Knee malalignment and laterality influence 2-year meniscus tear repair outcomes: A pilot study

Area of Science:

• Orthopedic surgery
• Sports medicine
• Biomechanics

Background:

• Longitudinal vertical meniscal tears (LVMTs) in the posterior horn are common knee injuries.
• Repair outcomes for posterior horn LVMTs can be variable.
• Biomechanical factors influencing repair success require further investigation.

Purpose of the Study:

• To analyze biomechanical determinants affecting radiological and clinical outcomes of posterior horn longitudinal vertical meniscal tear (LVMT) repairs.
• To identify risk factors for nonhealing and poor patient-reported outcomes.

Main Methods:

• Prospective cohort pilot study involving patients undergoing primary repair of posterior horn LVMTs.
• Evaluated factors included malalignment, meniscal laterality, concomitant anterior cruciate ligament reconstruction (ACLR), and cartilage damage.
• Primary outcome was posterior horn nonhealing rate at 6 months (assessed by CTA and Henning's criteria); secondary outcomes included PROMs at 6 months and ≥2 years.

Main Results:

• The nonhealing rate for posterior horn LVMTs was 53%.
• Malalignment and medial meniscal involvement were independently associated with nonhealing.
• The combination of varus malalignment and medial meniscal involvement significantly increased nonhealing risk (MRR=2.54) and negatively impacted KOOS and IKDC scores.

Conclusions:

• Combined varus malalignment and medial meniscus involvement are strong predictors of repair nonhealing after posterior horn LVMT repair.
• These biomechanical factors significantly influence mid-term and long-term clinical outcomes and patient-reported scores.