Meniscus root repair with posterior horn socket may improve outcomes
Click Here to Manage Email Alerts
Key takeaways:
- Partial meniscectomy is not effective for meniscus root tears, according to a presenter.
- A meniscus root repair with a posterior horn socket may reduce bone edema and extrusion.
WAILEA, Hawaii — Meniscus root repair with a posterior horn socket, transtibial fixation and centralization may reduce subchondral bone edema and extrusion while repairing meniscal root tears, according to data presented here.
“You have to think about meniscus root repair because you cannot make the diagnosis by physical exam,” Michael J. Stuart, MD, said in his presentation at Orthopedics Today Hawaii. “You have to have clinical suspicion by history and exam, but you need MRI and arthroscopy to make the diagnosis.”
However, before completing a meniscus root repair, Stuart said a surgeon must catch any potential contraindications.
“The absolute contraindications we agree on [are] advanced chondromalacia based upon MRI arthroscopy, advanced arthritis based upon standing radiographs, and limb malalignment based on full-length standing radiographs,” Stuart said.
For the procedure itself, Stuart said a surgeon should create an exposure space to work in, consider releasing the meniscal tibial ligament to ensure reduction and eliminate extrusion, and create a high-accessory anteromedial portal to place a knotless suture anchor.
“Then, you are able to insert that repair suture with your chosen device through the inferior lateral portal, shuttle that suture back down into the anchor with a passing suture, and tension and cut it,” Stuart said. “This is a way to repair the meniscus back to the tibia with a knotless suture anchor. You then proceed with your transosseous root repair using an anatomic socket.”
Stuart added that he prefers to use three cinch sutures to place the socket anatomically.
In addition, Stuart said the rehabilitation process for meniscus root repair is an important aspect of a successful procedure.
“Ensure careful postoperative rehabilitation,” Stuart said. “This is different than doing a partial meniscectomy or a bucket-handle repair because it requires more prolonged protection and a slower progression back to activities.”
Collapse
Stuart MJ. How I fix a root tear and my technique for posterior horn repairs. Presented at: Orthopedics Today Hawaii; Jan. 7-11, 2024; Wailea, Hawaii.
Read more about
Click Here to Manage Email Alerts