Meniscus Root Repair for Meniscus Tears

Enrolling by invitation at 1 trial location

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Mayo Clinic

Disqualifiers: Subchondral collapse, Obesity, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: Surgical procedure

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new method to treat meniscus root tears in the knee using the transtibial pullout technique. The goal is to determine if this treatment can effectively repair the tear and potentially slow arthritis progression. Individuals with a meniscus root tear, who have also experienced ligament injuries or undergone corrective bone surgery, might be suitable candidates for this trial. As an unphased trial, it offers participants the chance to contribute to innovative research that could lead to improved treatment options.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that the transtibial pullout technique is safe for meniscus root repair?

Research has shown that the transtibial pullout technique for repairing a torn meniscus in the knee is generally safe, though some risks exist. One study found that about 9.7% of patients required additional surgery after their initial repair, indicating that most did not face major issues necessitating another procedure. Another study found that this technique enhances knee stability and can slow the progression of arthritis. While it often improves knee function, it may carry a higher risk of complications compared to other methods. Overall, the treatment appears well-tolerated, with many patients experiencing improved outcomes. ^{1 2 3 4 5}

Why are researchers excited about this trial?

The transtibial pullout technique for meniscus root repair is unique because it focuses on preserving the natural biomechanics of the knee, which can potentially lead to better long-term outcomes compared to traditional methods like partial meniscectomy or non-operative management. This technique involves threading sutures through a tunnel in the tibia to reattach the torn meniscus root, thereby restoring its function more completely. Researchers are excited about this approach as it aims to reduce the risk of further joint degeneration and improve knee stability and function, which are common issues with current treatment options.

What evidence suggests that the transtibial pullout technique is effective for meniscus root tears?

Research has shown that the transtibial pullout repair technique, evaluated in this trial, can improve short-term outcomes for individuals with tears in the meniscus root, a crucial knee component. Studies have found that this method aids in better healing of the meniscus and slows its displacement from the normal position. It also helps maintain the knee joint space, which is vital for preventing arthritis. Compared to other methods, this approach may yield better results in both medical check-ups and X-ray evaluations. Overall, the transtibial pullout technique appears to be a promising option for effectively treating meniscus root tears. ^{3 6 7 8 9}

Who Is on the Research Team?

Daniel Saris, MD

Principal Investigator

Mayo Clinic

Are You a Good Fit for This Trial?

This trial is for individuals aged 18-65 with a specific type of knee injury called meniscus root avulsion tear. It's suitable even if they have other ligament injuries or need bone alignment correction. However, it's not for those who are very obese (BMI over 40), have advanced arthritis (Kellgren Lawrence > grade 2), are on worker's compensation, or have certain severe knee conditions noted in pre-op assessments.

Inclusion Criteria

Meniscus root avulsion tear (defined as meniscus posterior horn root avulsion or full thickness tear within 9 mm of the root attachment)

Age 18-65

It is okay if you have undergone a corrective surgery for bone misalignment.

Exclusion Criteria

Obesity with BMI over 40

Kellgren Lawrence > grade 2

Worker's compensation status

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo meniscus root repair using a transtibial pullout technique

Surgical procedure

Follow-up

Participants are monitored for clinical and radiographic outcomes after the surgical procedure

2 years

What Are the Treatments Tested in This Trial?

Interventions

• Transtibial pullout technique

Trial Overview Surgeons in this study will use the transtibial pullout technique to repair meniscus root tears and evaluate its effectiveness. They aim to see if this method can delay arthritis progression in the affected area and identify factors that might predict less favorable outcomes.

How Is the Trial Designed?

Group I: Transtibial pullout technique Experimental Treatment 1 Intervention

Evaluation of the clinical and radiographic outcomes for patients undergoing a meniscus root repair (MRR) using a transtibial pullout technique.

Who Is Running the Clinical Trial?

Mayo Clinic

Lead Sponsor

Trials

3,427

Recruited

3,221,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11604777/

Transtibial pullout repair improved short-term clinical ... Transtibial pullout repair improved short-term clinical outcomes in patients with oblique medial meniscus posterior root tear comparable to ...

2. arthroscopytechniques.org arthroscopytechniques.org/article/S2212-6287(23)00081-6/fulltext

Top Ten Pearls for a Successful Transtibial Pull-Out Repair ... The authors describe a detailed checklist with 10 crucial points of emphasis when performing the gold-standard transtibial pull-out repair of the MMPR.

3. sciencedirect.com sciencedirect.com/science/article/pii/S0972978X24004318

Comparison of the effects between arthroscopic transtibial ... This study compared the efficacy of the arthroscopic Transtibial pullout technique and the All-inside repair method for treating medial meniscus posterior root ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10854085/

Superior outcomes of pullout repairs for medial meniscus ... Partial medial meniscus posterior root tears showed better meniscal healing and less medial meniscus extrusion progression following pullout repair.

5. arthroscopyjournal.org arthroscopyjournal.org/article/S0749-8063(24)00152-X/fulltext

Root Repair Has Superior Radiological and Clinical ... Current evidence suggests root repair may be the most effective treatment strategy in lessening joint space narrowing of the knee and producing improvements in ...

6. arthroscopytechniques.org arthroscopytechniques.org/article/S2212-6287(24)00224-X/fulltext

Transtibial Pullout for Medial Meniscus Posterior Root ... Similarly, LaPrade et al. reported a 9.7% failure rate and need for revision after repair of MMPRT using the transtibial pullout technique.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11700375/

A Systematic Review and Meta-Analysis of Medial Meniscus ... Repair strategies, particularly the transtibial pull-out technique, have shown favorable outcomes in restoring knee stability and preventing OA ...

8. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40083750/

Outcomes After Isolated Medial Meniscus Posterior Root ... Anatomic transtibial pullout repair for isolated MMPR tears resulted in improved IKDC, KOOS JR, and VR-12 Physical scores at minimum 2-year follow-up.

9. mdpi.com mdpi.com/2077-0383/14/20/7440

Short-Term Outcomes After Transtibial Repair of Medial ... Biomechanical studies have shown that a torn root has effects similar to a total meniscectomy and is associated with rapid progression to osteoarthritis (OA) as ...