Objective: This study aimed to compare the postoperative clinical and functional outcomes of patients undergoing arthroscopic medial meniscus repair with and without application of the medial collateral ligament (MCL) pie-crusting technique at our institution.

Material and Method: A retrospective analysis was conducted on 43 patients who underwent arthroscopic medial meniscus repair between January 2017 and January 2021, with a minimum follow-up period of one year. Patients were identified through hospital registries and archive records. Preoperative and final postoperative clinical assessments were performed, including evaluation of functional outcomes. Participants were stratified into two groups: those who underwent meniscal repair with MCL pie-crusting (n = 21) and those who underwent repair without pie-crusting (n = 22).

Results: Comparative analysis of operative duration, time to return to sports, and functional outcomes measured by Lysholm and Cincinnati knee scores revealed no statistically significant differences between the two cohorts. Operative time showed no significant variance (p = 0.318). Similarly, postoperative Lysholm (p = 0.784) and Cincinnati (p = 0.511) scores did not differ significantly between groups. Both cohorts demonstrated significant postoperative improvement relative to baseline functional scores.

Conclusion: The findings indicate that the application of the MCL pie-crusting technique during arthroscopic medial meniscus repair does not significantly impact operative time or postoperative functional outcomes compared to standard repair methods. However, the pie-crusting technique facilitates enhanced visualization of the medial joint compartment, potentially reducing iatrogenic cartilage injury risk. Further prospective studies with larger sample sizes are required to substantiate these findings and optimize surgical protocols for medial meniscus repair.