Outcomes After Isolated Medial Meniscus Posterior Root Repairs Using an Anatomic Transtibial Pullout Technique in Patients Older Than 60 Years: A Matched Cohort Study

Abstract

Background: Management of isolated medial meniscus posterior root (MMPR) tears is challenging, especially in older patients, where indications for repair must be weighed against potential repair failure and osteoarthritic progression. Purpose: To compare patient-reported outcomes and incidence of failure after anatomic transtibial pullout repair for isolated MMPR tears in patients >60 versus ≤60 years of age. Study Design: Cohort study; Level of evidence, 3. Methods: Included in the study were patients aged ≥18 years who underwent isolated anatomic transtibial pullout repair using either the single- or double-tunnel technique for MMPR tears at a single institution between January 2016 and September 2020. Patients with a minimum 2-year follow-up were divided based on age at surgery (>60 vs ≤60 years). Patients completed the International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR), and Veterans RAND 12-Item Health Survey (VR-12) Physical score preoperatively and at final follow-up. Differences between age groups in outcome scores as well as repair failures (defined as the need for repeat arthroscopy) were analyzed using the 2-sided Student t test or chi-square test. Results: A total of 20 patients aged >60 years (mean age, 65.7 ± 4.1 years; range, 60.2-74.9 years) were identified and compared against 40 patients aged ≤60 years (mean age, 49.3 ± 9.0 years; range, 23.4-59.8 years). Significant improvement on all outcomes scores was observed in both groups at final follow-up when compared with preoperative values, with no significant between-group difference on any of the scores at final follow-up. Revision repair was required in 1 patient (2.5%) in the ≤60-year group but not in patients in the >60-year group. Conclusion: Anatomic transtibial pullout repair for isolated MMPR tears resulted in improved IKDC, KOOS JR, and VR-12 Physical scores at minimum 2-year follow-up, with no significant differences between our cohorts of patients >60 versus ≤60 years of age.