Comparison of two simple stitches and modified Mason-Allen suture for medial meniscus posterior root tear based on the progression of meniscal posterior extrusion: A retrospective cohort study

Purpose: Medial meniscus (MM) posterior root (PR) tear leads to severe MM posterior extrusion (PE), resulting in rapid knee cartilage degeneration. MMPR repairs are recommended to reduce MMPE, especially during knee flexion. However, the difference in MMPE between different repair techniques remains unknown. This study aimed to investigate preoperative and postoperative MMPE following several pullout repair techniques. We hypothesized that a technique using two simple stitches (TSS) would be more useful than FasT-Fix-dependent modified Mason-Allen suture (F-MMA) to prevent the progression of MMPE in knee extension.
Methods: This retrospective study included 35 patients who underwent MMPR repair. To compare MMPE, patients were divided into two groups according to the use of F-MMA while grasping the posterior capsule and TSS without grasping it. Open magnetic resonance imaging was performed at 10 degrees and 90 degrees knee flexion preoperatively, and at 3 and 12 months postoperatively, and the MMPE of both groups was evaluated.
Results: A significant difference was observed between preoperative and 3-month postoperative MMPE at 90 degrees knee flexion in both groups (p < .01). A significant difference was observed in 3- and 12-month postoperative MMPE at 10 degrees knee flexion between both groups (p = .04/.02), whereas no significant difference in the preoperative MMPE at 10 degrees knee flexion was observed between them (p = .45).
Conclusions: Both repairs were found to be useful to reduce MMPE in knee flexion. Further, F-MMA repair increased MMPE in knee extension, unlike TSS repair. These findings suggest that TSS might have more advantages for load distribution when standing or walking.