Arthroscopic Belt Capsulodesis Using a Knotless Soft Suture Anchor for Extruded Medial Meniscus

In recent years, degenerative meniscal lesions have received increasing attention as an etiologic factor of knee osteoarthritis. Among various relevant factors, medial meniscal extrusion has been shown to be an independent predictor of the onset and progression of knee osteoarthritis. Therefore, surgical reduction of the extruded medial meniscus to restore meniscal function is key to preventing osteoarthritis of the knee. The arthroscopic centralization technique using knotless anchors has been developed and refined to reduce meniscal extrusion in the posteromedial region of the knee. Although a short-term study has reported favorable outcomes, the technique presents some pitfalls and can be technically challenging. This article describes the rationale and procedure for arthroscopic belt capsulodesis using 2 knotless anchors for reduction of medial meniscal extrusion. The reported procedure is technically simple and efficiently reduces meniscal extrusion by repairing the meniscotibial capsule, and it may be useful in the prevention of osteoarthritic progression.