Postmenopausal Status Is Associated With Increased Risk of Medial Meniscus Posterior Root Tears and Subsequent Arthroplasty.

PURPOSE: To identify risk factors for medial meniscus posterior root tears (MMPRT) and arthroplasty-free survival in postmenopausal women, while secondary objectives included analyzing menopause-specific factors associated with MMPRT and defining risk factors for conversion to arthroplasty in patients with a confirmed MMPRT.

METHODS

All patients at our institution with a diagnosed meniscal tear through December 2024 were identified. From this cohort, women with a menopausal diagnosis preceding their meniscal tear were matched one-to-one with men by age and body mass index. Imaging studies were reviewed to identify MMPRTs. Subsequent arthroplasty, Charlson Comorbidity Index, menopausal type (surgical or physiologic), hormone replacement therapy, bisphosphonate usage, and bone mineral density were recorded. Logistic and Cox regression were used to define risk factors for MMPRT and arthroplasty; survivorship was determined using Kaplan-Meier analyses.

RESULTS

The final cohort consisted of 1564 patients (n = 782 women) with a median age of 63 years, of which 244 patients (15.6%) had MMPRT. Age and female sex were associated with MMPRT. The presence of an MMPRT, female sex, body mass index, and Charlson Comorbidity Index were associated with arthroplasty. Among postmenopausal women, age at menopause, surgical menopause, hormone replacement therapy, and bone mineral density were associated with MMPRT. For patients with MMPRT, female sex was associated with arthroplasty. Ten-year survivorship-free from arthroplasty in patients with MMPRT was 53.5% for women and 78.4% for men (P = .02).

CONCLUSIONS

Postmenopausal status, age, and hormone replacement therapy usage are risk factors for MMPRT. Compared with men, postmenopausal women with MMPRT exhibit reduced arthroplasty-free survival, underscoring the need for targeted interventions.

LEVEL OF EVIDENCE: Level III, retrospective comparative study.