Modified Arthroscopic Technique for Repair of Medial Meniscus Posterior Root Tear and Centralization of the Extruded Medial Meniscus Through a Double Transtibial Tunnel (Without Use of Accessory Ports)

Medial meniscus posterior root tears (MMPRTs) are significant injuries that compromise the biomechanical function of the knee, leading to meniscus extrusion and rapid progression of osteoarthritis if left untreated. While various arthroscopic repair techniques exist, persistent meniscus extrusion after repair remains a challenge. Centralization of the extruded meniscus has shown promise in improving repair outcomes and reducing arthritic progression. This Technical Note describes a modified arthroscopic technique for the repair of MMPRT and concomitant centralization of the extruded medial meniscus using a double transtibial tunnel approach, notably without the need for accessory portals. This modified technique offers advantages by utilizing only 2 routine portals, reducing technical demands, and shortening operative time, while achieving precise anatomic repair of the posterior root and effective centralization of the extruded meniscus. This combined approach aims to restore the meniscus's load-absorbing function, reduce stress on the root repair, potentially improve pain and functional scores, and reduce the risk of early osteoarthritis compared to root-only repairs. Early diagnosis and appropriate surgical management of MMPRT, particularly with concomitant centralization, are crucial for preserving knee joint health. This modified arthroscopic technique provides a streamlined and effective method for both posterior root repair and meniscus centralization, promoting optimal anatomic restoration and preventing osteoarthritic degeneration.