The Effect of Centralization on Medial Meniscal Extrusion for Medial Meniscus Posterior Root Tear Repair

The purpose of this research is to determine if meniscus root repair with or without centralization will have an impact on postoperative pain, function, activity levels, patient satisfaction, and incidence of revision meniscus surgery.

Study Overview

• Status: Enrolling by invitation
• Conditions: Meniscus Tear
• Intervention / Treatment: Procedure: Medial meniscus posterior root tear (MMPRT) repair with meniscus centralization; Procedure: Medial meniscus posterior root tear (MMPRT) repair without meniscus centralization

• Study Type: Interventional
• Enrollment (Estimated): 54
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Colorado
    • West Vail, Colorado, United States, 81657
      • The Steadman Clinic
  • Florida
    • Naples, Florida, United States, 34110
      • Hospital for Special Surgery at Naples Comprehensive Health (HSS at NCH),
  • Minnesota
    • Rochester, Minnesota, United States, 55902
      • Mayo Clinic

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Type 2 Medial Meniscus Posterior Root Tear demonstrated on MRI
• Notable extrusion (>3 mm) on preoperative MRI
• Patient able to consent for themselves
• Patient agrees to comply with trial schedules and plan

Pre-operative Exclusion:

• Concomitant ligamentous or meniscal procedures
• Meniscal extrusion > 6 mm on pre-operative MRI
• Kellgren-Lawrence grade > 2
• Varus malalignment > 10 degrees
• Asymmetric varus alignment > 5 degrees
• Varus thrust while weightbearing
• Grade 3 bipolar medial compartment changes (isolated grade 3 changes on single articular surface with ≤ grade 2 changes on the opposing surface remains eligible)
• Previous surgery of the affected knee
• Associated fractures requiring surgery
• Concurrent Vascular injuries
• Hypermobility/Ehlers-Danlos Syndrome
• Inflammatory or autoimmune disease
• Severe mental/physical disability precluding post operative rehabilitation demands
• Contraindications to MRI
• Pregnant women

Arthroscopy Inclusion Criteria:

• Complete radial tears within 9 mm of medial meniscus posterior root
• ICRS Grade 3 or better

Arthroscopy Exclusion Criteria:

• Requiring concomitant procedures other than MMPRT
• ICRS Grade 4 changes

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Repair with meniscus centralization; Medial meniscus posterior root tear (MMPRT) surgical repair with meniscus centralization	Procedure: Medial meniscus posterior root tear (MMPRT) repair with meniscus centralization; The centralization technique involves placement of 1.8-mm Knotless FiberTak suture anchors along the periphery of the tibial plateau, starting from the posteromedial corner and progressing anteriorly. The anchors are deployed using a curved drill guide, and sutures are passed in a mattress configuration to re-tension the meniscotibial ligament to centralize the meniscus. Once centralization is complete, the posterior root tear is repaired using an anatomic suture anchor for aperture medial meniscus root fixation.
Active Comparator: Repair without centralization; Medial meniscus posterior root tear (MMPRT) surgical repair without centralization	Procedure: Medial meniscus posterior root tear (MMPRT) repair without meniscus centralization; The posterior root tear is repaired using an anatomic suture anchor for aperture medial meniscus root fixation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Meniscus extrusion measurement	Meniscus extrusion is measured in millimeters (mm) on coronal MRI at the level of the tibial spine	Baseline (Preoperatively), 6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Kellgren-Lawrence grade on X-ray	The Kellgren-Lawrence (KL) system is a 0-4 scale used to grade the severity of knee osteoarthritis (OA) based on X-ray. It ranges from Grade 0 (no changes) to Grade 4 (severe).	Baseline (Screening), 12 months, 24 months
Change in Tegner Activity Score	The Tegner Activity Questionnaire is a 1-item questionnaire rating physical activity from 0 (Disabled) to 10 (Elite competitive athlete). Total scores range from 0 - 10, with higher scores indicating a higher level of activity.	Baseline, 2 weeks, 6 weeks, 3 months, 6 months, 12 months, 24 months
Change in Visual Analog Scale (VAS) Questionnaire score	The VAS is a 2-item questionnaire assessing pain using a scale of 0 (No pain) to 10 (Worst pain). Total scores range from 0 - 10, lower scores indicating lower pain and higher scores indicating greater pain.	Baseline, 2 weeks, 6 weeks, 3 months, 6 months, 12 months, 24 months
Change in Knee Injury and Osteoarthritis Outcome Score Jr. (KOOS, JR) Questionnaire score	The KOOS JR is a questionnaire designed to measure outcomes for patients with knee replacements. Questions focus on knee stiffness, pain, and function for daily activities and are assessed on a 5 point Likert-scale between 0 (None) and 4 (Extreme). Total scores range from 0 - 28, with higher scores indicating a greater impact of pain on daily functioning.	Baseline, 2 weeks, 6 weeks, 3 months, 6 months, 12 months, 24 months
Change in International Knee Documentation Committee (IKDC) Questionnaire score	The International Knee Documentation Committee (IKDC) Subjective Knee Evaluation assesses overall function over 3 domains: symptoms, athletic activity, and knee function. Higher scores indicate higher levels of function and lower levels of symptoms.	Baseline, 2 weeks, 6 weeks, 3 months, 6 months, 12 months, 24 months
Change in Likert Knee Questionnaire score	The Likert Knee Questionnaire is a 1-item survey asking the patient to rate knee pain post-surgery on a Likert scale where 0 (Much better than before surgery) and 5 (Much worse than before surgery).	Baseline, 2 weeks, 6 weeks, 3 months, 6 months, 12 months, 24 months
Surgery Satisfaction Questionnaire	The Surgery Satisfaction Questionnaire is a 1-item survey asking the patient to rate satisfaction with knee surgery on a Likert scale where 0 (Not at all) and 10 (Most Satisfied).	2 weeks, 6 weeks, 3 months, 6 months, 12 months, 24 months

Collaborators and Investigators

• Sponsor: Mayo Clinic
• Investigators: Principal Investigator: Aaron J. Krych, MD, Mayo Clinic

Study record dates

Study Major Dates

• Study Start (Actual): February 17, 2026
• Primary Completion (Estimated): September 1, 2028
• Study Completion (Estimated): March 1, 2030

Study Registration Dates

• First Submitted: January 28, 2026
• First Submitted That Met QC Criteria: January 28, 2026
• First Posted (Actual): February 5, 2026

Study Record Updates

• Last Update Posted (Actual): April 13, 2026
• Last Update Submitted That Met QC Criteria: April 8, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Meniscus tear; Meniscus extrusion; Medial meniscus root repair; Meniscus centralization
• Additional Relevant MeSH Terms: Biological Phenomena; Regeneration; Wound Healing
• Other Study ID Numbers: 25-011455

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No