Novel Posterior Anchoring Method Associated with Medial Meniscus Posterior Root Repair

Introduction: Transtibial pullout repair is the gold standard surgical treatment for medial meniscus (MM) posterior root tear. However, posteromedial extrusion of the MM during knee flexion may remain a problem postoperatively. Materials and Methods: We used a novel posterior anchoring technique to help reduce posteromedial extrusion, applying two cinch sutures (TCSs) to the MM posterior horn and creating a bone tunnel at the center of the posterior root attachment to pullout the suture. Another bone tunnel was created at the posterior corner of the medial tibial plateau in the externally rotated knee flexion. The first anchor of an all-inside meniscal repair device was inserted through the inferior surface of the MM posterior horn with tensioning TCS and the second anchor into the bone tunnel. Tibial fixation of pullout sutures was performed using a bioabsorbable screw in 30 degrees knee flexion. Conclusions: Our posterior anchoring method, combined with conventional pullout repair with TCS, helped reduce posteromedial extrusion in patients with a MM posterior root tear.