Primary Repair of Medial Meniscal Avulsions

Qualitative and Quantitative Anatomic Analysis of the Posterior Root Attachments of the Medial and Lateral Menisci

“…It has been reported that a medial meniscal posterior root tear, which is the most likely meniscal attachment to sustain injury, 10,16 is functionally equivalent to a total medial meniscectomy. 1 Clinically, it has been reported that rapid progression of arthritis often accompanies a medial meniscal root tear because of the loss of its ability to resist hoop stresses and the significant alteration in its load-sharing ability as a result of medial meniscal extrusion.…”

“…1 Clinically, it has been reported that rapid progression of arthritis often accompanies a medial meniscal root tear because of the loss of its ability to resist hoop stresses and the significant alteration in its load-sharing ability as a result of medial meniscal extrusion. 3, 16 Although it has been reported that the proper selection of anchoring sites for the posterior horns is likely of greater importance than the surgical technique of reinsertion of the attachments, 19 much of the new studies about meniscal root tears have focused on varying surgical techniques, 5,7,12,15,16 and there are few reports beyond the initial qualitative studies defining the anatomy of the posterior root attachments of the menisci. 9,13,16 Studies have quantitatively described the locations of the anterior root attachments of the medial and lateral menisci in relation to bony and soft tissue landmarks, 4,9,13,18 but little research has quantitatively described the locations for the posterior root attachments.…”

Effects of Medial Meniscus Posterior Horn Avulsion and Repair on Tibiofemoral Contact Area and Peak Contact Pressure with Clinical Implications

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Avulsion of the posterior horn of the medial meniscus is a described entity that produces meniscus extrusion, 7,11,22,23,25,27,30 articular cartilage loss and osteophyte formation, 22 and medial joint-space narrowing. 1,14,16,18,22,32 Meniscus extrusion prevents the meniscus from resisting hoop stresses and shielding the adjacent articular cartilage from axial load.

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Transosseous Medial Meniscal Root Repair Using a Modified Mason-Allen Suture Configuration

“…Multiple techniques for the medial meniscus followed, using accessory portals and numerous passing devices, suture configurations, and drilling techniques. [12][13][14][15] Proponents of the transosseous techniques support the theoretical advantages of stronger fixation and the lack of the necessity for a posteromedial portal ( Table 1). Healing of the meniscal root using the transosseous repair technique has been confirmed by magnetic resonance imaging as well as second-look arthroscopy.…”

“…Healing of the meniscal root using the transosseous repair technique has been confirmed by magnetic resonance imaging as well as second-look arthroscopy. 15,16 In our technique we advocate the use of the modified Mason-Allen stitch to repair the medial meniscal root tear. This stitch configuration recently showed superior cyclic loading and load-to-failure characteristics, as well as decreased meniscal extrusion, when compared with other stitch configurations.…”