Medial meniscus posterior root tear reconstructed with gracilis autograft improve healing rate and patient reported outcome measures

Abstract

Background Many surgeries have not reversed or prevented progressive symptomatic knee arthritis, and there is no consensus regarding the ideal repair or reconstruction technique for meniscal root treatment. Additionally, there is a lack of studies comparing the clinical efficacy evaluation of different repair techniques. The aim of the present study is to compare the clinical efficacy and healing rates of meniscus root in the treatment of medial meniscus posterior root tear (MMPRT) with the arthroscopically assisted meniscus root reconstruction with gracilis autograft and transtibial pull-out technique. Methods Patients with MMPRT (type II) who received treatment of posterior meniscus root attachment point through the tibial tunnel between January 2018 and April 2019 were included in this study. Patients were divided into 2 groups (arthroscopically assisted gracilis autograft reconstruction technique: 29 cases; transtibial pull-out technique group: 35 cases) according to the different treatment methods. The mean follow-up period was 26.9 ± 2.3 months. The demographics, functional recovery of the knee, and meniscus root healing rates (assessed using knee magnetic resonance imaging (MRI) at the final follow-up) were compared between the two groups. Results There was a statistically significant improvement in the Lysholm score, international knee documentation committee (IKDC) score, and visual analogue scale (VAS) score (P < 0.001 in both groups). Additionally, compared with the transtibial pull-out repair group, the arthroscopically assisted reconstruction with gracilis autograft showed significant improvement in the meniscus root healing rates, Lysholm score, and IKDC score at the end of follow-up (P < 0.05). Conclusions Compared with the transtibial pull-out technique, the arthroscopically assisted meniscus root reconstruction with gracilis autograft was advantageous for treating these patients with superior clinical outcome and higher meniscus root healing rates. Level of evidence Level III.

Medial Meniscus Posterior Root Reconstruction and Open-Wedge High-Tibial Osteotomy for Medial Meniscus Posterior Root Tear With Varus Knee Alignment: A Retrospective Study on Short-Term Outcomes

“…However, Chung et al reported that the K-L grade progressed in approximately 70% of patients at an average follow-up of 72 months after pull-out suturing [ 25 ]. Recently, MMPR-R has attracted significant attention [ 10 , 11 ]. Li et al compared MMPR-R and pull-out repair and reported that both the IKDC score and Lysholm score of patients who underwent MMPR-R significantly improved [ 10 ].…”

“…Recently, MMPR-R has attracted significant attention [ 10 , 11 ]. Li et al compared MMPR-R and pull-out repair and reported that both the IKDC score and Lysholm score of patients who underwent MMPR-R significantly improved [ 10 ]. In addition, Kim et al revealed that a varus knee alignment of > 5° requires alignment correction [ 15 ].…”

“…Recently, Wang et al first evaluated the healing status of patients who underwent MMPR reconstruction on MRI. They reported that the CH, PH, and FH rates of reconstructions were 82.8%, 10.3%, and 6.9%, respectively [ 10 ]. However, the healing status on the second-look examination was not reported [ 10 ].…”

“…They reported that the CH, PH, and FH rates of reconstructions were 82.8%, 10.3%, and 6.9%, respectively [ 10 ]. However, the healing status on the second-look examination was not reported [ 10 ]. In this study, MMPR-R and OWHTO were performed.…”

“…Therefore, the suitable treatment options remain controversial [ 5 , 6 , 9 ]. Li et al reported that treatment by suturing a degenerated meniscus and implanting it into the bone tunnel is debatable as to the healing of the meniscus [ 10 ]. Therefore, in recent years, some studies have used medial meniscus posterior root reconstruction (MMPR-R) with autologous gracilis tendons.…”