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Lower preoperative Kellgren–Lawrence grade is associated with improved long‐term survivorship following medial meniscus posterior root repair

Year: 2026

Type: article

Abstract: PURPOSE: The purpose of this study was to determine whether there was an association between preoperative Kellgren-Lawrence (KL) grade and long-term failure rates, reoperation free survival rates, and patient reported outcomes of patients undergoing medial meniscal posterior root repair (MMPRR). METHODS: Consecutive skeletally mature patients who underwent primary isolated MMPRR performed at a single institution between January 2005 and September 2022 were included. Preoperative radiographs were evaluated by three independent orthopaedic surgeons and classified utilising the KL grading system. Chi-squared tests were used to assess associations between categorical variables, while T-test and Rank sum tests were used for continuous variables, and Kaplan-Meier estimates were used to assess reoperation free survival rates using log-rank test. RESULTS: In total, 240 patients were identified, and 170 patients were included (71% follow-up rate). The final cohort was composed of 93 patients with KL grade 0-1 and 77 patients with KL grade 2-4. Intra-class correlation coefficient (ICC) score for absolute agreement among three raters was 0.79 (95% confidence interval [CI] 0.64-0.86) for the mean of raters indicating good reliability and 0.55 (95% CI 0.37-0.68) for single measurements indicating moderate reliability. The failure rate in the KL 0-1 group was 13% (12/93) compared with 23% (18/77) in the KL 2-4 group, which was not significantly different (p = 0.075). In terms of reoperation free survival, the KL 0-1 group demonstrated a significantly higher survival probability of 51% at 14.9 years compared with the KL 2-3 group demonstrating a survival probability of 16% at 15.8 years (p = 0.046). CONCLUSIONS: This study demonstrated that preoperative KL grade was associated with reoperation free survivorship in patients undergoing MMPRR with low-grade (0,1) KL scores demonstrating significantly longer survivorship and lower risk of reoperation than high-grade (2,3) KL scores. These results allow us to have further informed discussions with our patients undergoing MMPRR and can help guide patient expectations regarding long-term outcomes. LEVEL OF EVIDENCE: Level IV.

Source: Knee Surgery Sports Traumatology Arthroscopy

DOI: 10.1002/ksa.70270