Medial Meniscus Root Repair: A Transtibial Pull-Out Surgical Technique

Meniscus root tears represent an increasingly recognized epidemic that, if left untreated, lead to significant morbidity, including functional limitations and potential conversion to total knee arthroplasty. The mid- and long-term results of medial meniscus root repair are favorable in well-selected patients, with demonstrated decreased rates of osteoarthritis and arthroplasty when compared to partial meniscectomy and nonoperative management. Repair is advised whenever possible, since patients treated with meniscectomy or nonoperative management fare poorly in subjective outcomes measures including measures of pain, activity, and quality-adjusted life years. Furthermore, repair has recently been demonstrated to be beneficial not only at the level of the individual patient, but also in terms of overall societal healthcare costs. The following provides a description of the authors preferred method of medial meniscus root repair. Advantages of the presented technique include a biomechanically strong suture construct, no need for a posterior portal, and instrumentation designed specifically for the knee. The methods described represent a readily-employable approach to meniscus repair and preservation, an undertaking which is critically important to preserving knee function.