Abstract
Background:
Investigating the possible association between medial posterior tibial slope (PTS) and healing of repaired medial meniscal posterior root tear (MMPRT) is very limited in the relevant literature.
Purpose/Hypothesis:
The purpose of this study was to investigate the association between medial PTS and healing of MMPRTs after all-inside suture anchor repair. We hypothesized that there would be a significant difference in the medial PTS between the healing and nonhealing groups.
Study Design:
Case-control study; Level of evidence, 3.
Methods:
From March 2008 to December 2023, consecutive patients who underwent MMPRT repair using the all-inside repair technique with suture anchors were selected. MMPRTs were repaired in patients with grade 1 or 2 chondromalacia according to the Outerbridge classification of the medial compartment, minimal extrusion (<3 mm), normal limb alignment (hip-knee-ankle angle <3°), and minimally displaced root tears. The patients were divided into 2 (healed and nonhealed) groups according to the magnetic resonance imaging (MRI) appearance of the repaired MMPRT at 6 months after surgery. The medial PTS was measured on the mid-central slice of the sagittal MRI. The 2 groups were compared according to age, body mass index (BMI), and PTS.
Results:
There were 47 patients in the healed group and 25 patients in the nonhealed group. Age and BMI did not differ significantly between the 2 groups (P = .763 and P = .073). PTS of the nonhealed group was significantly higher than that of the healed group (5.9 ± 2.2 vs 4.4 ± 2.5; P = .017). Logistic regression analysis demonstrated that the PTS was associated with failure to heal after the MMPRT repair (odds ratio [OR], 1.31; 95% CI, 1.04–1.73; P = .022). However, age and BMI were not associated with nonhealing after the MMPRT repair (OR = 0.99; 95% CI, 0.93–1.08; P = .759; OR = 0.85; 95% CI, 0.70–1.02; P = .079).
Conclusion:
Increased PTS was associated with failure to heal MMPRT after all-inside suture anchor repair. This factor should be considered when counseling patients undergoing MMPRT repair.
Keywords: all-inside suture anchor repair, medial meniscal root tear, posterior tibial slope
Medial meniscal posterior root tears (MMPRT) have been reported to significantly alter biomechanical properties and result in accelerated progression of medial compartment osteoarthritis. 3 MMPRTs commonly occur in women aged >50 years. 17 MMPRT is frequently associated with degenerative change of the posterior horn and major extrusion of the midbody.12,16 Nonoperative treatment and meniscectomy are treatment options for the MMPRT. However, repair using the pullout or all-inside techniques is recommended to restore the hoop stress of the meniscus. Transtibial pullout repair is the traditional gold standard technique for the MMPRT. This technique passes sutures through the MMPR and secures them through a drilled tibial bone tunnel, demonstrating superior biomechanical stability and effectively restoring the load-bearing capacity of the meniscus. 21 However, the long suture length of this construct allows for micromotion under cyclic loading. Conversely, all-inside suture anchor repair fixes the MMPR directly into the posterior tibial plateau without creating a transosseous tibial bone tunnel, as required for transtibial pullout repair. While this technique is technically demanding, it is potentially advantageous for concurrent surgeries, such as high tibial osteotomy or anterior cruciate ligament (ACL) reconstruction. 21
Although the goal of MMPRT repair is successful meniscal healing, complete healing after repair is by no means guaranteed. A systematic review reported that 62.4% of patients demonstrated complete healing, 32.6% demonstrated incomplete healing, and 5% demonstrated complete failure or retearing on follow-up magnetic resonance imaging (MRI) or second-look arthroscopy. 9
Several risk factors for poor clinical outcomes after MMPRT repair have been investigated.5,6,15,27,32,34 A systematic review demonstrated that preexisting high-grade (Outerbridge grade ≥3) chondral lesions and varus knee alignment (>5°) were significant risk factors for poor clinical outcomes. 15 Another systematic review reported that the status of the articular cartilage, Kellgren-Lawrence grade, and meniscal extrusion were associated with worse clinical outcomes. 31 However, preoperative risk factors for failure to heal after MMPRT repair are rarely reported in the literature. 22
An increased posterior tibial slope (PTS) is an important risk factor for medial meniscal posterior horn (MMPH) tears. Wang et al 33 reported that an increased medial PTS is a risk factor for these tears. Similarly, Moon et al 24 found that an increased PTS strongly correlates with a higher incidence of MMPH tears, identifying a cutoff PTS value of 6.6° to discriminate between the tear and control groups. 24 An increased PTS is also a risk factor for the MMPRT. A recent systematic review demonstrated that increased PTS is associated with increased risk of the MMPRT. 7 Until now, investigation of the association between medial PTS and healing of repaired MMPRT is very limited in the relevant literature. Therefore, the purpose of this retrospective study was to investigate the association between medial PTS and healing of the MMPRT after all-inside suture anchor repair. It is hypothesized that there would be a significant difference in the medial PTS between the healing and nonhealing groups.
Methods
Study Population
From March 2008 to December 2023, medical charts of consecutive patients from 2 medical centers who underwent MMPRT repair using the all-inside repair technique with suture anchor were reviewed. Meniscal repair was recommended for patients with grade 1 or 2 chondromalacia according to the Outerbridge classification of the medial compartment, minimal extrusion (<3 mm), normal limb alignment (hip-knee-ankle angle <5°), and a minimally displaced root tear. Corrective osteotomy was performed for patients with focal or diffuse chondromalacia of the medial compartment, malalignment >5° of hip-knee-ankle angle, extrusion (>3 mm), and a widely displaced root tear. Patients who suffered from traumatic MMPRT or did not undergo follow-up MRI were excluded. This study protocol was reviewed and approved by the institutional review board of Nowon Eulji Medical Center (IRB No. EMCS-2025-09-030).
Surgical Procedure
Routine anteromedial and anterolateral portals were made, and MMPRT was confirmed (Figure 1). A high posteromedial portal was made for anchor fixation. A ring curette was introduced through the anteromedial portal, and the cartilage just medial to the insertion area of the MMPH was removed to enhance MMPR healing (Figure 2). Through the high posteromedial portal, an anchor loaded with 2 (blue and striped) nonabsorbable sutures was placed at the insertion area of the MMPR (Figure 3). A curved suture hook (ConMed Linvatec) was passed through the MMPR from superior to inferior (Figure 4). The leading limb of a polydioxanone (PDS) suture (Ethicon) was advanced sufficiently. The curved suture hook was retrieved, and the leading limb of PDS was retrieved and used for shuttle-relay for a blue suture loaded to the anchor. The same procedure was repeated for the striped suture loaded to the anchor (Figure 5). Using 2 limbs of each suture, 2 SMC knots were tied at 30° of knee flexion, and secure fixation of the MMPR was confirmed using a probe (Figure 6). After surgery, toe-touch weightbearing without a knee brace was recommended during the first 6 weeks. Progressive weightbearing after 6 weeks was allowed, and squatting was allowed after 3 months.
Figure 1.
The MMPRT was torn in the right knee. MMPRT, medial meniscal posterior root tear.
Figure 2.
The cartilage just medial to the insertion area of the posterior horn was removed to enhance MMPR. MMPRT, medial meniscal posterior root tear.
Figure 3.
An anchor loaded with 2 nonabsorbable sutures was fixed through the posteromedial portal.
Figure 4.
A curved suture hook was passed through the MMPR from superior to inferior. MMPRT, medial meniscal posterior root tear.
Figure 5.
Two nonabsorbable sutures were passed through the posterior horn using a shuttle-relay technique.
Figure 6.
The MMRT was securely repaired using a suture anchor. MMPRT, medial meniscal posterior root tear.
Radiologic Evaluation
A follow-up MRI was routinely performed at 6 months to evaluate the healing status of the repaired MMPR. MRI scans were interpreted by a musculoskeletal radiologist. The patients were divided into 2 groups according to the MMPRT healing status. The repaired meniscus was considered healed if there was no cleft of high signal intensity on axial and coronal views, or no ghost sign on consecutive sagittal views (Figure 7). Presence of either of these findings was considered nonhealed. 16
Figure 7.
Follow-up MRI demonstrated a healed root after all-inside suture anchor repair. A white arrow indicated the previous tear site. MFC, medial femoral condyle; MRI, magnetic resonance imaging; MTP, medial tibial plateau.
The medial PTS was measured on the central sagittal MRI. 13 On a central sagittal slice showing the tibial attachment of the posterior cruciate ligament, a proximal circle was drawn, and its boundary was the anterior, posterior, and proximal tibial cortex. The boundary of the distal circle was the anterior and posterior cortical border. A line connecting the centers of the 2 circles was regarded as the longitudinal axis of the proximal tibia (Figure 8). On a sagittal view at the middle of the medial tibial plateau, a line perpendicular to the longitudinal axis was drawn. Another line tangential to the medial tibial plateau was drawn. The angle between the 2 lines was defined as the medial PTS (Figure 9). All measurements were performed by an orthopaedic resident who was blinded to the patient group. All measurements were repeated 4 weeks later to calculate the intraobserver intraclass correlation coefficient (ICC).
Figure 8.
A sagittal image showing the tibial attachment of the posterior cruciate ligament, the intercondylar eminence, and the anteroposterior tibial cortices was chosen. The proximal circle was drawn, and its boundary was the anterior, posterior, and proximal tibial cortex bone. The boundary of the distal circle was the anterior and posterior cortex border. A line (white solid line) connecting the centers of the 2 circles was regarded as the long axis of the proximal tibia.
Figure 9.
A sagittal view was chosen at the mediolateral center of the medial tibial plateau. A line (solid line) perpendicular to the longitudinal axis of the proximal tibia was drawn. Another line (dotted line) tangential to the lateral tibial plateau was drawn. The asterisk indicates the angle between the 2 lines, which was measured as the medial posterior tibial slope.
Statistical Analysis
Age, body mass index (BMI), and PTS are reported as the mean and standard deviation. Measurements of age, BMI, and PTS were compared between the healed and nonhealed groups using the independent t test. The sample size was determined by a power analysis using G*Power (Version 3.1.9.4; Heinrich Heine University Düsseldorf). Based on data from a previous study (root tear group: mean = 4.0°, SD = 1.9°; no root tear group: mean = 2.4°, SD = 2.5°) 1 , analysis was performed with a significance level (α) of .05 and a statistical power of 80%. This resulted in a required sample size of at least 24 patients per group. Logistic regression analysis was performed to determine the risk factors for nonhealed MMPRT among age, BMI, and PTS. Data were analyzed using the SPSS statistical package, Version 25.0 (IBM). The significance level was set at .05.
Results
A total of 91 patients were enrolled during the study period. Follow-up MRI was unavailable in 11 patients. Eight patients were <30 years and suffered from concomitant ligamentous injury. After excluding 19 patients, 72 patients were included in this study.
There were 47 patients in the healed group and 25 (34.7%) in the nonhealed group. Demographic characteristics of the 2 groups are described in Table 1. Age and BMI did not differ significantly between the 2 groups (P = .763 and P = .073). PTS of the nonhealed group was significantly higher than that of the healed group (5.9°± 2.2° vs 4.4°± 2.5°; P = .017). Logistic regression analysis demonstrated that the PTS was associated with failure to heal after MMPRT repair (odds ratio [OR] = 1.31; 95% CI, 1.04–1.73; P = .022). However, age and BMI were not associated with failure to heal (OR = 0.99; 95% CI, 0.93–1.08; P = .759; OR = 0.85; 95% CI, 0.70–1.02; P = .079, respectively). The ICC for the intraobserver reliability for the PTS was 0.89 (95% CI, 0.76-0.95).
Table 1.
Preoperative Demographic Characteristics and PTS of the Healed and Nonhealed Groups a
| Healed Group n = 47 |
Nonhealed Group n = 25 |
P | |
|---|---|---|---|
| Age, years | 54.6 ± 6.7 | 55.1 ± 6.8 | .736 |
| Sex, M/F | 6/41 | 2/23 | .705 |
| BMI, kg/m2 | 25 ± 3.1 | 26.2 ± 2.7 | .073 |
| HKA angle, deg | 178.1 ± 1.7 | 177 ± 2 | .154 |
| Extrusion, mm | 2 ± 1 | 1.8 ± 1 | .45 |
| PTS, deg | 4.4 ± 2.5 | 5.9 ± 2.2 | .017 |
Data are presented as mean SD or n/n. BMI, body mass index; HKA, hip-knee-angle; PTS, posterior tibial slope.
Discussion
The most important finding of this study was that the PTS of the nonhealed group was significantly higher than that of the healed group. PTS was a risk factor for failure to heal after MMPRT repair. The hypothesis of this study was confirmed.
Meniscal repair is the most effective treatment for the MMPRT to restore hoop tension of the meniscus and prevent accelerated progression of osteoarthritis caused by loss of hoop tension. However, most MMPRT occurs in middle-aged and older individuals, and torn menisci are usually accompanied by degenerative change. Most importantly, the MMPRT is a radial tear that is subject to distraction force during weightbearing in the postoperative period. 30 Although clinical improvement was observed, extrusion was widely prevalent, with worsening progression of femoral and tibial chondral disease. 18
Meniscal healing and the resulting protection of the hoop tension are ultimate goals of MMPRT. However, the healing rate among the current papers is unsatisfactory. A systematic review reported that MMPRT repair appears to satisfy subjective outcomes. 9 However, postoperative MRI and second-look arthroscopy demonstrate a relatively high rate of incomplete healing (32.6%) or retearing and failure 9 of the construct (5%). The status of MMPRT healing affects postoperative extrusion. One study reported that patients with healed or partially healed menisci showed better extrusion correction than those with nonhealed menisci. 29 Another study reported that complete meniscal root healing is an independent risk factor correlated with the good correction of meniscal extrusion. 26 The degree of extrusion is closely associated with progression of knee osteoarthritis.
Although several risk factors for inferior clinical outcomes after MMPRT repair are reported,8,15,20 risk factors for healing of repaired MMPRT are rarely reported in the literature. Cho et al 2 reported that healing status by second-look arthroscopy after 17 MMPRT repairs was not related to age, BMI, preoperative alignment, or extrusion. However, the sample size of their study was too small. Liao et al 22 reported that age >37.5 years, BMI >24.5 kg/m2, preoperative extrusion >2.7 mm, and varus degree >3.3° were independent risk factors for incomplete meniscus root healing status.
Increased PTS has several biomechanical implications. Increased PTS shifts the resting position of the proximal tibia anteriorly, which is amplified under axial loads. This renders the knee more susceptible to anterior instability. 10 Increased PTS is known as a risk factor for noncontact ACL injury and failed ACL reconstructions.4,11 Increased PTS is also associated with the MMPRT. An increased PTS affects compression and anterior shear forces at the MMPR. 23 Si et al 28 reported that a medial tibial slope >7.4º was a risk factor correlated with MMPRT. A systematic review 7 reported that the MMPRT group had significantly increased medial PTS compared with controls (8.1°± 2.5° vs 4.3°± 0.7°; P < .001).
No literature exists on anterior closing osteotomy for protecting isolated MMPRTs. Given that MMPRTs frequently coexist with medial compartment chondral lesions, a modified hybrid closing wedge high tibial osteotomy could be a viable option to protect the repair. 19 This technique utilizes a unique hinge point to combine a lateral closed wedge and a medial open wedge, minimizing lateral bone loss while achieving greater correction. However, drawbacks include the need for a fibular osteotomy and potential instability with lateral plate fixation.
In this study, the medial PTS of the nonhealed group was 5.9°± 2.2°, which is relatively lower than previous studies.7,28 Although indications for MMPRT repair in this study were limited to patients with nearly normal alignment and a lower grade of medial compartment chondral lesion (extrusion <3 mm), medial PTS was associated with failure to heal MMPR. However, other factors may be considered as potential risk factors for nonhealing. Frequent squatting or deep flexion during activities of daily living after surgery may affect healing of the MMPRT. Increased flexion angle significantly increases medial shear forces of the MMPR from 3.8 N at 0° of knee flexion to 8.4 N at 90° of knee flexion. 23 In Asia and the Middle East, many everyday activities involve squatting, kneeling, or sitting cross-legged. 25 However, these activities may vary from patient to patient. Poor compliance with the rehabilitation protocol may be another risk factor for nonhealing of the MMPR. In this study, toe-touch weightbearing was recommended during the first 6 weeks after surgery. However, older patients may have decreased grip strength, worse balance, and decreased thigh muscle power, all of which make walking with crutches more difficult.
Limitations
Several limitations were acknowledged. The retrospective design of this study precludes establishing a causal relationship between PTS and healing after all-inside suture anchor repair. Therefore, only an association between these variables can be inferred. The sample size of this study was small; however, it does achieve adequate power. Also, 19 of 91 patients were excluded because of younger age, unavailable follow-up MRI, and concomitant ligamentous injury. This introduces a transfer bias. Because PTS measurement techniques remain controversial in the literature, 14 the chosen method may influence the outcomes of this study. However, the Hudek et al 13 method is a validated and widely accepted technique. Another limitation of this study is that PTS measurements were performed by a single observer. Although excellent intraobserver reliability was demonstrated (ICC = 0.89), interobserver reliability was not assessed. Therefore, the reproducibility of the measurements between different observers could not be evaluated. Avoidance of squatting and sitting cross-legged, and adherence to toe-touch weightbearing during the early postoperative period may vary from patient to patient. Poor compliance with the rehabilitation protocol may affect the MMPR healing rate.
Conclusion
Increased PTS was associated with failure to heal MMPRT after all-inside suture anchor repairs. This factor should be considered when counseling patients undergoing MMPRT repair.
Footnotes
Final revision submitted July 20, 2026; accepted July 26, 2026.
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Ethical approval for this study was obtained from the Nowon Eulji Medical Center, Eulji University (EMCS 2025-09-030).
ORCID iD: Bong-Seok Yang 
https://orcid.org/0000-0001-7001-4174
References
- 1. Allende F, García JR, Ayala SG, et al. Medial meniscal posterior root tears are associated with steeper medial posterior tibial slope and varus alignment. Arthrosc Sports Med Rehabil. 2024;7(1):100998. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2. Cho JH, Song JG. Second-look arthroscopic assessment and clinical results of modified pull-out suture for posterior root tear of the medial meniscus. Knee Surg Relat Res. 2014;26(2):106-113. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3. Choi NH. Editorial commentary: determinants of outcome after repair of knee medial meniscus posterior root tear are multifactorial. Arthroscopy. 2023;39(6):1384-1385. [DOI] [PubMed] [Google Scholar]
- 4. Choi NH, Lee DM, Victoroff BN. Bone morphological characteristics as risk factors for anterior cruciate ligament injury: comparison between contact and noncontact injury. Orthop J Sports Med. 2023;11(6):23259671231179757. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5. Chung KS, Ha JK, Ra HJ, Kim JG. Prognostic factors in the midterm results of pullout fixation for posterior root tears of the medial meniscus. Arthroscopy. 2016;32(7):1319-1327. [DOI] [PubMed] [Google Scholar]
- 6. Chung KS, Ha JK, Ra HJ, Kim JG. Preoperative varus alignment and postoperative meniscus extrusion are the main long-term predictive factors of clinical failure of meniscal root repair. Knee Surg Sports Traumatol Arthrosc. 2021;29(12):4122-4130. [DOI] [PubMed] [Google Scholar]
- 7. Dzidzishvili L, Allende F, Allahabadi S, Mowers CC, Cotter EJ, Chahla J. Increased posterior tibial slope is associated with increased risk of meniscal root tears: a systematic review. Am J Sports Med. 2024;52(13):3427-3435. [DOI] [PubMed] [Google Scholar]
- 8. Dzidzishvili L, López-Torres II, Arguello JM, Sáez D, Calvo E. Prognostic factors and midterm clinical outcome of transtibial pullout and partial meniscectomy for medial meniscus posterior root tears in middle-aged patients. Indian J Orthop. 2022;56(8):1457-1463. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9. Edwards C, Goldman BH, Turley J, Richey B, Deal MJ, Kalbac D. Outcomes after surgical repair of medial meniscal root tears: a review. J Knee Surg. 2021;34(14):1599-1602. [DOI] [PubMed] [Google Scholar]
- 10. Giffin JR, Vogrin TM, Zantop T, Woo SL, Harner CD. Effects of increasing tibial slope on the biomechanics of the knee. Am J Sports Med. 2004;32(2):376-382. [DOI] [PubMed] [Google Scholar]
- 11. Grassi A, Signorelli C, Urrizola F, et al. Patients with failed anterior cruciate ligament reconstruction have an increased posterior lateral tibial plateau slope: a case-controlled study. Arthroscopy. 2019;35(4):1172-1182. [DOI] [PubMed] [Google Scholar]
- 12. Hantouly AT, Aminake G, Khan AS, et al. Meniscus root tears: state of the art. Int Orthop. 2024;48(4):955-964. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13. Hudek R, Schmutz S, Regenfelder F, Fuchs B, Koch PP. Novel measurement technique of the tibial slope on conventional MRI. Clin Orthop Relat Res. 2009;467(8):2066-2072. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14. Jahn R, Cooper JD, Juhan T, et al. Reliability of plain radiographs versus magnetic resonance imaging to measure tibial slope in sports medicine patients: can they be used interchangeably? Orthop J Sports Med. 2021;9(10):23259671211033882. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15. Jiang EX, Abouljoud MM, Everhart JS, et al. Clinical factors associated with successful meniscal root repairs: a systematic review. Knee. 2019;26(2):285-291. [DOI] [PubMed] [Google Scholar]
- 16. Jung YH, Choi NH, Oh JS, Victoroff BN. All-inside repair for a root tear of the medial meniscus using a suture anchor. Am J Sports Med. 2012;40(6):1406-1411. [DOI] [PubMed] [Google Scholar]
- 17. Kamatsuki Y, Furumatsu T, Hiranaka T, et al. Epidemiological features of acute medial meniscus posterior root tears. Int Orthop. 2023;47(10):2537-2545. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18. Kaplan DJ, Bloom D, Alaia EF, et al. ICRS scores worsen between 2-year short term and 5-year mid-term follow-up after transtibial medial meniscus root repair despite maintained functional outcomes. Knee Surg Sports Traumatol Arthrosc. 2022;30(7):2235-2243. [DOI] [PubMed] [Google Scholar]
- 19. Koga H, Nakamura T, Nakagawa Y, et al. Simultaneous correction of varus deformity and posterior tibial slope by modified hybrid closed-wedge high tibial osteotomy. Arthrosc Tech. 2022Oct 20;11(11):e2081-e2089. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20. Krych AJ, Song BM, Nauert RF, III, et al. Prospective consecutive clinical outcomes after transtibial root repair for posterior meniscal root tears: a multicenter study. Orthop J Sports Med. 2022;10(2):23259671221079794. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21. Li J, Shen P, Zou T, et al. Comparison of the effects between arthroscopic transtibial pullout technique and all-inside repair in the treatment of medial meniscus posterior root tears. J Orthop. 2024;65:78-85. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22. Liao X, Li H, Nie S, Lan M. Risk factors of incomplete healing following medial meniscus posterior root tear repair with gracilis tendon. Sci Rep. 2023;13(1):22978. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 23. Melugin HP, Brown JR, Hollenbeck JFM, et al. Increased posterior tibial slope increases force on the posterior medial meniscus root. Am J Sports Med. 2023;51(12):3197-3203. [DOI] [PubMed] [Google Scholar]
- 24. Moon HS, Choi CH, Jung M, Lee DY, Eum KS, Kim SH. Medial meniscal posterior horn tears are associated with increased posterior tibial slope: a case-control study. Am J Sports Med. 2020;48:1702-1710. [DOI] [PubMed] [Google Scholar]
- 25. Mulholland SJ, Wyss UP. Activities of daily living in non-Western cultures: range of motion requirements for hip and knee joint implants. Int J Rehabil Res. 2001;24(3):191-198. [DOI] [PubMed] [Google Scholar]
- 26. Nie S, Li H, Liao X, Liu Q, Lan M. Younger patients, lower BMI, complete meniscus root healing, lower HKA degree and shorter preoperative symptom duration were the independent risk factors correlated with the good correction of MME in patients with repaired MMPRTs. Knee Surg Sports Traumatol Arthrosc. 2023;31(9):3775-3783. [DOI] [PubMed] [Google Scholar]
- 27. Okazaki Y, Furumatsu T, Kodama Y, et al. Steep posterior slope and shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tears. Knee Surg Sports Traumatol Arthrosc. 2021;29(1):44-50. [DOI] [PubMed] [Google Scholar]
- 28. Si N, Hongbo L, Jingping G, Jiayu H, Min L. Association between anatomical risk factors and medial meniscus posterior root tears: a retrospective study. BMC Musculoskelet Disord. 2025;26(1):455. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 29. Sundararajan SR, Ramakanth R, Sethuraman AS, Kannan M, Rajasekaran S. Correlation of factors affecting correction of meniscal extrusion and outcome after medial meniscus root repair. Arch Orthop Trauma Surg. 2022;142(5):823-834. [DOI] [PubMed] [Google Scholar]
- 30. Stärke C, Kopf S, Lippisch R, Lohmann CH, Becker R. Tensile forces on repaired medial meniscal root tears. Arthroscopy. 2013;29(2):205-212. [DOI] [PubMed] [Google Scholar]
- 31. Stein JM, Yayac M, Conte EJ, Hornstein J. Treatment outcomes of meniscal root tears: a systematic review. Arthrosc Sports Med Rehabil. 2020;2(3):e251-e261. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 32. Yoon KH, Bae BS, Ahn JH, Hwang SH. More than 3 mm of preoperative medial meniscal extrusion is identified as a key risk factor for varus progression in limb alignment after arthroscopic repair of medial meniscus posterior root tear. Knee Surg Sports Traumatol Arthrosc. 2024;32(9):2239-2247. [DOI] [PubMed] [Google Scholar]
- 33. Wang X, Jing L, Wang X, et al. Effects of medial meniscal slope and medial posterior tibial slope on the locations of meniscal tears: a retrospective observational study. Medicine (Baltimore). 2020;99(47):e23351. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 34. Zhang X, Furumatsu T, Okazaki Y, et al. High body mass index is a risk factor for unfavorable clinical outcomes after medial meniscus posterior root repair in well-aligned knees. J Orthop Sci. 2021;26(3):430-434. [DOI] [PubMed] [Google Scholar]