Comparison of Isolated Meniscus Repair Versus Combined Meniscus Repair and Notch Microfracture: A Randomized Controlled Trial Evaluating Functional and Imaging Outcomes

Meniscal tears are the most common injury among musculoskeletal injuries. The incidence rate has varied across different studies in Europe, with a mean incidence of 60 to 70 per 100,000 annually. Despite advanced meniscal repair techniques, the failure rates are still 20-24% within two years, rising to 26% in medial tears.

Outcomes improve significantly when repair is combined with ACL reconstruction, where healing rates increase up to 93%, likely due to the biologically enriched environment created by bone tunnels and associated release of growth factors. The microfracture technique reproduces this environment by making small channels in the intercondylar notch of the femur that release marrow-derived factors to enhance healing.

Retrospective studies have been undertaken comparing the two repair methodologies. However, prospective comparative studies have not yet been explored in human populations.

This study aims to compare the functional and imaging outcomes of meniscus repair with notch microfracture in comparison with meniscal repair alone through a randomized controlled trial.

Although meniscal preservation is considered essential for long-term knee function, isolated repairs continue to show high failure rates. Evidence of superior outcomes when repair is combined with ACL reconstruction highlights the importance of a biologically enriched intra-articular environment. Microfracture replicates this environment by releasing stem cells and growth factors into the joint.