Editorial Commentary: Concomitant Osteotomy and Meniscus Centralization Should Be Considered in Selected Patients Undergoing Medial Meniscus Posterior Root Repair

Medial meniscus posterior root tears (MMPRTs) are associated with severe biomechanical consequences (loss of hoop force transmission) that are broadly equivalent to a total meniscectomy. The resultant increase in contact pressures predisposes to high rates of advanced medial compartment arthritis at long-term follow-up. Repair of MMPRTs is associated with significantly better outcomes than partial meniscectomy or nonoperative treatment (including improved patient-reported outcome measures and delay or even avoidance of arthroplasty). However, some patients may benefit from the addition of concomitant procedures (including osteotomy and meniscus centralization) to improve clinical outcomes and mitigate modifiable risk factors for failure of MMPRT repair. Although high-quality comparative studies are lacking, this strategy is supported by biomechanical data, clinical studies (including second-look arthroscopy data), and international consensus group statements.