Medial Meniscus Root Tear Refixation: Comparison of Clinical, Radiologic, and Arthroscopic Findings With Medial Meniscectomy

PurposeTo investigate the clinical, radiologic, and arthroscopic findings of pullout repair in medial meniscus root tear (MRT) and to compare the results of pullout repair and partial meniscectomy.MethodsThis study enrolled 58 consecutive patients with medial MRT who underwent partial meniscectomy (M group, n = 28) or pullout repair (R group, n = 30) between September 2003 and August 2007. The patients were evaluated by the Lysholm knee score, International Knee Documentation Committee (IKDC) subjective knee score, joint space narrowing, and Kellgren-Lawrence grade on simple radiographs. Medial meniscal extrusion and the state of the meniscus and articular cartilage on magnetic resonance imaging (MRI) were documented. We performed second-look arthroscopy in 14 patients with pullout repair and evaluated fixation strength and hoop tension of the meniscus and the state of the articular cartilage.ResultsThere were no differences in demographic data (age, sex, and body mass index) between the 2 groups. The mean follow-up was 48.5 months in the R group and 46.1 in the M group. Lysholm and IKDC scores improved significantly in both groups (P < .05). However, the R group had better Lysholm and IKDC scores and less joint space narrowing and progression of the Kellgren-Lawrence grade than the M group did (P < .05). In a subgroup analysis of the R group, medial meniscal extrusion on MRI decreased from 3.13 to 2.94 mm. Of the patients, 28 (93.3%) showed complete or partial healing of the meniscus. On MRI, 6 (20%) showed arthrosis progression. On second-look arthroscopic examinations in 14 patients in the R group, 9 (64.3%) showed normal fixation strength, 10 (71.4%) had normal restoration of hoop tension, 5 (35.7%) showed arthrosis progression, and 2 (6.7%) had repeat tears of the meniscus.ConclusionsArthroscopic pullout repair of a medial MRT gave significantly better clinical and radiologic results than partial meniscectomy, and sound healing with restoration of hoop tension of the meniscus was observed on MRI and second-look arthroscopy. We propose that this method is an effective treatment for medial MRT.Level of EvidenceLevel III, retrospective comparative study.