Editorial Commentary: Root Cause of Failure: Surgeons and Patients Must Take Medial Meniscus Root Repair Seriously

Medial meniscus posterior root tears, which may account for up to one fifth of meniscal tears, often go undiagnosed or mistreated, contributing to substantial morbidity. They can be detected on magnetic resonance imaging by the classic "ghost sign" on sagittal sequences-the absence of an identifiable dark meniscus or presence of high signal in place of the normal dark appearance of the meniscus. These tears result in a dramatic impairment in hoop stress force transmission and have been shown to have a similar effect as a subtotal medial meniscectomy, resulting in rapid joint degeneration and an increased risk of early joint replacement. While medial meniscus root repair affords the opportunity to restore meniscus function, failure rates remain high, which shows the need to further refine patient selection, surgical techniques, and rehabilitation strategies to improve outcomes.