Suture Anchor Refixation of Meniscal Root Tears Without an Additional Portal

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Abstract
The biomechanical consequences of a tear of the posterior root of the medial meniscus are comparable to that of a complete meniscectomy. The integrity of the meniscal roots is crucial to enable the important function of load sharing and shock absorption. An untreated root tear leads to extrusion and loss of function of the meniscus causing early degenerative arthritis of the respective knee compartment. Meniscal root repair can be achieved by 2 main techniques: indirect fixation using pullout sutures through a transtibial tunnel with extracortical fixation and direct fixation using suture anchors. Pullout sutures are prone to elongation or abrasion of the suture material due to the length of the bone tunnel. Current suture anchor techniques are challenging as they require an additional posterior portal with higher risk of damage to neurovascular structures. Even with the use of specially designed curved passing devices, secure insertion of the anchor is difficult. We present a technique for suture anchor refixation of the posterior root of the medial meniscus without the need for an additional posterior portal. Technique Video: video See video under supplementary data.

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