Residual meniscal extrusion was not associated with 2-year clinical outcomes after posterior lateral meniscus root repair in a cohort predominantly undergoing anterior cruciate ligament reconstruction

INTRODUCTION/OBJECTIVES: The clinical significance of residual meniscal extrusion after posterior lateral meniscus root repair, particularly with concomitant anterior cruciate ligament (ACL) reconstruction, remains uncertain. This study evaluated longitudinal clinical and imaging outcomes after transtibial pull-out repair of traumatic posterior lateral meniscus root tears and examined whether residual extrusion was associated with the final Lysholm score or change from baseline at 2-year follow-up. METHODS: Thirty patients with arthroscopically confirmed traumatic posterior lateral meniscus root tears underwent transtibial pull-out repair and completed 2-year follow-up; 28 underwent concomitant ACL reconstruction. Lysholm scores were obtained preoperatively and at 3, 6, 12, and 24 months. Residual extrusion was measured once on 1.5-T magnetic resonance imaging at 24 months. Associations of extrusion with the postoperative score and score change were assessed using Spearman correlation. A sensitivity analysis was restricted to patients with concomitant ACL reconstruction. RESULTS: [4] = 120.0; p < 0.0001; Kendall W = 1.00). Twenty-nine patients (96.7%) reported returning to their preinjury recreational sport. Mean residual extrusion was 2.06 ± 0.51 mm. Extrusion was not statistically significantly associated with the 24-month Lysholm score (Spearman ρ = -0.13; 95% confidence interval, -0.48 to 0.25; p = 0.495) or change from baseline (ρ = 0.18; p = 0.340). Results were similar in the sensitivity analysis of the 28 patients with concomitant ACL reconstruction. CONCLUSION: In this small cohort, predominantly comprising patients treated with combined meniscal root repair and ACL reconstruction, Lysholm scores improved over 2 years. Within the limited observed extrusion range of 1.20-3.15 mm, no statistically significant association with clinical outcomes was demonstrated. LEVEL OF EVIDENCE: IV.