Meniscus Centralization in Medial Meniscus Posterior Root Repair

Meniscal root tears have an estimated prevalence of 60 to 70 persons per 100,000, and they have gained increased interest recently. Meniscal extrusion is defined as an extrusion >3 mm for medial meniscus tears from the tibial articular cartilage. Root tear-associated meniscal extrusion has been associated with degenerative cartilage damage, particularly since it contributes to increased tibiofemoral stresses during axial loading.

Medial meniscus extrusion >3 mm in the setting of medial meniscus posterior root horn tears.

The medial meniscus is released from the capsule from its body to the posterior horn. The medial meniscus root is repaired using the pullout technique. The meniscus body is then centralized using a 1.8-mm single-loaded, all-suture, knotless anchor. Additional all-inside sutures are added for increased stability and enhanced healing of the meniscus.

Two- and 3-year outcomes demonstrated a significant decrease in meniscal extrusion following centralization at the time of medial meniscus posterior root repair, and no conversion to total knee arthroplasty was reported.

Medial meniscus centralization provides increased contact surface between the femur and tibia and thus helps prevent progression of knee osteoarthritis in the early follow-up.

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