Medial Meniscus Posterior Root Tear Repairs Show Osteoarthritis Progression Over Time With Higher Rates Seen With Higher Body Mass Index.

PURPOSE: To examine osteoarthritis (OA) development or progression and conversion to total knee arthroplasty (TKA) following medial meniscal posterior root rear (MMPRT) repair.

METHODS

In adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, PubMed, Scopus, and Embase were searched from database inception to July 2024 using the terms "menisc* root" and "menisc* root repair." Studies reporting (1) MMPRT repair as an intervention, (2) patient sociodemographics, and (3) outcomes including either conversion to TKA or radiographic evidence of progression of OA with (4) full text available and (5) published in English were included. Case reports, systematic reviews and meta-analyses, studies published in non-peer-reviewed journals, in non-English language, and studies not reporting on subsequent surgeries or progression of OA were excluded. Studies were analyzed using forest plots, chi-square analysis or Fischer's exact test with alpha set to P < .005.

RESULTS

Twenty-five studies met the inclusion criteria. All (100%) studies were of moderate quality evidence by Methodological Index for Non-Randomized Studies (MINORS) score. Sixteen (64%) studies had follow-up time between 2 and 5 years, while only one (4%) had follow-up beyond 10 years. Twenty (80%) studies populations were >60% female. Within the 18 (72%) studies reporting Kellgren-Lawrence (KL) grade OA, progression was 11.1% for BMI <25 kg/m2, 13.6-71.8% for BMI's between 25 and 30 kg/m2, and 29.9%-30.3% for BMI's between 30 and 35 kg/m2. Conversion to TKA was reported in 12 (48%) studies, and conversion rates ranged from 0 to 21.6%. No TKAs occurred within the first 2 years postoperatively.

CONCLUSIONS

Following MMPRT repair, MMPRT repairs show progression of OA with higher rates with elevated BMI. Conversion to TKA occurred at low rates and increased gradually with follow-up time. More than 75% of patients had not converted to TKA after 10 years.

LEVEL OF EVIDENCE: Level IV, systematic review of Level III and IV studies.