Weight loss enhances meniscal healing following transtibial pullout repair for medial meniscus posterior root tears

PurposeThis study investigated the impact of weight change on the success of transtibial pullout repair for medial meniscus (MM) posterior root tears (MMPRTs).MethodsThe study included 129 patients diagnosed with MMPRTs who had undergone transtibial pullout repair. The patients were screened between July 2018 and November 2021. Patient-reported outcomes were assessed preoperatively and at 12 months postoperatively using the Knee injury and Osteoarthritis Outcome Score (KOOS). MM extrusion (MME) and Delta MME (postoperative MME - preoperative MME) were calculated preoperatively and at 12 months postoperatively using magnetic resonance imaging.ResultsPatients were divided into weight loss (body mass index [BMI] decrease of at least 0.5 kg/m2 after primary repair; n = 63) and weight gain (BMI increase of at least 0.5 kg/m2; n = 66) groups. Both groups had similar demographic variables and preoperative clinical scores; patient-reported outcomes significantly improved postoperatively. The weight loss group had significantly greater improvement in KOOS-quality of life (weight loss, 29.4 +/- 23.7; weight gain, 23.9 +/- 27.6; p = 0.034), lower postoperative MME (weight loss, 3.9 +/- 1.7 mm; weight gain, 4.2 +/- 1.2 mm; p = 0.043) and lower Delta MME (weight loss, 0.8 +/- 0.8 mm; weight gain, 1.2 +/- 0.9 mm; p = 0.002) than the weight gain group. Total arthroscopic healing scores (weight loss, 7.6 +/- 1.0; weight gain, 7.2 +/- 1.5; p = 0.048) and associated subscales, including anteroposterior bridging tissue width (weight loss, 4.0 +/- 0.0; weight gain, 3.8 +/- 0.7; p = 0.004) and MM posterior root stability (weight loss, 2.6 +/- 0.7; weight gain, 2.4 +/- 0.7; p = 0.041), significantly differed between the groups.ConclusionsWeight loss was associated with better meniscal healing and less MME progression after MMPRT repair, highlighting the significance of weight management in individuals undergoing meniscal surgery. These findings provide valuable insights into the clinical significance of weight loss in the success of transtibial pullout repair for MMPRTs.Level of EvidenceLevel III.