The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Outcomes of Meniscal Repairs in Patients Aged 40 Years or Older: A Retrospective Case Series Comparing Failure and Successful Repair

Document Type : RESEARCH PAPER

Authors
Anna M. Ifarraguerri 1
Ainsley K. Bloomer 2
Kirby W. Bonvillain 2
Kennedy K. Gachigi 3
Alexander N. Berk 3
Joshua D. Meade 1
Madilyn L. Feik 4
Michael S. Collins 4
Claude T. Moorman 2
Dana P. Piasecki 1
James E. Fleischli 1
Patrick N. Siparsky 3
Bryan M. Saltzman 3
1 OrthoCarolina Sports Medicine Center, Charlotte, North Carolina, US -OrthoCarolina Research Institute, Charlotte, North Carolina, US -Atrium Health – Musculoskeletal Institute, Charlotte, North Carolina, US
2 Atrium Health – Musculoskeletal Institute, Charlotte, North Carolina, US
3 Indiana University Health Physicians, Orthopedics & Sports Medicine, Indianapolis, Indiana, US - Indiana University School of Medicine, Department of Orthopaedic Surgery, Indianapolis, Indiana, US
4 Indiana University Health Physicians, Indianapolis, IN, US
10.22038/abjs.2026.93091.4215
Abstract
Objectives: Meniscal repair has become common as meniscectomies have fallen out of favor, yet the growing body of literature has not fully assessed outcomes in older patients. The purpose of this study is to report outcomes among patients aged 40 years or older following meniscus repair.
Methods: An administrative database from a single academic institution was queried using Current Procedural Terminology codes to identify patients who underwent meniscal repair between 2010 and 2018. Patients aged 40 years or older with a minimum two-year follow-up after primary meniscal repair were included. Complications, repair failure, and patient-reported outcomes were collected.
Results: Of the 179 included patients, 68 (38%) experienced meniscal repair failure, 41 (22.9%) underwent reoperation, and 9 (5%) were converted to total knee arthroplasty. The Knee Injury and Osteoarthritis Outcome Score (KOOS) Quality of Life subscale was lower in the repair failure cohort (odds ratio (OR) -14.33; 95% confidence interval (CI) -28.06 to -0.61; P=0.041). Patients with meniscal repair failure had higher complication rates (48 (70%)) than patients without meniscal failure (28 (18%)) (OR 7.11; 95% CI 3.62 to 13.97; P<0.001). On multivariate analysis, postoperative complications were significantly associated with meniscal repair failure (OR 6.22; 95% CI 3.1 to 12.47; P<0.001), and a cumulative effect analysis revealed a stepwise relationship between the risk of repair failure and the number of complications.
Conclusion: Patients aged 40 years or older experienced a 38% meniscal repair failure rate, with a significant association between postoperative complications and repair failure. Surgeons can anticipate that at least one-third of patients in this demographic will experience repair failure and consider the number of complications associated with repair failure risk.
Level of evidence: IV
Keywords
Age
Meniscus repair failure
Meniscus tear
Subjects
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The Archives of Bone and Joint Surgery
Volume 14, Issue 11
November 2026
Pages 711-721

  • Receive Date 06 December 2025
  • Revise Date 14 May 2026
  • Accept Date 11 July 2026