Effectiveness of Meniscal Repair in the over-50 Population: Clinical Results with a Mean 2-Year Follow-Up

Background/Objectives: The purpose of this study was to evaluate the outcomes of meniscal suture repair in patients over 50 years of age with a minimum follow-up of 6 months, following failure of at least 6 months of conservative treatment. Methods: We retrospectively reviewed patients older than 50 years treated between 1 January 2017 and 30 June 2023 at the Orthopaedics and Traumatology Division of ASST Papa Giovanni XXIII (Bergamo, Italy) who underwent meniscal repair after failed conservative management. Patients underwent clinical, radiological and functional assessments. Meniscal healing was evaluated by MRI at 6 months postoperatively. Patient-reported outcome measures (PROMs), including KOOS, IKDC, Lysholm and Tegner Activity Scale, were collected preoperatively and at final follow-up. Results: Eleven patients were included, with a mean age of 53.4 ± 4.1 years (range, 50-64). Nine patients had lateral meniscus tears, and two had medial meniscus tears. At a mean follow-up of 22.0 ± 16.8 months (range, 6-66), significant improvements were observed in KOOS, IKDC and Lysholm scores (p < 0.05), with mean postoperative values of 95.4 ± 5.1, 87.5 ± 8.3 and 97.1 ± 3.5, respectively. All patients returned to their pre-injury activity level according to the Tegner scale. One complete failure and one partial failure were observed, both in patients with medial meniscus tears. Conclusions: In this small cohort, arthroscopic meniscal repair in patients over 50 years of age was associated with significant improvements in clinical and functional outcomes, with a failure rate of 18.2%. These findings suggest that meniscal repair may be a viable joint-preserving option in carefully selected middle-aged patients, particularly in lateral meniscus lesions. However, results should be interpreted cautiously given the limited sample size and retrospective design.