Clinical Outcomes of Meniscal Root Repair: A Narrative Review of the Literature
DOI:
https://doi.org/10.63403/re.v33i2.485Keywords:
Meniscus root tear, Posterior root repair, Medial meniscus posterior root tear, MMPRT, LMPRT, Pullout repair, Meniscal extrusion, Meniscal root outcomeAbstract
Meniscal root tears behave biomechanically like a total meniscectomy, causing increased tibiofemoral pressures, meniscal extrusion, and accelerated cartilage degeneration. In the last decade, root repair has emerged as the preferred strategy for preserving meniscal function; however, long-term clinical outcomes remain variable. The aim of this study was to summarize the clinical, radiological, and joint survival outcomes of medial and lateral meniscal root repair reported in the last 15 years, with a greater focus on medial meniscal roots than lateral ones, due to their prominence in the literature, comparing them with meniscectomy and conservative treatment. A narrative review was conducted following the SANRA criteria. Studies published between 2010 and 2025 were searched in PubMed and Scopus using the terms “meniscus root tear”, “posterior root repair”, “MMPRT”, and “pull-out repair”. Studies with ≥12 months of follow-up reporting clinical outcomes, radiographic progression, or conversion to arthroplasty were included, prioritizing those with ≥5 and ≥10 years. Twenty-two studies were included. Root repair showed better functional results (IKDC, KOOS, Lysholm), less progression of osteoarthritis, and significantly lower rates of conversion to total knee arthroplasty compared with meniscectomy and nonoperative management. At follow-ups ≥10 years, meniscectomy for medial root tears showed accelerated OA progression and up to 72% TKA, while repair better preserved joint space and function. MRI demonstrated partial reduction of extrusion and healing rates of 70-80%. Advanced age, varus, obesity, and preexisting OA were associated with worse outcomes. Overall, recent evidence supports meniscal root repair as the most effective therapeutic option for preserving function and delaying joint degeneration, provided that the knee has favorable biological and mechanical conditions for recovery.
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Copyright (c) 2026 Césár A. Jiménez Aroche, Juan R. Jiménez Castro, José E. Miranda Mayén, Laurence J. Conway Restrepo
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