Comparison of the effects between arthroscopic transtibial pullout technique and all-inside repair in the treatment of medial meniscus posterior root tears

Background: Medial meniscus posterior root tears (MMPRTs) significantly contribute to knee dysfunction, leading to abnormal biomechanics and accelerated cartilage degeneration. Arthroscopic transtibial pullout and all-inside repair are two commonly used techniques for treating MMPRTs, each with unique advantages and limitations. Objective: To compare the clinical and functional outcomes of the transtibial pullout and all-inside repair techniques in the treatment of MMPRTs, with a focus on postoperative recovery, knee function, and complications. Methods: 40 patients with MMPRTs were randomized to undergo either the transtibial pullout or all-inside repair technique. Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC) score, Tegner activity scale, Lysholm score, and active range of motion (AROM) of knee flexion, both before and after surgery. Data on operative time, time to ambulation, hospital stay duration, and complications were also collected. Results: Both surgical groups showed significant improvements in clinical outcomes postoperatively (p < 0.001). The transtibial group exhibited greater functional recovery, with IKDC, Tegner, and Lysholm scores improving by approximately 60 %, 110 %, and 68 %, respectively, compared to the all-inside group. However, complications were more frequent in the transtibial group, including three cases of wound healing issues and one infection, while the all-inside group had one case of deep vein thrombosis. No re-tears were observed in either group during follow-up. Conclusion: Both the transtibial pullout and all-inside repair techniques effectively restore knee function in patients with MMPRTs. While the transtibial pullout provides better functional outcomes, it is associated with a higher complication rate. The choice of surgical approach should consider patient-specific factors, including tear characteristics and overall health, to optimize results.