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Midterm Outcomes of Posterior Medial Meniscus Root Tear Repair: A Systematic Review
Peter S Chang1, Logan Radtke2, Patrick Ward3
1Department of Orthopaedic Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA.
Background:
Whereas there has been growing interest in surgical repair of posterior medial meniscus root tears (PMMRTs), our understanding of the medium- and long-term results of this procedure is still evolving.
Purpose:
To report midterm clinical outcomes from PMMRT repairs.
Study Design:
Systematic review.
Methods:
A literature review for this systematic analysis was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We identified studies that reported the results of arthroscopic repair of PMMRTs. Functional and imaging outcomes were reviewed and summarized.
Results:
In total, 28 studies with a total of 994 patients (83% female) with an overall mean age of 57.1 were included in this review. Clinical outcomes (Lysholm, International Knee Documentation Committee, Hospital for Special Surgery, and Tegner scores) were improved at final follow-up in all studies. Of patients, 49% had radiographic progression of at least 1 grade in the Kellgren-Lawrence scale at a mean follow-up of 4.0 years in 11 studies. Cartilage degeneration had progressed at least 1 grade on magnetic resonance imaging scans in 23% of patients at a mean follow-up of 31.6 months in 4 studies.
Conclusion:
PMMRT repairs provide a functional benefit with consistent improvements in clinical outcome scores. There is some evidence that PMMRT repair slows the progression of osteoarthritis but does not prevent it at midterm follow-up.
Insights
Surgical repair of posterior medial meniscus root tears (PMMRTs) improves knee function. While PMMRT repair shows potential to slow osteoarthritis progression, it does not prevent it in the midterm.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomedical Engineering
Background:
- Growing interest in surgical repair for posterior medial meniscus root tears (PMMRTs).
- Limited understanding of medium- and long-term outcomes following PMMRT repair.
Purpose of the Study:
- To evaluate midterm clinical outcomes of PMMRT repairs.
- Synthesize current evidence on functional and imaging results after PMMRT surgery.
Main Methods:
- Systematic review conducted following PRISMA guidelines.
- Literature search for studies reporting arthroscopic PMMRT repair outcomes.
- Analysis of functional scores and radiographic/MRI findings.
Main Results:
- 28 studies including 994 patients (mean age 57.1, 83% female) were analyzed.
- Significant improvements in clinical outcome scores (Lysholm, IKDC, HSS, Tegner) were observed.
- Radiographic osteoarthritis progression (Kellgren-Lawrence grade ≥1) occurred in 49% of patients at a mean of 4.0 years.
- MRI-confirmed cartilage degeneration (grade ≥1) was noted in 23% of patients at a mean of 31.6 months.
Conclusions:
- PMMRT repair offers functional benefits with consistent improvements in clinical scores.
- Evidence suggests PMMRT repair may slow, but not halt, osteoarthritis progression at midterm follow-up.
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