Prognostic Factors on Preoperative MRI for Patient-Reported Outcomes After Posterior Medial Meniscus Root Repair.

Area of Science:

• Orthopedic Surgery
• Radiology
• Sports Medicine

Background:

• Posterior medial meniscus root (PMMR) tears can be effectively treated with surgical repair, potentially delaying knee osteoarthritis progression.
• However, limited data exists on prognostic factors influencing outcomes after PMMR repair.

Purpose of the Study:

• To identify preoperative magnetic resonance imaging (MRI) factors predicting patient-reported outcomes (PROs) after PMMR repair.
• Hypothesized that increased degenerative changes on MRI correlate with poorer PROs.

Main Methods:

• Retrospective cohort study (Level of evidence, 3) of 29 patients with PMMR repair and minimum 2-year follow-up.
• Preoperative MRIs were assessed for meniscus, cartilage, bone marrow edema-like lesions (BMELL), and meniscal extrusion using the Whole-Organ Magnetic Resonance Imaging Score.
• Postoperative outcomes included visual analog scale (VAS) pain scores and PRO surveys (e.g., Knee injury and Osteoarthritis Outcome Score - KOOS).

Main Results:

• Significant VAS pain reduction post-surgery (4.9 to 1.6, P < .001).
• Patient Acceptable Symptom State (PASS) achievement varied by KOOS subscale (44.8%–72.4%).
• Patients with medial tibial BMELL (MT-BMELL) showed significantly lower KOOS Symptoms scores (P = .032).

Conclusions:

• Preoperative MT-BMELL on MRI is associated with worse KOOS Symptoms scores following PMMR repair.
• Cartilage quality and meniscal extrusion did not significantly impact outcomes.