Functional and Radiological Outcome of Meniscal Repair and Conservative Management for Medial Meniscal Root Tear - A Prospective Comparative Study.

Abstract

Introduction: To sustain hoop stress, prevent extrusion, and maintaining the function of the meniscus, the posterior root attachment point of the medial meniscus is essential. The purpose of this study is to determine the functional and radiological outcome of conservative therapy and meniscal repair for medial meniscal root tears.

Materials and methods: Prospective evaluations were performed on forty individuals who confirmed a diagnosis of Medial meniscus root tear (MMRT). Among the 40 patients, 20 underwent arthroscopic meniscal repair and 20 underwent conservative management and followed up a period of 2 years. Functional outcome between two groups was measured using Tegner Lysholm score and IKDC score. Radiological outcome was measured using X-rays (medial joint space width, joint space narrowing, K-L grade).

Results: Both group showed improvement in Lysholm score and IKDC. When comparing the clinical outcomes between both the groups, Group A showed significantly better outcome (P = 0.02). About 60% of patients in Group A and all patients in Group B showed K-L grade progression. Of the patients in Group A, 5% had significant K-L grade progression and 10% had severe joint space constriction. Of the patients in Group B, 80% had significant K-L grade progression and 25% had severe joint space constriction. Meniscal repair had considerably superior outcomes for radiologic parameters than conservative care (P < 0.01) when we examined the final results of Groups A and B.

Conclusion: The MMRT repair group had better functional and radiological outcome than the conservative treatment group. Although treatment did not entirely stop the advancement of arthrosis, meniscal repair decreased the rate of arthritic changes when compared to the conservative group.