Arthroscopic Anatomic Repair of Lateral Meniscal Posterior Root Tears with All-Suture Anchors using Percutaneous Exchange Rod Technique Through High Posterolateral Portal

Meniscal posterior root tears disrupt knee joint mechanics and can lead to early-onset osteoarthritis if untreated. Surgical repair is crucial to restore meniscal integrity, yet challenges remain, including achieving anatomical fixation, reducing neurovascular risks, and avoiding growth plate interference in young patients. Traditional transtibial pullout repair for medial meniscal posterior root tear is less biomechanically effective than suture anchor techniques, while conventional posteromedial portal approaches for anchor placement have risks. Repairing lateral meniscal posterior root tears in adolescents is even more challenging due to concerns about physeal damage and peroneal nerve proximity. We present an arthroscopic technique for meniscal root repair applicable to both medial and lateral tears, utilizing a single high posterolateral portal. It features 2 key innovations: the percutaneous exchange rod technique for accurate portal localization, enhancing minimally invasive access and reducing peroneal nerve injury risk, and the use of all-suture anchors for fixation, minimizing hardware-related cartilage trauma while ensuring biomechanical stability. This technique enables anatomical reattachment without transosseous tunnels, making it suitable for adult patients with medial meniscal posterior root tear and adolescents with lateral meniscal posterior root tear.