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Meniscal Root Repair: Surgical Technique

March 15, 2015

Contributors: Eric Jason Strauss, MD, FAAOS; Shane Blackmore, MD; Maxwell Weinberg, MD; William Ryan, BS; Dylan Lowe, MD; Laith M Jazrawi, MD, FAAOS; Laith M Jazrawi, MD, FAAOS

BACKGROUND: Meniscal roots are essential attachments of the menicus transferring hoop stresses during tibiofemoral axial loads in both knee extension and deep flexion. Injury to the root of the meniscus alters tibiofemoral contact pressures and kinematics. Meniscal root tear injuries have been linked to clinically significant medial meniscus extrusion, which may dramatically impair hoop stress transmission and lead to accelerated articular degenerative wear. Operative management of meniscal root tears traditionally was limited to partial or total meniscectomy. However, recent data suggests that operative repair of the meniscal root helps to restore the physiological transfer of hoop forces leading to better clinical and radiographic results. The purpose of this video is to demonstrate our surgical technique of an arthroscopic medial meniscal posterior root repair.

METHODS: The important concepts of meniscal root repair are discussed. Relevant patient history, imaging, surgical indications, postoperative rehabilitation, and clinical outcomes are presented. Our surgical technique is demonstrated in a case of a medial meniscal posterior root repair.

RESULTS: The video demonstrates the successful repair of a posterior root medial meniscal tear and offers pearls on achieving a stable repair with reproducible results. This transtibial technique reliably restores the meniscus to its anatomic position. Our results are supported in a retrospective study by Lee et al. who found that restoration of meniscal function via root repair leads to less progression of articular cartilage degeneration when compared to partial meniscectomy at a mean of four years follow up.

CONCLUSION: Although technically difficult, there are long-term advantages to meniscal root repair over partial meniscectomy for indicated patients. Meniscal root repair carries a higher probability of complete healing and restoration of meniscal function to convert axial load into hoop stresses distributed evenly across the tibiofemoral articulation. In this video presentation, we have highlighted the key steps to successful anchoring of the meniscus to its anatomical position.

Results for "Knee: Cartilage"

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