A new aiming guide can create the tibial tunnel at a favorable position in transtibial pullout repair for the medial meniscus posterior root tear

Abstract

An anatomical placement of the medial meniscus posterior root (MMPR) attachment is considered to be critical in transtibial pullout repair of the MMPR tear. However, tibial tunnel creation at the anatomical attachment of the MMPR is technically difficult using a conventional aiming deviee. The aim of this study was to compare two aiming guides. We hypothesized that a newly-developed guide creates the tibial tunnel at an adequate position rather than a conventional deviee. Twenty-six patients underwent transtibial pullout repairs using the Multi-use guide or the PRT guide that had a narrow twisting/curving shape. The MMPR anatomical center and tibial tunnel center were evaluated using the percentage-based posterolateral location on three-dimensional computed tomography images of the tibial surface (Tsukada's measurement method). Percentage distance between anatomical center and tunnel center was calculated. Anatomical center of the MMPR footprint located at a position of 78.5% posterior and 39.4% lateral. Both tunnels were anteromedial but tibial tunnel center located at a more favorable position in the PRT group. Percentage distance was significantly smaller in the PRT guide group (8.7%) than in the Multi-use guide group (13.1%). The PRT guide may have great advantage to achieve at a more anatomical location in MMPR pullout repair.