A Systematic Review of Adverse Events and Complications After Isolated Posterior Medial Meniscus Root Repairs

Abstract

Background: Medial meniscus posterior root (MMPR) tears are recognized as a substantial cause of disability and morbidity. However, meniscus root repair, regardless of technique, is not without potential complications. Purpose: To evaluate the reported incidence of complications and adverse events after isolated MMPR repair. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using Embase, PubMed, and Scopus databases with the following search terms combined with Boolean operators: “meniscus,”“root,” and “repair.” Inclusion criteria consisted of level 1 to 4 human clinical studies in English or English-language translation reporting complications and adverse events after isolated posterior medial meniscus root repairs. The overall incidence of specific complications was estimated from the pooled sample of the included studies. Results: Eleven studies with a total pooled sample of 442 patients were identified. The mean patient age was 58.1 years, while the mean final follow-up time was 37.2 months (range, 12-84.8 months). The overall incidence of complications was 9.7% (n = 43/442), with the most commonly reported complication being progressive degenerative changes within the knee (10.4%; n = 25/240; n = 5 studies). A total of 1.25% (n = 3/240) of patients who experienced degenerative changes required conversion to total knee arthroplasty. Repair failures were reported in 3.1% (n = 10/327; n = 8 studies) of patients. Conclusion: Repairing MMPR tears is critical in preventing accelerated progression of knee osteoarthritis in patients without significant knee osteoarthritis preoperatively. While this repair is still recommended and necessary in appropriate patients, this review found that the incidence of complications after isolated posterior medial meniscus root repair was 9.7%, primarily involving the presence of progressive degeneration, while repair failure was reported in 3% of patients.

Intercondylar notch width and osteophyte width impact meniscal healing and clinical outcomes following transtibial pullout repair of medial meniscus posterior root tears

“…The MM posterior root (MMPR) plays a crucial role in maintaining the meniscus's normal function by controlling its movement. A tear in the MMPR (MMPRT) can cause abnormal loading and movement of the meniscus, leading to accelerated articular cartilage degeneration in the knee joint [1,2]. MMPRTs are a significant concern in orthopaedic practice as they are associated with a range of functional impairments and pain.…”

Longitudinal changes in medial meniscus extrusion and clinical outcomes following pullout repair for medial meniscus posterior root tears: a 3-year evaluation

“…Consequently, MMPR repair is being performed more frequently. However, MMPR repair does not completely prevent the progression of osteoarthritic changes [ 6 , 7 ]. Moreover, it has been reported that there is a correlation between the MM extrusion (MME) progression and the narrowing of the medial joint space [ 6 ].…”

Accurate tibial tunnel position in transtibial pullout repair for medial meniscus posterior root tears delays the progression of medial joint space narrowing

“…The long-term outcomes of nonoperative management of medial meniscus (MM) posterior root (MMPR) tears (MMPRTs) are reported to be poor [18]; however, the mid-term to long-term outcomes of MMPR repair have known to be favourable [2,5,17]. Regardless, MMPR repair does not completely prevent the progression of osteoarthritis and medial joint space (MJS) narrowing [2,8,14]. While many similar studies have reported on postoperative MM extrusion (MME) progression [19,23,29], a previous study reported that MMPR repair slowed the progression of osteoarthritis compared with conservative treatment or meniscectomy in a rabbit model [3].…”