Simplified Centralization Technique With Dual-Tunnel Meniscal Root Repair

Meniscal extrusion has been identified as a major risk factor for altered knee kinematics, aberrant forces, and potential osteoarthritic progression. Failure of the meniscotibial ligament complex appears to be the primary cause. Centralization techniques have been developed to help properly reduce the extruded meniscus to its footprint, which can potentially restore its function in dissipating hoop stresses. Many described centralization procedures use suture anchors with an accessory portal, which can be somewhat technically challenging. We present our simplified meniscal centralization technique using all-inside meniscal repair devices to repair the meniscotibial ligament, reducing it to its footprint using a transtibial tunnel.