Posterior Meniscal Root Repairs: Outcomes of an Anatomic Transtibial Pull-Out Technique

LaPrade, Robert F.; Matheny, Lauren M.; Moulton, Samuel G.; James, Evan W.; Dean, Chase S.

doi:10.1177/0363546516673996

Cited by 181 publications

(207 citation statements)

References 29 publications

(39 reference statements)

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“…An anatomic transtibial single-tunnel pull-out meniscal root repair was performed using LaPrade et al 12 technique. The patient was positioned supine with the surgical leg in 70° of knee flexion, the thigh secured in a leg holder.…”

Section: Surgical Techniquementioning

confidence: 99%

Lateral Meniscus Posterior Root Tear (LMPRT): A Case Report

Khumra¹,

Laohathaimongkol²

2019

bkkmedj

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he meniscus of the knee has several important biomechanical functions, the most important of which is load transmission and shock absorption. 2 By converting the axial load to a radially directed force or hoop stress, the meniscus reduces wear on the hyaline articular cartilage. 3 The meniscus roots describe the insertions of the anterior and posterior meniscal horns on the tibial plateau. 4,5 These structures are critical for meniscal function since they prevent meniscus extrusion under axial load, thereby converting axial load to a radially directed force (so-called hoop stress). 6,7 Meniscus insufficiency, resulting from a posterior root tear, increases joint contact pressures, 8 especially with concomitant meniscofemoral ligament (MFL) disruption, 9,10 leading to articular cartilage degeneration over time.According to the study by Krych AJ et al., 1 there was a high rate of missed posterior lateral meniscus root tears ( LMPRT) on preoperative MRI reported. This retrospective cohort study reported 45 consecutive patients with arthroscopically confirmed LMPRTs between 2010 and 2017. Of these, only 15 of 45 LMPRTs (33%) were initially diagnosed on preoperative MRI.LaPrade et al., 11 reported a sensitivity of 0.600 (95% CI, 0.281-0.860) and a positive predictive value of 0.181 (95% CI, 0.085-0.261) for the diagnosis of LMPRTs on 3-T MRI by a blinded fellowship-trained musculoskeletal radiologist. They conclude sensitivity was higher for medial root tears, indicating a higher risk of missing lateral root tears on MRI. Imaging has an important role in identifying meniscus posterior horn root tears, however, some root tears may not be identified until arthroscopy. Case ReportA 37-year old Italian man suffered from a twisiting accident at the right knee 2 days before admission. He presented with right knee pain with swelling, and he was unable to walk and extend his right knee . Physical examination shown as belowRight Knee: Range of motion : 15-140 (extension Lag 15 degree). Lachmann test was positive. Anterior drawer test was positive 3+ with no end point. Pivot shift test unable to evaluate due to pain. AbstractThere is a high rate of missed lateral meniscus posterior root tear from pre operative magnetics resonance image (MRI) as reported in the study of Krych AJ. 1 It was found that there was a high frequency (67%) of tears that were missed on preoperative MRI in this consecutive series. In our case report we present the case that missed lateral posterior meniscus root tear from pre operative MRI in the setting concomittant with anterior cruciate ligament (ACL) injury.

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Section: Surgical Techniquementioning

confidence: 99%

Lateral Meniscus Posterior Root Tear (LMPRT): A Case Report

Khumra¹,

Laohathaimongkol²

2019

bkkmedj

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“…Eighty-four per cent showed no progression of Kellgren-Lawrence grading. In another recent study, meniscal root repairs using a transtibial technique were demonstrated to achieve improved outcomes despite patient age 26. It is worth noting that the healing rate of the posterior meniscal roots can also be a result of creating a bony bed during repair and biological factors from tunnel reaming in the transtibial repair technique.…”

Section: Considerationmentioning

confidence: 99%

Review of Arnoczky and Warren on the microvasculature of the human meniscus

et al. 2017

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“…7 Finally, the rest of the meniscal allograft is secured with a total of 6 to 10 nonabsorbable vertical mattress sutures placed 5 mm apart and distributed on both the superior and inferior meniscal surfaces (SharpShooter, Ivy Sports Medicine, LLC; Montvale, NJ). Additional soft-tissue repair and/or reconstruction procedures may be completed at this time.…”

Section: Tibial Resurfacing and Meniscus Transplantationmentioning

confidence: 99%

Tibial Allograft Transfer for Medial Tibial Plateau Resurfacing

Godin

Frangiamore

Chahla

et al. 2017

Arthroscopy Techniques

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A large cartilage lesion of the tibial plateau with a deficient meniscus in a young patient is a challenging pathology for the orthopaedic surgeon due to the limited options available. While hemiarthroplasty procedures can be an option, the risk of revision in a young patient is high, and therefore a reconstructive procedure is advocated. The purpose of this Technical Note is to describe our technique for tibial plateau resurfacing, including the preparation and implantation of a medial tibial plateau and medial meniscal allograft, in a patient with a post-traumatic KD-4 knee dislocation with a medial tibial plateau rim fracture, medial meniscus deficiency, and medial tibiofemoral joint subluxation.

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Posterior Meniscal Root Repairs: Outcomes of an Anatomic Transtibial Pull-Out Technique

Cited by 181 publications

References 29 publications

Lateral Meniscus Posterior Root Tear (LMPRT): A Case Report

Lateral Meniscus Posterior Root Tear (LMPRT): A Case Report

Review of Arnoczky and Warren on the microvasculature of the human meniscus

Tibial Allograft Transfer for Medial Tibial Plateau Resurfacing

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