Effective Reduction and Centralization of the Extruded Medial Meniscus With Capsular Advancement

Medial meniscus extrusion significantly compromises the load-distribution function of the meniscus, accelerating the progression of osteoarthritis. Current medial meniscus centralization techniques often involve release of the meniscotibial ligament, which can lead to further instability and result in ineffective reduction and advancement of the extruded medial meniscus. This Technical Note describes an arthroscopic technique for medial meniscus centralization with capsular advancement, which preserves the meniscotibial distal ligament attachment while efficiently centralizing the meniscus to reduce extrusion. By separating the superficial and deep layers of the medial collateral ligament with a small osteotome under direct arthroscopic visualization, the capsule and meniscus can be mobilized without compromising stability. Knotless suture anchors are used to secure the meniscus in a centralized position, restoring the meniscus's function and reducing medial compartment pressures. This approach addresses meniscal extrusion and aims to prevent further degeneration in patients with medial compartment osteoarthritis.