Suture Anchor Repair for a Medial Meniscus Posterior Root Tear Combined With Arthroscopic Meniscal Centralization and Open Wedge High Tibial Osteotomy

Abstract

Medial meniscus posterior root tear (MMPRT) is now attracting increased attention as a risk factor for the development of osteoarthritis. However, the healing rate after root repair by the suture anchor technique or the pull-out technique is still low. Here we report on a technique of MMPRT repair using suture anchor combined with arthroscopic meniscal centralization and open wedge high tibial osteotomy (OWHTO). The purposes of this technique are (1) to distribute the meniscal hoop tension between the root repair site and the centralization site and (2) to reduce the load on medial meniscus by OWHTO. The routine exposure for OWHTO with superficial medial collateral ligament release creates good visualization for arthroscopic root repair. The first anchor is inserted on the medial edge of the medial tibial plateau, and the second anchor is inserted on the root attachment through a posteromedial portal. After tying the knots, OWHTO could be performed without interference between the suture anchors and the screws of the plate for fixing the osteotomy. Although further follow-up is required, this technique could improve the outcomes after root repair, as well as have some technical advantages.