Clinical factors associated with successful meniscal root repairs: A systematic review.

PURPOSE: To systematically review the literature to determine what clinical factors influence patient outcomes after meniscal root repairs.

METHODS: A systematic review of multiple databases was performed. The inclusion criteria included English language, studies evaluating clinical and/or radiographic factors related to meniscal root repair outcomes, medial or lateral posterior root repairs, and human studies. The exclusion criteria included meniscectomy studies, meniscal body studies, technique descriptions, studies reporting only failure rate of meniscal repairs, multiligament repairs, abstracts, controlled laboratory studies, meta-analyses, and systematic reviews.

RESULTS: Five studies were included for final analysis including four case series and one retrospective cohort study. A total of 178 patients in the five studies underwent posterior meniscal root repair (179 knees total). The mean age was 51.4 years. The mean duration of follow-up was 34.5 months. The mean Moga quality rating for case series studies was 15 points (83.3%) and NOS score for the retrospective comparative study was 8. Body mass index (BMI) was not associated with outcomes in 3/3 studies assessing BMI. Increased age was associated with worse outcome in 1/5 studies and had no association in 4/5 studies. Knee varus >5° was associated with worse outcomes in 3/3 studies.

CONCLUSIONS: Risk factors for poor clinical outcomes after posterior meniscal root repair include pre-existing high-grade (Outerbridge grade ≥ 3) chondral lesions and severe varus knee alignment (>5°) for medial root repairs.

LEVEL OF EVIDENCE: IV, systematic review.