The Presence of Chondral Pathology Is Not Associated With an Increase in Meniscal Root Retear, Reoperation, or Subsequent Total Knee Arthroplasty Rates

Purpose To identify whether chondral pathology is associated with an increase in failure rates of isolated meniscal root repairs. Methods We retrospectively reviewed meniscus repairs from 2012 to 2022 at the author's institution. Nonroot repairs and cases with total or same compartment meniscectomy, cartilage restoration, osteotomy, or other concurrent ligament repair or reconstruction were excluded. Chondral pathology was defined as any abnormal finding in the articular cartilage of the medial, lateral, or patellofemoral compartments. We defined repair failure as clinical evidence of retear with magnetic resonance imaging confirmation, subsequent reoperation, or conversion to total knee arthroplasty (TKA). No minimum follow‐up time was established, but each case was followed to the most recent pertinent orthopaedic follow‐up. Fisher's two‐tailed exact test was used to determine significance. Results Sixty‐three isolated meniscus repairs (63 medial, 0 lateral) were included, of which 51 (81.0%) had existing chondral pathology. Five patients (7.9%) underwent reoperation, six (9.5%) had evidence of retear, and three (4.8%) had a subsequent TKA. Medial tears accounted for 100% (6/6) of retears. There was a failure rate of 11.8% (6/51) for repairs with existing chondral pathology. There was no significant difference in clinical retear rate (11.8% vs 0%, P = 1.000), reoperation rate (9.8% vs 0%, P = 1.000), or subsequent TKA rate (5.9% vs 0%, P = .476) with or without existing chondral pathology at the time of repair, respectively. 100% (3/3) of subsequent TKAs had existing chondral pathology at the time of repair. Conclusions In this study, we did not find a statistically significant difference in meniscal root retear, reoperation, or subsequent TKA rates with or without existing chondral pathology. Level of Evidence Level IV, retrospective therapeutic case series.