Medial meniscus posterior root tear with concomitant focal cartilage lesion may be successfully treated with pullout repair combined with additional bone marrow stimulation.
retrospective_cohort · Level III
Where this comes from
- Record sourced from PubMed, PMID 42318487.
- Also identified by DOI 10.1016/j.asmart.2026.05.012 and PMC identifier 13273478.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
Although many studies have reported the clinical outcomes of pullout repair for medial meniscus posterior root tears (MMPRTs) or microfractures for focal cartilage lesions alone, no study has specifically reported the clinical outcomes in patients with MMPRT combined with cartilage lesions. Therefore, we investigated the effectiveness of bone marrow stimulation via microfracture for treating focal cartilage lesions associated with MMPRT and compared the clinical outcomes between patients who underwent microfracture and those who did not. We hypothesised that favourable clinical outcomes could be achieved after transtibial pullout repair combined with microfracture for MMPRTs with focal cartilage lesions and that these outcomes would be comparable to those after transtibial pullout repair alone for MMPRTs without cartilage lesions. Ten patients who underwent transtibial pullout repair and microfracture for MMPRT with cartilage lesions (Group MF) and 37 patients who underwent only pullout repair for MMPRT without cartilage lesions (Group P) using the same pullout technique (two simple stitches) as Group MF between November 2016 and September 2023 were retrospectively evaluated. The age at the time of surgery, sex, height, weight, body mass index, duration from injury to surgery, and KL grade were recorded for each patient. The presence, location, and area of cartilage lesions were evaluated. Clinical outcomes were assessed, and all included patients underwent a second-look arthroscopy. The mean follow-up period, patient age, body mass index, femorotibial angle, and percentage of the mechanical axis in Group MF were 3.2 years, 60.2 years, 26.1 kg/m<sup>2</sup>, 176.3°, and 42.4%, respectively. All postoperative clinical outcomes at one and three years showed significant improvement compared with preoperative outcomes, including the KOOS and IKDC, Tegner, Lysholm, and pain VAS scores. Second-look arthroscopy confirmed good meniscal healing. No significant differences in demographic data, radiological parameters, clinical outcomes, or meniscal healing were observed between Groups MF and P, both preoperatively and at the three-year postoperative follow-up. The clinical outcomes of transtibial pullout repair combined with microfracture were favourable in patients with MMPRT and focal cartilage lesions in well-aligned knees. Moreover, no significant differences in clinical outcomes were detected between patients who underwent pullout repair combined with microfracture and those who underwent pullout repair alone. MMPRTs with focal cartilage lesions may be effectively treated with pullout repair combined with microfracture, provided that strict patient selection criteria are applied.