Meniscal root tear repair: why, when and how?

Abstract

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.

Initial Biomechanical Properties of Transtibial Meniscal Root Repair are Improved By Using a Knotless Anchor as a Post-Insertion Tensioning Device

“…Biomechanical studies confirmed the importance of meniscal root integrity to preserve joint contact load distribution [1][2][3][4] and stability 5 . Meniscal root repair surgery aims to re-establish these meniscal functions 6,7 and to minimize progression of osteoarthritis 8 .…”

“…After preconditioning the specimen with 10 cycles of a load [1][2][3][4][5][6][7][8][9][10]N at 0.1 Hz 9,18 , it was loaded for 1000 cycles ]N at 0.5 Hz. This load range approximates tensile forces at the meniscal root under 500 N of joint compression in neutral rotation in a [0°-90°] range of flexion 11 .…”

Cellular and Chemical Gradients to Engineer the Meniscus‐to‐Bone Insertion

“…Meniscal lesions are the most common intra‐articular knee injury, with over one million reparative surgeries performed annually in the United States . Current surgical procedures commonly involve transplantation of a meniscal allograft, cadaveric tissues consisting of the meniscal body, and its osseous transitional regions or entheses . The entheses allow for transosseous fixation of the allograft, providing a stable attachment point for the implant .…”

Transosseous Repair of Root Tears of the Lateral Meniscus: Operative Technique and Short-Term Clinical Follow-Up of 28 Patients

“…Furthermore, a higher rate of cartilage degradation associated with PLMRT has been reported [8] and increased contact pressures and decreased contact areas correlating with the existence of PLMRT have been demonstrated [20][21][22][23].…”