Arthroscopic Direct Repair for a Complete Radial Tear of the Posterior Root of the Medial Meniscus

Wang, Kook Hyun; Hwang, Dae Hee; Cho, Jin Ho; Changale, Sachin D.; Woo, Sung Jong; Nha, Kyung Wook

doi:10.4055/cios.2011.3.4.332

Cited by 29 publications

(15 citation statements)

References 10 publications

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“…Depending on the tear pattern, repair techniques include pull-out (transosseous), suture anchors, and side to side repair ( Figure 4 ). 47 , 48 Additional posteromedial and posterolateral portals can be established to facilitate the procedure.…”

Section: Diagnosismentioning

confidence: 99%

Meniscal root tear repair: why, when and how?

2015

Orthop Rev

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The integrity of the meniscal root insertions is fundamental to preserve correct knee kinematics and avoid degenerative changes of the knee. Injuries to the meniscal attachments can lead to meniscal extrusion, decreased contact surface, increased cartilage stress, and ultimately articular degeneration. Recent and well designed studies have clarified the anatomy and biomechanics of the medial and lateral meniscal roots. Although the treatment of meniscal root tears is still controversial, many different techniques have been described for root repair. The goal of this review is to summarize the existing knowledge regarding meniscal root tears, including anatomy, biomechanics and imaging. In addition, the most common surgical techniques, together with the clinical outcomes, are described.

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Section: Diagnosismentioning

confidence: 99%

Meniscal root tear repair: why, when and how?

2015

Orthop Rev

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“…After removing 469 duplicates, 1476 studies remained; of these, 1430 were excluded based on reading of the titles and abstracts, 32 were excluded to the lack of extrusion data, and two were excluded because they used an open approach or soft tissue fixation. After applying these criteria, 21 studies [ 4 , 9 – 20 , 22 – 26 , 28 – 30 ] were finally included in this meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

Incidence and Extent of Graft Extrusion following Meniscus Allograft Transplantation

Lee

2018

BioMed Research International

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Background The incidence and extent of graft extrusion after meniscus allograft transplantation (MAT) may differ in patients undergoing medial and lateral meniscus transplantation due to the use of different surgical techniques. This meta-analysis was therefore designed to quantify the extent and incidence of graft extrusion after meniscus allograft transplantation. Methods Following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, all studies reporting absolute extrusion, relative percentage of extrusion (RPE), or frequency of major extrusions (>3 mm) on magnetic resonance imaging in patients undergoing medial or lateral MAT were included. Results The pooled mean absolute extrusion following all MATs was 3.15 mm but was significantly greater following medial than lateral MAT (3.26 versus 3.01 mm; p = 0.001). The pooled mean RPE following all MATs was 32.79% and was significantly greater after medial than lateral MAT (32.69% versus 28.81%; p < 0.001). The pooled mean proportion of knees with major (>3 mm) extrusion was 53% (95% CI: 49% to 58%) and was significantly greater after medial than lateral MAT (61% versus 39%; p < 0.001). Conclusion Mean graft extrusion after arthroscopic assisted MAT using bony fixation was 3.2 mm, with major graft extrusion > 3 mm occurring in about 50% of transplanted menisci. Graft extrusion was significantly greater after medial than lateral MAT.

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“…25 Moreover, after the TTPR, the pivot site during meniscal movement moves to the pull-out suture site, altering normal joint mechanics. 12 In addition, sutures through a transtibial tunnel are susceptible to elongation and abrasion. 10 The tibial tunnel also can obstruct concomitant ligament reconstruction procedures.…”

Section: Discussionmentioning

confidence: 99%

“…4,[9][10][11] A radial tear of the posterior root is defined as a tear within 10 mm of the posterior tibial attachment of the medial meniscus. 12 These tears can weaken tensile strength, cause meniscal extrusion, and lead to abnormal biomechanics. 13 The purpose of this Technical Note and accompanying video is to convey a technique that repairs a radial tear adjacent to the medial meniscus posterior root (MMPR) by converting the radial tear to a root tear then performing a transtibial pull-out root repair using an efficient, easily replicable method with a disposable repair kit.…”

mentioning

confidence: 99%

Transtibial Pull-Out Repair of Converted Radial Tear Adjacent to Medial Meniscus Root

Yin¹,

Gogh²,

Youn³

et al. 2020

Arthroscopy Techniques

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Radial tears increase tibiofemoral contact pressure and disrupt the ability of the meniscus to withstand hoop stress, leading to earlier-onset osteoarthritis. Repair of radial tears is problematic because they have a lower healing rate and lack a single gold standard technique. However, when a radial tear is proximal to the root, there is an opportunity to convert it into a root tear. This is ideal because root tears fixed through a transtibial tunnel technique have improved clinical outcomes and reduced rates of osteoarthritis. This Technical Note and accompanying video describe a method for repairing a radial tear near the meniscus root by converting a radial tear to a root tear followed by a pull-out root repair through a transtibial tunnel. This method restores the meniscus root, allowing it to withstand hoop stress. Our technique uses a disposable root repair kit that includes a FlipCutter, a Knee Scorpion Suture Passer, a 4.75-mm SwiveLock anchor tap, a SutureLasso, a PassPort Cannula, 0 FiberLink sutures, and TigerLink sutures.

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Arthroscopic Direct Repair for a Complete Radial Tear of the Posterior Root of the Medial Meniscus

Cited by 29 publications

References 10 publications

Meniscal root tear repair: why, when and how?

Meniscal root tear repair: why, when and how?

Incidence and Extent of Graft Extrusion following Meniscus Allograft Transplantation

Transtibial Pull-Out Repair of Converted Radial Tear Adjacent to Medial Meniscus Root

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