Medial meniscus root tear refixation: comparison of clinical, radiologic, and arthroscopic findings with medial meniscectomy

Arthroscopy. 2011 Mar;27(3):346-54. doi: 10.1016/j.arthro.2010.08.005. Epub 2010 Oct 29.


Purpose: To investigate the clinical, radiologic, and arthroscopic findings of pullout repair in medial meniscus root tear (MRT) and to compare the results of pullout repair and partial meniscectomy.

Methods: This study enrolled 58 consecutive patients with medial MRT who underwent partial meniscectomy (M group, n = 28) or pullout repair (R group, n = 30) between September 2003 and August 2007. The patients were evaluated by the Lysholm knee score, International Knee Documentation Committee (IKDC) subjective knee score, joint space narrowing, and Kellgren-Lawrence grade on simple radiographs. Medial meniscal extrusion and the state of the meniscus and articular cartilage on magnetic resonance imaging (MRI) were documented. We performed second-look arthroscopy in 14 patients with pullout repair and evaluated fixation strength and hoop tension of the meniscus and the state of the articular cartilage.

Results: There were no differences in demographic data (age, sex, and body mass index) between the 2 groups. The mean follow-up was 48.5 months in the R group and 46.1 in the M group. Lysholm and IKDC scores improved significantly in both groups (P < .05). However, the R group had better Lysholm and IKDC scores and less joint space narrowing and progression of the Kellgren-Lawrence grade than the M group did (P < .05). In a subgroup analysis of the R group, medial meniscal extrusion on MRI decreased from 3.13 to 2.94 mm. Of the patients, 28 (93.3%) showed complete or partial healing of the meniscus. On MRI, 6 (20%) showed arthrosis progression. On second-look arthroscopic examinations in 14 patients in the R group, 9 (64.3%) showed normal fixation strength, 10 (71.4%) had normal restoration of hoop tension, 5 (35.7%) showed arthrosis progression, and 2 (6.7%) had repeat tears of the meniscus.

Conclusions: Arthroscopic pullout repair of a medial MRT gave significantly better clinical and radiologic results than partial meniscectomy, and sound healing with restoration of hoop tension of the meniscus was observed on MRI and second-look arthroscopy. We propose that this method is an effective treatment for medial MRT.

Level of evidence: Level III, retrospective comparative study.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroscopy / methods*
  • Chi-Square Distribution
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Menisci, Tibial / diagnostic imaging
  • Menisci, Tibial / surgery*
  • Middle Aged
  • Radiography
  • Retrospective Studies
  • Second-Look Surgery / methods
  • Statistics, Nonparametric
  • Suture Techniques
  • Tibial Meniscus Injuries*
  • Treatment Outcome