Transtibial Centralization Using Peripheral Stabilization Suture Reduces Medial Meniscus Extrusion and Varus...

Area of Science:

• Orthopedic surgery
• Knee joint biomechanics
• Meniscal repair techniques

Background:

• Medial meniscus posterior root tears (MMPRTs) can lead to significant knee dysfunction.
• Conventional transtibial pullout repair is a common surgical treatment.
• The efficacy of adjunctive techniques in improving outcomes requires further investigation.

Purpose of the Study:

• To evaluate the clinical and structural effects of adding peripheral stabilization suture (PSS) to conventional transtibial pullout repair for MMPRTs.
• To compare medial meniscus extrusion (MME), alignment, and osteoarthritis progression between the two techniques.

Main Methods:

• Retrospective review of 35 patients undergoing MMPRT repair (April 2019-March 2024) with ≥1-year follow-up.
• Comparison between conventional pullout repair and pullout repair with PSS.
• Assessment of MME via MRI, radiographic parameters (HKA, %MA, KL grade), and patient-reported outcome measures (PROMs).

Main Results:

• The PSS group demonstrated significantly less MME (3.2 mm vs. 5.3 mm) and reduced progression of varus alignment and KL grade at 1 year.
• The mechanical axis remained stable in the PSS group, unlike the conventional group.
• A significantly lower rate of clinically meaningful MME worsening was observed in the PSS group (22.2% vs. 88.2%).

Conclusions:

• Peripheral stabilization suture (PSS) effectively reduces postoperative medial meniscus extrusion (MME) after MMPRT repair.
• The addition of PSS suppresses the progression of varus alignment and osteoarthritic changes.
• While PROMs improved comparably in both groups, PSS offers superior structural protection.