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. 2025 Mar 12;13(3):23259671241274136.
doi: 10.1177/23259671241274136. eCollection 2025 Mar.

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

Garrett R Jackson  1 , Derrick M Knapik  2 , Zeeshan A Khan  3 , Harkirat Jawanda  1 , Obianuju A Obioha  1 , Daniel J Kaplan  1 , Johnathon R McCormick  1 , Joan Sugrañes  1   4 , Anjay Batra  1 , Enzo S Mameri  1   5   6 , Nikhil N Verma  1 , Jorge Chahla  1
Affiliations

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

Garrett R Jackson et al. Orthop J Sports Med. .

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.

Keywords: chronologic age; debridement; medial meniscus; outcomes; posterior root; repair.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: D.M.K. has received grant support from Arthrex and Medical Device Business Services, education payments from Arthrex and Smith+Nephew, honoraria from Encore Medical, and hospitality payments from Stryker. O.A.O. has received education payments from Medwest Associates. J.R.M. has received education payments from Medwest Associates and hospitality payments from Medical Device Business Services. N.N.V. has received consulting fees from Arthrex and Stryker; nonconsulting fees from Arthrex; royalties from Arthrex, Smith+Nephew, and Graymont Professional Products; and hospitality payments from Spinal Simplicity and Relievant Medsystems. J.C. has received grant support from Arthrex; education payments from Arthrex and Smith+Nephew; consulting fees from RTI Surgical, Smith+ Nephew, Vericel, Arthrex, DePuy, and Linvatec; nonconsulting fees from Smith+Nephew, Arthrex, Medical Device Business Services, and Linvatec; and hospitality payments from Stryker. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. Ethical approval for this study was obtained from Rush University Medical Center (ref No. 00000482).

Figures

Figure 1.
Figure 1.
Arthroscopic view of the anteromedial compartment of the knee demonstrating successful restoration of the medial meniscus posterior root (MMPR) to the native tibial insertion using transtibial suture pullout technique. MFC, medial femoral condyle; MM, medial meniscus; MTP, medial tibial plateau; PMMR, same as MMPR as defined in caption.
See this image and copyright information in PMC

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