Transtibial single-tunnel all-inside technique for repair of a complete radial meniscal tear

Introduction

Radial meniscus tears significantly compromise knee biomechanics due to loss of the circumferential fiber connections and have been shown to be biomechanically equivalent to a total meniscectomy. There is a paucity of data regarding the biomechanical performance of radial meniscal repairs and numerous technical challenges associated with surgical repair. Further, current repair methods have been shown to lead to high rates of incomplete, nonanatomical healing of the meniscus and can potentially cause progressive joint degeneration and osteoarthritis. This is particularly true for the avascular portions of the meniscus. As a result, such injuries have been historically treated with a partial meniscectomy. There has been a growing interest in transtibial repair mechanisms as a potential solution to this challenging pathology.

Objectives

The purpose of this technical note is to detail a method for repairing a complete radial tear of the medial meniscus using a single-tunnel transtibial technique.

Methods

After a thorough history and clinical examination, and imaging, the patient was diagnosed with a complex medial meniscal tear with a primary radial tear component. A single tunnel transtibial meniscal repair was indicated and performed.

Results

An anatomic repair was achieved with tension across the defect. The patient successfully returned to activities.

Conclusions

Single-tunnel transtibial repairs of radial tears in the meniscus may provide increased stability by anchoring the meniscal leaflets to the tibia as well as a potential biological benefit by releasing growth factors and progenitor cells from the bone marrow.