Posterior medial meniscus root repair at the time of anterior cruciate ligament reconstruction: Clinical outcomes, knee stability, and reoperations in a nondegenerative cohort.

OBJECTIVES

The aim of this study was to evaluate patient-reported outcomes, knee stability, and reoperation rates after repair of posterior medial meniscus root tears (PMMRTs) performed concomitantly with anterior cruciate ligament reconstruction (ACLR) in a nondegenerative patient population.

METHODS

This retrospective cohort study included patients who underwent arthroscopic PMMRT repair in conjunction with ACLR between 2015 and 2022, at a high-volume tertiary referral center for orthopedic sports medicine. Patients with prior meniscal surgery or radiographic or arthroscopic signs of degenerative joint disease were excluded. Patient-reported outcomes were assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS) at 2-year follow-up. Patient acceptable symptom state (PASS) and treatment failure (TF) thresholds were applied. Objective outcomes included range of motion, anterior knee laxity, and isokinetic strength at 6 months. Reoperations during follow-up were recorded.

RESULTS

Twenty-three patients were included, of whom 17 (73.9%) had available KOOS data at 2 years. Six-month clinical assessment data were available for 20 of 23 patients (87.0%). Mean KOOS values were 84.1 for Pain, 76.1 for Symptoms, 90.4 for Activities of Daily Living, 60.4 for Sport and Recreation, and 68.9 for Quality of Life. Overall, 70.6% of patients achieved PASS, while 11.7% met criteria for TF. Anterior knee laxity improved postoperatively, with no patients demonstrating a side-to-side difference greater than 5 mm at 6 months. Extension deficits greater than 5° were observed in 20% of patients. During follow-up, 43.5% of patients underwent additional surgical procedures, most commonly for arthrofibrosis-related conditions. No anterior cruciate ligament revisions or clinically detected re-ruptures of the repaired meniscal root were identified.

CONCLUSION

In this cohort of patients with nondegenerative knees undergoing concomitant PMMRT repair and ACLR, acceptable patient-reported outcomes, satisfactory knee stability, and no clinically detected root failures were observed. Reoperations were common and primarily related to ACLR rather than meniscal failure. Due to the absence of a control group, the specific contribution of PMMRT repair to these outcomes cannot be determined.

LEVEL OF EVIDENCE: IV.