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Dual-Root Repair of Concomitant Medial and Lateral Meniscal Root Tears Improves Patient-Reported Outcomes Whereas
Dane R G Lind1,2, Annabel R Geissbuhler1,2, John M Apostolakos1,2
1Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
Purpose:
To compare patient-reported outcomes (PROs), survivorship, and demographic characteristics of patients with medial and lateral meniscal root tears who underwent concurrent medial and lateral meniscal root (dual-root) repairs (dual-repair group) and patients who received an isolated repair of either the medial or lateral meniscal root, patients who were treated nonoperatively, or patients who underwent partial meniscectomy for concomitant tears (non-dual-repair group).
Methods:
A retrospective review of patients who presented to an orthopaedic surgery clinic with concomitant medial and lateral meniscal root tears was completed using magnetic resonance imaging to evaluate meniscal tears. Chart review for demographic characteristics and preoperative and minimum 2-year postoperative PROs-including International Knee Documentation Committee subjective knee evaluation, Western Ontario and McMaster Universities Osteoarthritis Index, Short Form 12 Physical Component Summary, and Short Form 12 Mental Component Summary-as well as information regarding mechanism of injury, was completed. The minimal clinically important difference and patient acceptable symptom state were also assessed. Patients were split into two groups depending on whether they had both meniscal roots repaired (dual-repair group) or they had one meniscus repaired, underwent partial meniscectomy, or underwent no meniscal repair (non-dual-repair group). Statistical analysis was completed to determine between-group differences in patient demographic characteristics and PROs.
Results:
This study included 13 subjects with dual root tears, 7 of whom underwent dual repair and 6 of whom underwent isolated single-root repair, meniscectomy, or no repair. The median age of the subjects was 57 years. At baseline and minimum 2-year follow-up, there were no differences in PROs between the two groups. Dual-repair patients showed significant improvement in the Lysholm score (P = .031) and Western Ontario and McMaster Universities Osteoarthritis Index (P = .031) from baseline to short-term follow-up, whereas the non-dual-repair group did not show improvement in any PRO. More dual-repair patients presented with traumatic injuries, whereas more non-dual-repair patients had chronic conditions leading to injury.
Conclusions:
Concurrent medial and lateral meniscal root repair significantly improves PROs compared with non-dual repair, although small sample size and heterogeneity in knee pathology limit definitive conclusions.
Level Of Evidence:
Level III, retrospective comparative study.
