Skip to main content
Log in

A new surgical technique for arthroscopic repair of the meniscus root tear

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Injury of the meniscal root can lead to meniscal extrusion and loss of normal hoop stress distribution by the meniscus. This has been shown to result in an excessive tibiofemoral contact pressures and has been associated with development of arthritis in the affected compartment of the knee. Repair of meniscal root avulsion has been shown to restore the normal contact stresses, and several techniques for such repair have been described. We report an all-arthroscopic technique that allows anatomic reattachment of the avulsed meniscal root, applicable to both the medial or lateral menisci. Our technique utilizes a novel retrograde reaming device to create a small intraosseous socket at the meniscal tibial attachment, and may be particularly useful for repairing meniscal root avulsions in knees with multiligamentous injuries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Ahn JH, Wang JH, Yoo JC, Noh HK, Park JH (2007) A pull out suture for transection of the posterior horn of the medial meniscus: using a posterior trans-septal portal. Knee Surg Sports Traumatol Arthrosc 15:1510–1513

    Article  PubMed  Google Scholar 

  2. Ahn JH, Wang JH, Lim HC et al (2008) Double transosseous pull out suture technique for transection of posterior horn of medial meniscus. Arch Orthop Trauma Surg. doi:10.1007/s0040200806391

  3. Allaire R, Muriuki M, Gilbertson L, Harner CD (2008) Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg 90:1922–1931

    Article  PubMed  Google Scholar 

  4. Baratz ME, Fu FH, Mengato R (1986) Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee. A preliminary report. Am J Sports Med 14:270–275

    Article  CAS  PubMed  Google Scholar 

  5. Berthiaume MJ, Raynauld JP, Martel-Pelletier J et al (2005) Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging. Ann Rheum Dis 64:556–563

    Article  PubMed  Google Scholar 

  6. Choi NH, Son KM, Victoroff BN (2008) Arthroscopic all-inside repair for a tear of posterior root of the medial meniscus: a technical note. Knee Surg Sports Traumatol Arthrosc 16:891–893

    Article  PubMed  Google Scholar 

  7. Costa CR, Morrison WB, Carrino JA (2004) Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear? Am J Roentgenol 183:17–23

    Google Scholar 

  8. Fairbank T (1948) Knee joint changes after meniscectomy. J Bone Joint Surg Br 30:664–670

    Google Scholar 

  9. Fukubayashi T, Kurosawa H (1980) The contact area and pressure distribution pattern of the knee. A study of normal and osteoarthrotic knee joints. Acta Orthop Scand 51:871–879

    Article  CAS  PubMed  Google Scholar 

  10. Hede A, Larsen E, Sandberg H (1992) Partial versus total meniscectomy. A prospective, randomised study with long-term follow-up. J Bone Joint Surg Br 74:118–121

    CAS  PubMed  Google Scholar 

  11. Hede A, Larsen E, Sandberg H (1992) The long term outcome of open total and partial meniscectomy related to the quantity and site of the meniscus removed. Int Orthop 16:122–125

    Article  CAS  PubMed  Google Scholar 

  12. Ihn JC, Kim SJ, Park IH (1993) In vitro study of contact area and pressure distribution in the human knee after partial and total meniscectomy. Int Orthop 17:214–218

    Article  CAS  PubMed  Google Scholar 

  13. Johnson DL, Swenson TM, Livesay GA, Aizawa H, Fu FH, Harner CD (1995) Insertion-site anatomy of the human menisci: gross, arthroscopic, and topographical anatomy as a basis for meniscal transplantation. Arthroscopy 11:386–394

    CAS  PubMed  Google Scholar 

  14. Jones AO, Houang MT, Low RS, Wood DG (2006) Medial meniscus posterior root attachment injury and degeneration: MRI findings. Australas Radiol 50:306–313

    Article  CAS  PubMed  Google Scholar 

  15. Kim YM, Rhee KJ, Lee JK, Hwang DS, Yang JY, Kim SJ (2006) Arthroscopic pullout repair of a complete radial tear of the tibial attachment site of the medial meniscus posterior horn. Arthroscopy 22(795):e1–e4

    Google Scholar 

  16. Krause WR, Pope MH, Johnson RJ, Wilder DG (1976) Mechanical changes in the knee after meniscectomy. J Bone Joint Surg 58:599–604

    CAS  PubMed  Google Scholar 

  17. Kurosawa H, Fukubayashi T, Nakajima H (1980) Load-bearing mode of the knee joint: physical behavior of the knee joint with or without menisci. Clin Orthop Relat Res 149:283–290

    Google Scholar 

  18. Lee YG, Shim JC, Choi YS, Kim JG, Lee GJ, Kim HK (2008) Magnetic resonance imaging findings of surgically proven medial meniscus root tear: tear configuration and associated knee abnormalities. J Comput Assist Tomogr 32:452–457

    Article  PubMed  Google Scholar 

  19. Magee T (2008) MR findings of meniscal extrusion correlated with arthroscopy. J Magn Reson Imaging 28:466–470

    Article  PubMed  Google Scholar 

  20. Marzo JM, Kumar BA (2007) Primary repair of medial meniscal avulsions: 2 case studies. Am J Sports Med 35(8):1380–1383

    Article  PubMed  Google Scholar 

  21. Marzo JM, Gurske-Deperio J (2008) Effects of medial meniscus posterior horn avulsion and repair on tibiofemoral contact area and peak contact pressure with clinical implications. Am J Sports Med. doi:10.1177/0363546508323254

  22. Pagnani MJ, Cooper DE, Warren RF (1991) Extrusion of the medial meniscus. Arthroscopy 7:297–300

    CAS  PubMed  Google Scholar 

  23. Petersen W, Zantop T (2006) Avulsion injury to the posterior horn of the lateral meniscus. Technique for arthroscopic refixation. Unfallchirurg 109:984–987

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest statement

None of the authors have any financial or other conflicts of interest relating to the information presented in this manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stephen J. Nicholas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nicholas, S.J., Golant, A., Schachter, A.K. et al. A new surgical technique for arthroscopic repair of the meniscus root tear. Knee Surg Sports Traumatol Arthrosc 17, 1433–1436 (2009). https://doi.org/10.1007/s00167-009-0874-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-009-0874-1

Keywords

Navigation