Arthroscopy - 2026-09-16 - Journal Article
Postmenopausal Status Is Associated With Increased Risk of Medial Meniscus Posterior Root Tears and Subsequent Arthroplasty.
Panos JA, Teubner L, Long K, Tagliero AJ, Hevesi M, Saris DBF, Nagelli CV, Krych AJ
Topics
Key Takeaway
Postmenopausal women with medial meniscus posterior root tears have significantly lower 10-year arthroplasty-free survival compared to age- and BMI-matched men (53.5% vs. 78.4%, P=.02).
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Summary
This study examined whether postmenopausal status confers independent risk for MMPRT and accelerated arthroplasty progression by comparing 782 postmenopausal women to age- and BMI-matched men within a single-institution meniscal tear registry. MMPRTs occurred in 15.6% of the cohort (n=244); age and female sex were independent predictors of MMPRT, while surgical menopause, earlier age at menopause, HRT use, and bone mineral density were MMPRT risk factors specific to women. Among MMPRT patients, female sex independently predicted arthroplasty conversion, with 10-year arthroplasty-free survival of 53.5% in women versus 78.4% in men (P=.02).
Key Limitation
Treatment allocation (repair vs. meniscectomy vs. nonoperative) is not reported or controlled for, making it impossible to determine whether the sex disparity in arthroplasty-free survival reflects biological vulnerability or differential surgical management.
Original Abstract
PURPOSE
To identify risk factors for medial meniscus posterior root tears (MMPRT) and arthroplasty-free survival in postmenopausal women, while secondary objectives included analyzing menopause-specific factors associated with MMPRT and defining risk factors for conversion to arthroplasty in patients with a confirmed MMPRT.
METHODS
All patients at our institution with a diagnosed meniscal tear through December 2024 were identified. From this cohort, women with a menopausal diagnosis preceding their meniscal tear were matched one-to-one with men by age and body mass index. Imaging studies were reviewed to identify MMPRTs. Subsequent arthroplasty, Charlson Comorbidity Index, menopausal type (surgical or physiologic), hormone replacement therapy, bisphosphonate usage, and bone mineral density were recorded. Logistic and Cox regression were used to define risk factors for MMPRT and arthroplasty; survivorship was determined using Kaplan-Meier analyses.
RESULTS
The final cohort consisted of 1564 patients (n = 782 women) with a median age of 63 years, of which 244 patients (15.6%) had MMPRT. Age and female sex were associated with MMPRT. The presence of an MMPRT, female sex, body mass index, and Charlson Comorbidity Index were associated with arthroplasty. Among postmenopausal women, age at menopause, surgical menopause, hormone replacement therapy, and bone mineral density were associated with MMPRT. For patients with MMPRT, female sex was associated with arthroplasty. Ten-year survivorship-free from arthroplasty in patients with MMPRT was 53.5% for women and 78.4% for men (P = .02).
CONCLUSIONS
Postmenopausal status, age, and hormone replacement therapy usage are risk factors for MMPRT. Compared with men, postmenopausal women with MMPRT exhibit reduced arthroplasty-free survival, underscoring the need for targeted interventions.
LEVEL OF EVIDENCE
Level III, retrospective comparative study.