Favorable clinical outcomes are achieved in both male and female following medial meniscus posterior root repair

Abstract

Purpose: In recent years, medial meniscus (MM) posterior root tears (PRT) have received increasing attention due to their association with rapidly progressive knee osteoarthritis. MM posterior root (PR) repair has been reported to yield good clinical outcomes, but no study has yet to compare the postoperative outcomes after MMPR repair between sexes. The purpose of this study is evaluating the postoperative clinical outcomes following MMPR pullout repair by sex.

Methods: Eighty-six patients who underwent pullout repair for isolated MMPRTs at our institution between October 2016 and November 2019 were evaluated. Patients were divided into two groups according to sex, and their clinical outcomes were compared preoperatively and at 2 years postoperatively.

Results: The cohort was comprised of 21 male and 65 female patients. Three factors related to physical status (height (p < 0.01), body weight (p < 0.01), and BMI (p = 0.02)) were significantly higher in male patients. No significant differences were observed in preoperative clinical scores between male and female. All clinical scores significantly improved at 2 years postoperatively in both sexes. In the clinical scores, the KOOS-symptom (p = 0.03), KOOS-QOL (p = 0.03), and Tegner activity scores (p < 0.01) showed significantly better scores in male patients.

Conclusion: Following MMPR pullout repair, the clinical outcomes significantly improved in both sexes. These results indicate that MMPR pullout repair is a universally effective technique regardless of the disadvantages of females in morphological characteristics.

Keywords: Clinical outcome; Medial meniscus; Posterior root tear; Pullout repair; Sex difference.

Fig. 1

Representative arthroscopic findings of the primary surgery in male (a and b) and female (c and d). a Medial meniscus (MM) posterior root tear (PRT) was confirmed (red arrow). b Pullout repair was performed using two simple stitches concomitant with an additional all-inside suture. c MMPRT was confirmed by probing (red arrow). d Pullout repair was performed using a modified Mason-Allen suture. MFC, medial femoral condyle; MTP, medial tibial plateau; PR, posterior root (color figure online)

Fig. 2

Representative arthroscopic findings of a second-look arthroscopy at 1 year postoperatively in male a and female b. a Sufficient width, stability, and synovial coverage were observed, with scores of 4, 3, and 1, totaling 8. b Sufficient width, stability, and synovial coverage were observed, with scores of 4, 4, and 2, totaling 10. MFC, medial femoral condyle; MTP, medial tibial plateau; PR, posterior root

Fig. 3

Representative magnetic resonance images (MRI) preoperatively and 2 years postoperatively in male (a and b) and female (c and d). a Preoperative coronal MRI presents Giraffe neck sign (dotted area). b Postoperative coronal MRI shows a continuity of the medial meniscus (blue arrow). c Preoperative coronal MRI presents Giraffe neck sign (dotted area) and cleft sign (red arrow). d Postoperative coronal MRI shows a continuity of the medial meniscus (blue arrow) (color figure online)