In middle-aged and older patients, Non-anatomic reconstructi
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A Study was conducted to describe a non-anatomic arthroscopic all-inside repair technique for middle-aged and older patients with medial meniscus posterior root tears (MMPRTs) and to evaluate the short- to mid-term clinical and radiologic results. The hypothesis was that this procedure would yield good clinical outcome results and structural healing in middle- and older-aged patients.

This was a retrospective study evaluating patients who had undergone MMPRT repair by suturing the meniscal root directly to the capsule, rather than by the transtibial technique. This all-inside repair technique was performed for patients with type II MMPRTs who were over 40 years old.

The Lysholm score, Tegner activity score and International Knee Documentation Committee (IKDC) score were evaluated preoperatively and at the final follow-up. Medial meniscal extrusion, the International Cartilage Repair Society (ICRS) grades of the medial compartment, and the healing status of the medial meniscus root were assessed on MRI preoperatively and at the final follow-up.

Results:
--29 patients (mean age 61.7±7.9) were included; the mean follow-up duration was 46.2±7.9 months.

--The mean Lysholm score significantly improved from 33.7±20.9 preoperatively to 81.7±19.9 at the final follow-up, the median Tegner activity score improved from 1.0 (range 1–4) to 3.0 (range 2–4), and the mean IKDC score improved from 20.1±16.4 to 69.6±16.2.

--On MRI, 9 cases had complete healing; 17 had partial healing; and 3 had failed healing.

--Mean meniscal extrusion significantly increased from 2.3±1.7 mm preoperatively to 3.5±1.5 mm postoperatively.

Despite increased meniscal extrusion, non-anatomic arthroscopic all-inside repair of MMPRTs to the posterior capsule resulted in good to excellent clinical outcomes and a high rate of healing in the medial meniscus root on MRI in middle-aged and older patients at short- to mid-term follow-up. For treating MMPRTs in middle- and older-aged patients, this procedure is an alternative to the transtibial pullout repair technique.

Source: https://link.springer.com/article/10.1007/s00167-021-06532-9
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