Posterior Tibial Slope Is Not Associated With Failure After Medial Meniscus Posterior Root Tear Repair at a Minimum 2‐Year Follow‐Up

Purpose To examine the relation between posterior tibial slope (PTS) and failure after medial meniscus posterior root tear (MMPRT) repair. Methods Patients who underwent isolated primary arthroscopic transtibial pullout MMPRT repair between 2012 and 2022 at a single institution and with a minimum 2‐year follow‐up were retrospectively identified. Patients were grouped into high (PTS ≥ 12°), intermediate (PTS 8°‐11°), and low (PTS ≤ 7°) categories. Failure was defined as repeat ipsilateral knee arthroscopy or conversion to knee arthroplasty. A Kaplan‐Meier curve and log‐rank test were employed to analyze the relation between PTS and MMPRT repair failure. Results A total of 74 patients (77% women) with a mean age of 52.3 ± 9.3 years (range 23.5‐73.3 years) with a minimum 2‐year follow‐up were identified. The mean follow‐up time was 4.8 years (range 2.4‐7.8 years) in the failure group and 6.2 years (range 3.4‐9.2 years) in the nonfailure group ( P = .004). The mean follow‐up was 6.21 ± 1.74 years in the high PTS group, 5.91 ± 1.64 years in the intermediate group, and 5.50 ± 1.81 years in the low group ( P = .478). The overall failure rate was 15/74 (20.3%) at a median (interquartile range) of 2.70 (0.80‐5.19) years. No significant differences in time to failure were observed among PTS groups. The median (interquartile range) surgery‐free survival time was 6.2 (4.6‐7.8) years in the high PTS group (n = 22; 5 failures), 6.2 (4.7‐7.8) years in the intermediate PTS group (n = 38; 8 failures), and 5.5 (3.9‐7.2) years in the low PTS group (n = 14; 2 failures) ( P = .91). There were also no significant differences in coronal alignment among PTS groups. Conclusions In this study, PTS was not significantly associated with failure rates or time to failure after isolated MMPRT repair. Level of Evidence Level III, therapeutic retrospective comparative study.