Meniscus Root Repair

Abstract

Root tears are a subset of meniscal injuries that result in significant knee joint pathology. Occurring on either the medial or lateral side, root tears are defined as radial tears or avulsions of the posterior horn attachment to bone. After a root tear, there is a significant increase in tibio-femoral contact pressure concomitant with altered knee joint kinematics. Previous cadaver studies from our institution have shown that root repair of the medial meniscus is successful in restoring joint biomechanics to within normal limits. Indications for operative management of meniscal root tears include (1) a symptomatic medial meniscus root tear with minimal arthritis and having failed non-operative treatment, and (2) a lateral root tear in associated with an ACL tear. In this review, we describe diagnosis, imaging, patient selection, and arthroscopic surgical technique of medial and lateral meniscus root injuries. In addition we highlight the pearls of repair technique, associated complications, post-operative rehabilitation regimen, and expected outcomes.

Medial Posterior Meniscal Root Tears Are Associated with Development or Worsening of Medial Tibiofemoral Cartilage Damage: The Multicenter Osteoarthritis Study

“…Surgical repair of meniscal root tears varies depending on the exact location and nature of the tear (27), but a relatively young patient with knee OA and an isolated meniscal root tear is likely to benefit from surgical intervention.…”

Meniscectomy: The Basics

“…Recent data suggest that radial tears left in situ offer more contact stress protection than fully resected tear [ 4 ]. Thus, the senior author resects only very unstable elements of radial tears.…”

Indications in Meniscus Surgery: Synthesis

“…True traumatic root avulsions are rare, frequently associated with ACL tears. These meniscal tears correspond to a total functional meniscectomy and must so be repaired by a transosseous tibial reinsertion [ 29 ].…”