Outcomes after Surgical Repair of Medial Meniscal Root Tears: A Review

At the present time, there is a paucity of literature regarding medial meniscal posterior root repair and outcomes. This review seeks to examine the currently available data to further elucidate the clinical risks and benefits and any associated risks of medial meniscal posterior root repair. A systematic literature search was performed up to July 2018 in the databases of Medline via PubMed, EBSCOhost, and EMBASE. The results were reviewed independently by two authors and appropriate articles were reviewed and eligibility determined based on established criteria. The best-evidence synthesis was subsequently used. Thirteen studies (324 patients) were included in this review with a mean patient age of 54 years. There were no control studies with nonoperative treatment of medial meniscal posterior root tears. All studies included a minimum of 10 patients in a case series or case-control manner. Of patients treated with medial meniscal posterior root repair, 62.43% demonstrated complete healing on follow-up magnetic resonance imaging (MRI) or second-look arthroscopy. Among them, 32.60% demonstrated incomplete healing, loosening of the construct, or excessive scar tissues formation. Also, 4.97% demonstrated complete failure or retearing of the construction. At a mean follow-up period of 33 months, patients demonstrated a mean improvement in Lysholm's score of 30.5 ( p <0.00001), International Knee Documentation Committee (IKDC) score of 31.9 ( p <0.00001), and HSS Knee Score of 38.3 ( p <.00001). Surgical repair of medial meniscus posterior root tears appears to result in highly satisfying subjective outcomes. Patients included in this review meet criteria for both statistically and clinically significant improvement, based on published guidelines for minimal clinically important difference. Despite this, however, postoperative MRI and second-look arthroscopy demonstrate a relatively high rate of incomplete healing (32.60%) or retearing and failure of the construct (4.97%). More highly powered studies are required to confirm these findings.