Recent Advances in Posterior Meniscal Root Repair Techniques

Posterior root avulsions of the medial and lateral menisci result in decreased areas of tibiofemoral contact and increased tibiofemoral contact pressures. These avulsions may lead to the development of osteoarthritis. Therefore, two surgical techniques, the transtibial pullout repair and the suture anchor repair, have recently been developed to restore the native structure and function of the meniscal root attachment. Compared with the historical alternative of partial or total meniscectomy, these techniques allow for meniscal preservation and anatomic reduction of the meniscal roots, with the goal of preventing the development and progression of osteoarthritis. However, early biomechanical and clinical studies have reported conflicting results on the effectiveness of both techniques with regard to resisting displacement and facilitating healing. Although there is currently a lack of consensus on which is the superior technique, transtibial pullout and suture anchor repairs are increasingly used in clinical practice.