| example
Background
Medial meniscus posterior root tears (MMPRTs) disrupt meniscal hoop stress function, leading to altered knee biomechanics, increased tibiofemoral contact pressures, and accelerated degenerative changes. Although arthroscopic medial meniscus posterior root repair has demonstrated favorable clinical outcomes, the potential influence of patient sex on postoperative clinical and structural outcomes remains incompletely understood.
Objective
To compare clinical outcomes, achievement of the minimal clinically important difference (MCID), and MRI-based healing characteristics between male and female patients undergoing arthroscopic MMPR repair.
Study Design
Retrospective cohort study; Level of evidence, 3.
Methods
Consecutive patients diagnosed with an isolated MMPRT confirmed by clinical evaluation and magnetic resonance imaging (MRI), who underwent arthroscopic MMPR repair between June 2019 and April 2024, were retrospectively reviewed. Patients were stratified by sex. Inclusion criteria comprised isolated MMPRTs, Kellgren–Lawrence (KL) grade 0–2 osteoarthritis, and Outerbridge grade 0–II cartilage status. Patients with prior ipsilateral knee surgery, concomitant procedures, subchondral insufficiency fracture, or varus malalignment ≥5° were excluded. Clinical outcomes (International Knee Documentation Committee [IKDC] and Lysholm scores) were assessed preoperatively and at 2 years postoperatively. MCID achievement for IKDC was evaluated. Structural outcomes, including meniscal healing status and medial meniscal extrusion, were assessed on 1-year postoperative MRI in a subset of patients.
Results
Seventy-six patients met the inclusion criteria, including 20 males and 56 females. Baseline demographic characteristics, radiographic severity, and preoperative outcome scores were comparable between groups. At 2-year follow-up, both groups demonstrated substantial clinical improvement. No significant differences were observed between males and females in 2-year IKDC scores (65.5 ± 12.8 vs 68.2 ± 11.3; p = 0.30) or Lysholm scores (78.1 ± 11.8 vs 80.3 ± 11.6; p = 0.42). MCID achievement rates for IKDC were similarly high (90% vs 89%; p = 0.93). MRI evaluation revealed no statistically significant sex-based differences in meniscal healing status (p = 0.28). However, females demonstrated significantly lower medial meniscal extrusion both preoperatively and at 1 year postoperatively (p = 0.04 for both).
Conclusion
Arthroscopic MMPR repair resulted in significant clinical improvement at 2 years in both male and female patients, with comparable outcome scores, MCID achievement rates, and healing status. Females exhibited less medial meniscal extrusion preoperatively and postoperatively, although the clinical significance of this difference warrants further investigation.
|
