Comparable Midterm Survival After Medial Meniscus Root Repair for High and Low Intraoperative Outerbridge...

Area of Science:

• Orthopedic Surgery
• Knee Biomechanics
• Meniscus Repair

Background:

• Medial meniscus posterior root repairs (MMPRRs) aim to mitigate biomechanical issues from root tears.
• The efficacy of MMPRR in patients with significant pre-existing chondral damage (advanced osteoarthritis) remains debated.
• Intraoperative assessment of chondral health using Outerbridge grading is crucial for surgical decision-making.

Purpose of the Study:

• To compare the midterm survival rates of MMPRR between patients with Outerbridge grades 0-2 and grades 3-4.
• To evaluate and compare patient-reported outcomes (PROs) following MMPRR based on intraoperative chondral damage severity.
• To test the hypothesis that advanced chondral damage negatively impacts MMPRR survival and patient outcomes.

Main Methods:

• A retrospective cohort study (Level of evidence, 3) included 170 patients undergoing primary isolated MMPRR.
• Patients were categorized into Outerbridge grades 0-2 (n=74) or 3-4 (n=96) based on arthroscopic findings.
• Midterm survival (defined by reoperation) and PROs (IKDC, VAS pain, Marx activity) were analyzed with a minimum 2-year follow-up.

Main Results:

• No significant differences in midterm survival or failure rates were observed between the Outerbridge grade groups.
• Overall median survival was 11 years, with 80% survival at 8 years for both groups.
• Postoperative International Knee Documentation Committee (IKDC) scores significantly improved, exceeding the minimal clinically important difference (MCID) in both groups.

Conclusions:

• Midterm survival and patient-reported outcomes after MMPRR are comparable, irrespective of intraoperative chondral damage severity (Outerbridge grades 0-4).
• MMPRR demonstrates durable efficacy, with overall 80% survival at 8 years.
• Intraoperative Outerbridge grade should not deter surgeons from performing MMPRR, as outcomes remain favorable.