Posterior Medial Meniscus Root Repair at the Time of Anterior Cruciate Ligament Reconstruction: Clinical Outcomes, Knee Stability, and Reoperations in a Nondegenerative Cohort.

Abstract

To evaluate patient-reported outcomes, knee stability, and reoperation rates after repair of posterior medial meniscus root tears (PMMRTs) performed concomitantly with anterior cruciate ligament reconstruction (ACLR) in a nondegenerative patient population. This retrospective cohort study included patients who underwent arthroscopic PMMRT repair in conjunction with ACLR between 2015 and 2022, at a high-volume tertiary referral center for orthopedic sports medicine. Patients with prior meniscal surgery or radiographic or arthroscopic signs of degenerative joint disease were excluded. Patient-reported outcomes were assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS) at 2-year follow-up. Patient Acceptable Symptom State (PASS) and Treatment Failure (TF) thresholds were applied. Objective outcomes included range of motion (ROM), anterior knee laxity, and isokinetic strength at 6 months. Reoperations during follow-up were recorded. Twenty-three patients were included, of whom 17 (73.9%) had available KOOS data at 2 years. Six-month clinical assessment data were available for 20 of 23 patients (87.0%). Mean KOOS scores were 84.1 for Pain, 76.1 for Symptoms, 90.4 for Activities of Daily Living, 60.4 for Sport and Recreation, and 68.9 for Quality of Life. Overall, 70.6% of patients achieved PASS, while 11.7% met criteria for treatment failure. Anterior knee laxity improved postoperatively, with no patients demonstrating a side-to-side difference greater than 5 mm at 6 months. Extension deficits greater than 5° were observed in 20% of patients. During follow-up, 43.5% of patients underwent additional surgical procedures, most commonly for arthrofibrosis-related conditions. No anterior cruciate ligament revisions or clinically detected re-ruptures of the repaired meniscal root were identified. In this cohort of patients with nondegenerative knees undergoing concomitant PMMRT repair and ACL reconstruction, acceptable patient-reported outcomes, satisfactory knee stability, and no clinically detected root failures were observed. Reoperations were common and primarily related to ACL reconstruction rather than meniscal failure. Due to the absence of a control group, the specific contribution of PMMRT repair to these outcomes cannot be determined. IV.