Combined Pullout Repair and Centralization for Medial Meniscus Posterior Root Tear

Abstract

Medial meniscus posterior root tear (MMPRT) is usually accompanied by meniscus extrusion. Our research found that MMPRT and genu varus were the risk factors of medial meniscus extrusion [1]. Meniscus extrusion means the peripheral border of the meniscus is located outside the tibial plateau margin, and when the distance between the peripheral border of the meniscus and the tibial plateau margin is greater than 3 mm, it is considered as meniscus extrusion clinically [2]. Theoretically, meniscus extrusion will result in hoop strain failure under axial loading, leading to a condition biomechanically similar to a total meniscectomy. It can lead to osteoarthritis due to a decreased tibiofemoral contact area and increased contact pressure [3]. A number of researches showed that meniscus extrusion was corelated with femorotibial joint cartilage injury and subchondral bone marrow lesions [4–6]. It has been reported that the repair of MMPRT was an effective method for the treatment of meniscus extrusion complicated with MMPRT [7]. However, there is increasing recognition that meniscus root repair alone is not always able to completely correct extrusion [8–10]. Therefore, we try to combine medial meniscus posterior root repair (MMPRR) by pullout suture with meniscus centralization to restore the nearly normal position of medial meniscus.