Arthroscopic Medial Meniscal Posterior Root Repair With Transtibial Luggage-Tag and Horizontal Mattress Sutures

Abstract

Medial meniscal posterior root repair techniques have shown positive yet varied results in the literature. The decision to perform repair has improved clinical outcomes in many situations, although the healing rate is approximately 64% and the repair strength is roughly one-third of the native root strength, with meniscal extrusion being common. We present a technique based on biomechanical evidence to obtain a strong anatomic posterior root repair to restore nearly normal knee mechanics, combining an increased size of footprint under the lateral aspect of the medial meniscal horn for healing and a luggage-tag suture with a posteriorly placed horizontal mattress suture. The horizontal mattress suture is passed to capture the circumferential fibers of the meniscus and the luggage-tag suture is passed to capture the radial fibers of the meniscal body, through a single transtibial tunnel. The aim of this repair is to restore the normal meniscal function.

Arthroscopic Transtibial Pull-Out Repair for Meniscal Posterior Root Tear: The Slip Knot Technique

“…It is time saving, technically simple, and relatively cost-effective because it mimics the function of the cinch loop created by using the more costly FiberSnare or FiberLink (Arthrex) described in previous Technical Notes. [27][28][29][30][31][32] Third, unsought iatrogenic injury to the meniscus is minimized with just one piercing of passing device. Fourth, using the 2-mm-width Fibertape (Arthrex) preloaded on the tibial-fixating SwiveLock (Arthrex) in making the second slip knot on the meniscus provides further stability to the suture construct without an additional cost to the surgery.…”