Comparison of the therapeutic effects of palliative all-inside suture technique and pull-out reconstruction technique in the treatment of medial meniscus posterior root tear

Objective: To investigate the clinical efficacy of palliative suture technique that suture the posterior root to the posterior cruciate ligament and pull-out reconstruction technique in the treatment of medial meniscus posterior root tear (MMPRT). Methods: A total of 59 patients with MMPRT who received surgical treatment in our hospital From September 2022 to July 2024 were included in this study, and were divided into the palliative suture group and the Pull-out reconstruction group according to different treatment technique. In the palliative suture group, there were 26cases, 9 males and 17 females, aged 54.49±2.57 years, disease course 7.75±4.75 weeks; In the Pull-out reconstruction group，there were 33 cases, 15 males and 18 females, age of 55.29±2.23 years, disease course 6.46±3.54 weeks. Clinical outcomes were assessed using International Knee Documentation Committee Subjective Knee Form (IKDC) and Lysholm functional questionnaire. The progression of arthritis, meniscus extraction and meniscus healing were evaluated through X-ray and MRI examinations of the knee joint. Results: There was no statistically significant difference in the IKDC score and Lysholm score two years after surgery between two groups (palliative suture group vs pull-out reconstruction group: IKDC score 70.58±2.70 vs 71.03±2.03 p=0.135; Lysholm score: 73.96±4.73 vs 73.21±2.99 p=0.461), And there is no statistical difference in the comparison of each sub-item. There was no statistically significant difference in the incidence two years after surgery between the two groups (palliative suture group vs Pull-out reconstruction group: 76.92% vs 57.58% p=0.083) ; while there was statistically significant difference in the degree of extraction (palliative suture group vs pull-out reconstruction group: 3.75±0.74mm vs 3.33±0.81mm p=0.041). There was no statistically significant difference in the meniscus healing results between the two groups after surgery (palliative suture group vs Pull-out reconstruction group: Complete healing was achieved in 14 cases 53.85%), partial healing in 10 cases 38.46%), and non-healing in 2 cases (7.69%) vs complete healing in 17 cases (51.52%), partial healing in 15 cases (45.45%), and non-healing in 1 case (3.03%), p=0.549). Conclusion: The palliative all-inside suture technique is similar to Pull-out reconstruction in improving knee joint function and imaging outcomes in patients with MMPRT. It is a good supplement to the MMPRT repair techniques. However, considering that the palliative suture method is not an anatomical reconstruction of the posterior root of the medial meniscus, it is not recommended to use this technique as a routine technique for MMPRT repair.