Outcomes after posterior meniscal root repair significantly improved postoperatively and patient satisfaction was high, regardless of age or meniscal laterality. Patients <50 years had outcomes similar to those of patients ≥50 years, as did patients who underwent medial versus lateral root repair. Transtibial double-tunnel pull-out meniscal root repair provided improvement in function, pain, and activity level, which may aid in delayed progression of knee osteoarthritis.

This study demonstrated that it was possible to establish a concise classification system to group patients with meniscal root tears by tear morphology. Treatments received varied across tear types.

Case: This case series describes the surgical technique for and outcomes after a modified transtibial pull-out repair for posterior root avulsions of the lateral meniscus. This modified technique is designed to prevent tunnel convergence during a concomitant or staging of an anterior cruciate ligament (ACL) reconstruction. Promising short-term clinical outcomes were seen at the two-year follow-up for both patients. On second-look arthroscopy, one patient also demonstrated excellent healing. Conclusion: Results provide preliminary evidence suggesting that this technique may (1) facilitate anatomic healing of the root and (2) allow for concomitant or staged ACL reconstruction tunnel reaming.

Quantitative descriptions of the anterior meniscal roots elucidate the relationship between the root attachments and pertinent surgical landmarks. In addition, the supplemental attachments of both menisci may contribute to native meniscal function, and further investigation is recommended.

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