Preoperative Knee Bone Marrow Edema Is Associated With Poor Clinical Outcomes Following Posterior Medial Meniscal Root Repair

PURPOSE: To determine if preoperative femoral or tibial bone marrow edema (BME) is indicative of higher rates of re-tear and conversion to total knee arthroplasty (TKA) after posterior medial meniscal root tear repair, and, secondarily, whether preoperative BME impacted patient-reported outcome measures and rates of infection and arthrofibrosis. METHODS: Patients that underwent posterior medial meniscal root tear repair between 2013 and 2021 with a 2-year minimum follow-up were retrospectively analyzed. Primary outcome measures included re-tears and TKA conversion. Secondary outcomes included International Knee Documentation Committee (IKDC) score and Lysholm score, infection, and arthrofibrosis. Cohort-specific minimally clinically important difference and Patient Acceptable Symptomatic Scale rates were calculated. Two-tailed t-tests, Wilcoxon rank-sum tests, and Fisher's exact tests were used where appropriate. RESULTS: The study population consisted of 97 knees (74 without BME [NBME], 23 with BME) with average follow-up of 38.9 months (24-68). Preoperatively, the NBME group had higher IKDC scores (P = .008). Postoperatively, the NBME group had higher IKDC scores at 6 months, 1 year, and 2 years (84.5 [6.0] vs 68.5 [11.0]) (P = .041,