Clinical and radiographic outcomes of arthroscopic repair versus conservative management for medial meniscus posterior root tears: A comparative cohort study.

OBJECTIVES

This study aims to compare clinical and radiographic outcomes of arthroscopic repair versus conservative management in patients with medial meniscus posterior root tears (MMPRTs).

PATIENTS AND

METHODS

Between January 2019 and December 2021, a total of 41 patients (9 males, 32 females; mean age: 49±12 years; range, 35 to 68 years) who underwent MMPRT repair and 123 patients (11 males, 112 females; mean age: 52±7 years; range, 26 to 74 years) who refused to undergo MMPRT repair and were managed conservatively were included in the study. Surgical candidates had neutral or mild varus alignment (≤5°), preserved joint space, and Kellgren-Lawrence (K-L) Grade 1-2 osteoarthritis. Baseline K-L grades, Lysholm Knee Scores (LKS), and International Knee Documentation Committee (IKDC) scores were recorded.

RESULTS

The mean follow-up was 32±11 (range, 24 to 60) months in the repair group and 28±6 (range, 24 to 48) months in the control group (p=0.025). Baseline LKS scores were similar between the groups (p=0.685), while IKDC scores were lower in the repair group (p=0.001). At final follow-up, the repair group showed higher LKS scores (78±19 vs. 65±32; p=0.021) and greater improvements in LKS (+46±25 vs. +36±38; p=0.046) and IKDC scores (+38±18 vs. +26±27; p=0.002). No repair patients progressed to K-L Grade 4, compared to 11% of controls (p=0.027). No repair patients required further surgery, whereas 20% of conservative patients did, including 7% undergoing arthroplasty.

CONCLUSION

Arthroscopic MMPRT repair yielded a more favorable functional improvement, no subsequent surgeries, and improved radiographic preservation compared to conservative management, supporting early surgical intervention in selected patients.