Type II Medial Meniscus Root Repair With Peripheral Release for Addressing Meniscal Extrusion
Medial meniscal root tears are often disabling injuries that can occur in isolation during low-velocity, deep knee flexion movements in middle-aged patients. These lesions often demonstrate a type II pattern, which is described by a tear perpendicular to the fibers of the meniscus near its attachment to the tibia. These injuries have been associated with meniscal extrusion, which is when the meniscus displaces and protrudes out of the joint space by 3 millimeters or more, posing a challenge for surgeons to relocate during surgical repair. This study describes a surgical technique to overcome some of the difficulties encountered during this operative repair of the medial meniscus.
Sufficiently releasing the displaced medial meniscus from the posteromedial capsule and associated adhesions helps increase mobility of the medial compartment and return the meniscus back into the joint space. Additionally, another form of tissue release, described as pie-crusting, of the superficial fibers of the MCL may allow for increased visualization and opening of the medial compartment for improved root repair access. Patients not recommended for this procedure are those with high grades of osteoarthritis and chondromalacia as well as an inability to complete the postoperative rehabilitation protocol, which requires being non-weightbearing for 6 weeks.