Editorial Commentary: Treatment Options for Medial Meniscal Root Tears Include Repair, With High Tibial Osteotomy When Indicated, and Reconstruction for Irreparable Tears.

Medial meniscal root tears (MMRTs) are currently a hot topic at the result of their associated morbidity. Because of mixed evidence, controversy regarding whether to repair these tears in all scenarios and in all patient populations remains. Further, even with a successful repair, there may still be postoperative extrusion. Now in addition to the decision to repair is the decision to reconstruct with a gracilis autograft, which has the potential to reduce extrusion and improve outcomes. This is a much more complex surgery than medial meniscal root repair (MMRR) that is associated with both greater technical skill on the surgeon and greater patient morbidity from the graft harvest. Over time, we will see whether the benefits outweigh the increased complexity and risk of reconstruction versus repair. These results will determine whether medial meniscal posterior root reconstruction is discarded or becomes the new standard of care for medial meniscal posterior root tears.