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

Abstract

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.