Midterm Outcomes Following Repair of Complex Meniscus Tears: A Retrospective Analysis of Failure Risk and...

Despite increasing evidence supporting the efficacy of repair for most meniscus tear types, research assessing the outcomes of repair of complex tears is limited. The purpose of this study is to analyze failure risk and postoperative complications following repair of complex meniscus tears. A retrospective review of medical records was performed for patients who underwent meniscus surgery between 2011 and 2022 at a single academic medical center. Only patients with a complex meniscus tear treated through repair with a minimum follow-up period of 2 years were included. Patients were evaluated for demographic information (age, sex, BMI, race, smoking status), surgical information (type of tear), failure of meniscus repair, and postoperative complications. Failure of meniscus repair was defined as repeat surgery on the index meniscus (including meniscectomy or revision repair) or total knee arthroplasty. A total of 77 patients underwent repair of a complex meniscus tear during the study period (mean age, 32.6 ± 13.9 years; BMI, 28.5 ± 6.5 kg/m²) with an average follow-up time of 4.6 years. Overall, 17 (22.1%) patients had a failure of their meniscus repair, of which 14 underwent partial meniscectomy, 2 underwent a total knee arthroplasty, and 1 had a revision repair. On univariate analysis, previous knee surgery was the only significant predictor of postoperative failure when considering lateral meniscus repairs (p = 0.036) in isolation. All other demographic and surgical variables were statistically insignificant. The only postoperative complication seen acutely after surgery was a surgical site infection (1/77, 1.3%) managed by oral antibiotics. Patients with complex meniscus tears who underwent repair demonstrated a 22.1% failure rate at 4.6 years after surgery and demonstrated a low incidence of acute postoperative complications. Level of evidence is IV.