing status following transtibial pullout repair for medial meniscus posterior root tear

Abstract

BackgroundTo investigate the relationship between tibial tunnel aperture location and postoperative meniscal healing. MethodsWe enrolled 25 patients (20 women and five men, mean age: 62.5 years) who underwent transtibial pullout repair for medial meniscus (MM) posterior root repair. The expected MM posterior root attachment center (AC) and tibial tunnel center (TC) were identified using three-dimensional computed tomography, and the minimum AC–TC distance was calculated. The meniscal healing status following transtibial pullout repair was assessed by second-look arthroscopy (mean postoperative period: 15 months) using a previously reported scoring system (meniscal healing score; range: 0–10). The association between AC–TC distance and meniscal healing score was investigated using univariate linear regression models. The optimal AC–TC distance cut-off for improved MM healing score (≥7) was determined using receiver operating characteristic analysis. ResultsThe AC–TC distance and meniscal healing score were significantly associated (y = −0.42x + 9.48, R2 = 0.342; P = 0.002), with the optimum AC–TC distance being 5.8 mm. This cut-off had a sensitivity of 100% and specificity of 53%. ConclusionsThis study demonstrates that AC–TC distance is significantly correlated with postoperative meniscal healing. Anatomical repair within 5.8 mm of the AC may result in improved meniscal healing.