Arthroscopic suture anchor repair of posterior root attachment injury in medial meniscus: technical note

Abstract

A root attachment injury (root tear) of the meniscus can abolish the ability of the meniscus to bear hoop stress and predispose to increase articular contact stress which contribute to femorotibial degenerative changes. A pull out suture technique to repair the root tear has been described, but the procedure making the tibial tunnel may be difficult and troublesome. This article describes a repair technique using a suture anchor and posterior trans-septal portal.

Medial Meniscus Posterior Root Repair Using a Transtibial Technique

“…This requires a posterior portal and a curved suture passing device that can be difficult to manipulate within the knee. 6,7 We present a technique for posterior medial meniscus root repair using 3 sutures (1 leader, 2 cinch), standard arthroscopy portals, and transtibial fixation.…”

Arthroscopic Meniscal Root Repair Using a Ceterix NovoStitch Suture Passer

“…Suture anchor 3,4 and pull-through suture repair 1,5,6 techniques have been reported with satisfactory results. These techniques, to date, have all required use of a posterior portal 1,3-5 and/or a curved sutureshuttling device, 1,5,6 both of which can be technically challenging.…”

“…In addition, prior root repair techniques have used varying suture configurations: simple, 4,6 double simple, 3 and single-locking loop. 1 A recent biomechanical study showed a double-locking loop configuration, as described in our technique, to have higher maximum load to failure than other configurations.…”

“…1,2 Two main repair techniques have been described: suture anchor fixation and sutures pulled through a tibial tunnel. Although reported results show satisfactory healing, the techniques can be technically demanding because they require a posterior portal [3][4][5] and/or a curved suture-shuttling device, [4][5][6] which can be difficult to manipulate in the knee joint. A recent study evaluating the strengths of various root repair techniques showed that a double-locking loop suture configuration provides significantly higher load to failure than other suture configurations, with little increase in surgical time.…”

A Medial Meniscal Root Pullout Repair With the Use of a Tibial Tunnel Suturing Technique

“…Ahn et al 9 have shown the technique of the pullout suture using a trans-septal portal with the suturing done using a crescent-shaped suture hook from the posteromedial portal. Kim et al 10 have described the technique used to repair the medial meniscal root using a suture anchor. One study has shown superior biomechanical properties of the suture anchor repair technique when compared with the transtibial pullout repair.…”