Objectives: This study aimed to investigate whether the initial suture tension when pullout sutures are fixed affects postoperative clinical outcomes following medial meniscus posterior root repair.
Methods: The data of 48 patients who underwent transtibial pullout repair using two simple stitches (outer and inner sutures) with an additional all-inside posteromedial pullout were retrospectively investigated. The patients were sequentially divided into two groups to compare the clinical efficacy of the initial pullout tension (N) when pullout sutures were fixed: the 30 N Group (April 2019 to September 2019, 24 patients) and the 15 N group (October 2019 to February 2020, 24 patients). The rate of suture breakage (suture cutout or rupture) at the second-look arthroscopy at 1 year postoperatively and clinical outcomes at 2 years postoperatively were compared between the two groups.
Results: In both groups, each clinical score significantly improved at 2 years postoperatively. At the second-look arthroscopy, the rate of posteromedial suture breakage was significantly higher in the 30 N group (19 patients, 79 %) than in the 15 N group (10 patients, 42 %); the rate of outer suture breakage was also higher in the 30 N group (five patients, 21 %) than in the 15 N group (no patients). On comparing 2 years of preoperative clinical scores between the groups categorized according to posteromedial suture breakage, the pain score was significantly higher in the suture breakage group.
Conclusions: The initial tension of pullout repair of the medial meniscus posterior root tear is related to suture breakages. To prevent suture breakage, 15 N is a more initially suitable condition than 30 N.
Level of evidence: Level III.
Keywords: Medial meniscus; Posterior root tear; Posteromedial pullout; Pullout repair; Second-look arthroscopy.
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