Isolated Medial Meniscus Root Tears Show Elevated Posterior Tibial Slope and Pain Interference Scores Especially in Females

PURPOSE: To understand the effect of tibial slope and translation on patient-reported outcomes (PROs) with isolated meniscal root tears compared with a cohort of isolated nonroot meniscus tears. METHODS: A retrospective chart review was conducted on all patients who underwent isolated knee arthroscopy for meniscal repair or debridement, excluding those with concurrent knee pathologies, from a single-surgeon patient repository at a high-volume academic institution between 2020 and 2024. The inclusion process for the root tear cohort was defined as patients with an isolated root tear or radial tear within 1 cm of the root. The control group were randomly selected patients with isolated nonroot tear meniscal injuries. If the patient possessed an additional tear meniscal tear or concomitant injury, they were excluded. Medial posterior tibial slope (MPTS), lateral posterior tibial slope (LPTS), static anterior tibial translation (SATT) were measured using radiograph lateral view, and PROs, including pain, single assessment numeric evaluation, International Knee Documentation Committee (IKDC), Patient-Reported Outcome Measurement Information System (PROMIS) were recorded. The minimum time for follow-up for inclusion is 2 years. RESULTS: Patients in the root tear (n = 63, average age 52.59) cohort showed significantly higher MPTS (12.00 vs 9.73; P < .01), LPTS (11.71 vs 9.89; P = .03), and PROMIS Pain Interference (66.39 vs 63.05; P = .03) scores at time of presentation compared with those in the nonroot tear cohort (n = 63, average age 57.72). Furthermore, minimal clinically important difference analysis illustrated that 30.51% of patients with root tears were greater than or equal to the threshold (70.02) compared with 29.82% in the nonroot tears cohort (67.43) with respect to initial PROMIS Pain Interference scores. SATT (3.88 vs 3.87) scores were found not to be significantly different (P = .73) between the root tear and nonroot tear. When each tear cohort is stratified by gender, data showed that female patients with root tears exhibited statistically significantly higher MPTS (P < .02), with a mean angle of 12.5°, compared with all other subgroups. The average follow-up time for the root and nonroot tear cohorts was approximately 9 (.4-30.4) and 7 (0-30.7) months, respectively. CONCLUSIONS: Overall, this study shows that patients with isolated meniscal root tears had higher MPTS, LPTS, and initial PROMIS Pain Interference scores than patients with other types of meniscus tears. Upon gender stratification, female patients with isolated meniscal root tears had the highest MPTS values compared with the male cohort. Further, female patients in the matched nonroot tear cohort had lower function pain scores, lower initial IKDC scores, and higher initial PROMIS Pain Interference scores compared with matched cohort males with nonroot tears. LEVEL OF EVIDENCE: Level III, comparative case series.