Clinical and Radiologic Outcomes of Patients With Lax Healing After Medial Meniscal Root Repair: Comparison With Subtotal Meniscectomy

Abstract

Purpose: To compare radiologic and clinical outcomes between patients who underwent medial meniscus posterior root tear (MMPRT) repair and were subsequently classified as having lax healing based on second-look arthroscopy and patients who underwent subtotal meniscectomy for an MMPRT.

Methods: The patients who received pullout repair or subtotal meniscectomy due to MMPRT between January 2011 and December 2014 were retrospectively reviewed. Among the patients who underwent MMPRT repair, those whose lax healing of the repair site was confirmed by second-look arthroscopy (repair/lax healing group) and among the patients who received subtotal meniscectomy, those who have varus deformity of <5° and a Kellgren-Lawrence grade of ≤2 (meniscectomy group) were included in the study population. Medial joint space width, Kellgren-Lawrence grade, International Knee Documentation Committee Subjective Knee Evaluation Form score, and Lysholm Knee score were used for radiologic and clinical assessment.

Results: The meniscectomy group included 24 patients (average follow-up, 37.2 months), and the repair/lax healing group included 21 patients (average follow-up, 39.2 months). The 2 groups showed improved patient-reported outcomes postoperatively (P < .001). However, medial joint space width (P < .001) became narrow and Kellgren-Lawrence grade (P = .002 and P = .005, respectively) worsened. Comparison of the radiologic outcomes between the 2 groups revealed that the repair/lax healing group had less Kellgren-Lawrence grade progression than the meniscectomy group (P = .014). The grade progressed by ≥2 grades in 4 patients (16.7%) and 0 patients in the meniscectomy and repair/lax healing groups, respectively (P < .001).

Conclusions: Although the repair/lax healing group showed improved functional outcomes on short-term follow-up, arthritic change progressed radiologically. Nevertheless, the repair/lax healing group showed better radiologic outcomes than the meniscectomy group, despite lax healing of the repair site. However, because of the small number of cases in this study, the results of this study could be associated with potential for type II or β errors.

Level of evidence: Level III, retrospective comparative study.