Early functional outcomes after medial meniscal posterior root tear repair

Background Meniscal root tears represent a functional loss; therefore, they greatly increase the risk of osteoarthritis. Root re-insertion aims to restore the anatomy and biomechanical function of the knee, reducing the risk of arthritis. Different techniques have been described. Preparation of the bed and instrumentation remains a challenge. Aim To demonstrate good early clinical outcomes after root re-insertion using accessory supra-meniscal portal, which helps both preparation and instrumentation of the bed. Patients and methods Between January 2019 and August 2019, we operated on 16 patients who met our inclusion criteria, having root tears of the medial meniscus. All patients underwent arthroscopic evaluation and re-insertion of the root tear medial meniscus using heavy braided suture material shuttled through a tibial tunnel and tied over a bone button. An accessory supra-meniscal portal was used to facilitate instrumentation and suture management. All patients were followed up for 2 years, and the Lysholm knee score was used for assessment at the final follow-up. Results A total of 16 patients were operated upon and followed up for a mean of 24 months. The mean Lysholm score improved from 73.5±12.61 preoperatively to 93.75±6.90 postoperatively, with a P value of 0.001. The mean preoperative and postoperative Lysholm scores were higher for the traumatic tears as compared with degenerative tears. Older patients showed lower functional outcomes. Conclusion Root re-insertion helps restore knee function and biomechanics, thereby prevents detrimental arthritis. Younger patients and those who have sustained traumatic injuries are more likely to improve as compared with elder patients and degenerative tears.