Refixation of the root of medial meniscus. Evaluation of postoperative treatment results and the influence of extrusion on clinical outcome

Introduction. Medial meniscus root injury (MMRI), a frequent knee pathology that can lead to complete loss of medial meniscus (MM) function and significant degenerative changes in the knee joint. Residual extrusion of the medial meniscus on postoperative magnetic resonance imaging (MRI) is noteworthy. Several authors have not found a correlation between surgical outcome and functional outcome. The aim of this study was to evaluate subjective and objective results after refixation of the root of the medial meniscus. Materials and Methods. A prospective non-randomised study, 32 patients with MM root rupture who underwent root refixation with modified technique transtibial Pull-Out fixation using a were included. All patients were women, 43-72 years old, and none of them had chondromalacia not exceeding the 2nd degree according to the ICRS classification. Functional status was assessed by KOOS and VAS, and MRI was performed to evaluate meniscus excursion and the degree of MM root fusion before and after surgery. The follow-up period was 12 months. Results. Complete healing was noted in 28 patients (87.5%) and partial healing in 4 (12.5%). The pain score decreased from 7.7 ± 0.7 VAS score to 1.8 ± 1.2. The mean KOOS score improved from 38.6 ± 12.5 points to 75.6 ± 14.4 points. The mean meniscus extrusion preoperatively was 4.06 ± 0.82 mm and postoperatively 2.67 ± 0.71 mm, which was statistically significant. Conclusion. Meniscus root refixation performed using a modified technique allowed to achieve good results in 75.0% of cases. The degree of MM extrusion after arthroscopic fixation of its root showed a moderate close relationship with the function of the knee joint. In case of varus deformity of the lower limb with the value of the NKA angle < 175°, the functional results statistically significantly worsened and were assessed as unsatisfactory.