Medial Meniscus Root Tears: Management With Single-Tunnel Repair and Meniscus Centralization

Background Meniscus root tears (MRTs) are radial tears located near the anterior or posterior meniscotibial attachment, which are often underdiagnosed and associated with accelerated knee osteoarthritis (OA). Medial meniscus posterior root tears (MMPRTs), frequently observed in middle-aged women, lead to altered knee biomechanics and joint degeneration if untreated. While historically managed with meniscectomy, the modern approach emphasizes arthroscopic repair to restore joint stability and delay OA progression. Objective This study evaluates the clinical outcomes of single-tunnel root repair combined with medial meniscus centralization, focusing on pain relief, functional improvement, and patient satisfaction in patients above 40 years of age. Methods A prospective cohort study was conducted between 2021 and 2023 at a secondary orthopedic center. Fifteen patients (mean age: 54.2 years; 86.7% female) with symptomatic MMPRTs confirmed by magnetic resonance imaging (MRI) were included. Functional outcomes were assessed using the Lysholm Knee Scoring Scale and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) preoperatively, and at six months and one year postoperatively. The surgical repair involved single-tunnel root fixation and medial meniscus centralization using No. 0 FiberWire. A standardized rehabilitation protocol was followed. Results The Lysholm score improved significantly from 45.3 ± 10.2 preoperatively to 82.3 ± 9.1 at six months and 87.6 ± 10.4 at one year. WOMAC scores decreased from 49.1 ± 10.4 to 10.7 ± 4.9 and 7.4 ± 4.1 over the same periods, reflecting reduced pain and improved function. Correlation analysis revealed no significant impact of body mass index (BMI) or varus knee alignment on outcomes, though earlier intervention (<3 months) correlated with better recovery. One patient experienced repair failure due to an incidental injury and underwent successful revision surgery. Conclusion Single-tunnel root repair with medial meniscus centralization is an effective surgical technique for MMPRTs in patients above 40 years, offering significant pain relief, functional improvement, and delayed OA progression. Timely diagnosis and repair are crucial for optimal outcomes, emphasizing the importance of meniscal preservation over meniscectomy.