Background: Meniscal root tears (MRTs) are a significant cause of knee pain and dysfunction. An MRT can alter the biomechanics of the knee joint, leading to cartilage damage and osteoarthritis. This systematic review aims to evaluate the impact of MRTs on the progression of knee osteoarthritis in patients undergoing non-operative treatment. Methods: A systematic review was performed based on the PRISMA guidelines in PubMed, Scopus, and ScienceDirect databases (“meniscal root injuries” OR “meniscal root tears”) AND (“osteoarthritis” OR “joint degeneration”). Results: Eight studies, including 1160 patients with MRTs, met the inclusion criteria. MRTs were associated with more severe cartilage damage on the medial femoral condyle (Noyes score, 4.95; P < 0.001) and on the medial tibial plateau (Noyes score, 3.9; P < 0.005) compared with other meniscus tear patterns. Eighty per cent of medial meniscus posterior root tears had an ICRS grade ≥2 chondral lesions at the medial femoral condyle, and those chondral lesions had a more progressive and faster nature compared with medial meniscus posterior horn tears. MRTs and meniscal extrusion were predominant factors associated with accelerated osteoarthritis progression (odds ratio 4.64; 95 % confidence interval, 1.61–13.34; P = 0.004). Conclusions: MRTs have a crucial role both in the initiation and the progression of knee osteoarthritis, leading to severe cartilage damage and dramatic consequences on quality of life. Early diagnosis and appropriate management could preserve knee function and delay osteoarthritic changes.
