Editorial Commentary: Meniscus Root Repair Must Heal Without Laxity to Slow Osteoarthritis Progression.

Medial meniscus posterior root tears are debilitating injuries that can lead to the rapid progression of osteoarthritis (OA) if left untreated. Medial meniscus root tears commonly occur in older patients (≥55 years old) and are usually degenerative-type tears, rather than acute traumatic injuries (like those most commonly seen with lateral meniscal root tears). These degenerative-type tears are functionally equivalent to a total medial meniscectomy. Repair is becoming the gold standard for treatment, but laxity to probing indicates a nonfunctional repair, and progression of OA can still occur. Although many patients have satisfactory patient-reported outcomes at least 2 years follow-up, patients may still experience radiographic progression of OA, likely attributable to meniscus extrusion and meniscal degeneration. Solutions include anatomic tunnel placement for the medial meniscus root, addition of a centralization suture, concomitant repair of the meniscocapsular attachment, attention to suture type and configuration, and protected rehabilitation. Meniscus root repairs should aim to reduce postoperative meniscus repair laxity and extrusion to slow the progression of OA.