Arthroscopic Repair of Medial Meniscus Posterior Root Tear with Adjustable Titanium Plate Fixation

Summary

This article describes a surgical approach to repairing a medial meniscus posterior root tear (MMPRT) using a single-suture, double-loop, adjustable titanium plate internal fixation under arthroscopy.

Abstract

Medial meniscus injury is one of the most prevalent knee disorders, with posterior root tears occurring in approximately 10% to 21% of affected individuals. A posterior root tear disrupts the meniscus's continuous annular structure, compromising its ability to absorb pressure and protect the knee's articular cartilage. If left untreated, this can result in increased stress on the cartilage, leading to conditions such as varus deformity and accelerated joint degeneration. Partial removal (resection) of the medial meniscus further exacerbates these issues, often leading to quicker joint deterioration. Repairing medial meniscus posterior root tears (MMPRTs) plays a crucial role in restoring the meniscus's structural integrity and improving knee biomechanics. Studies have shown that compared to partial medial meniscectomy or conservative treatments, repairing MMPRTs enhances clinical outcomes and significantly delays the onset of arthritis. This article details a surgical procedure that uses a single-suture, double-loop, adjustable titanium plate fixation technique under arthroscopy for effective MMPRT repair.

Introduction

The meniscus consists of fibrocartilage and cannot repair itself after an injury, except for partial injuries to the margins, which can heal on their own. A normal meniscus increases the depth of the tibial condyle and cushions the medial and external femoral condyles, enhancing joint stability and absorbing shock. After a meniscus injury, joint space pain can occur, and in severe cases, it may be accompanied by symptoms such as joint locking. Posterior root tears occur in 10% to 21% of patients with medial meniscus injuries^1,2,3,4. The atta....

Protocol

This protocol was approved by the Ethics Committee of Hebei Medical University Third Hospital (K2023-086-1). The patient and their family agreed upon the surgical plan, and an informed consent form was signed. The inclusion criteria for the surgical approach were patients with knee MMPRT and Kellgren-Lawrence grade 0-III osteoarthritis without severe varus deformity. Exclusion criteria were: patients with knee MMPRT with injury to the medial meniscus body or anterior horn, injury to the anterior or posterior cruciate lig.......

Discussion

Treatment options for MMPRTs include posterior root repair, partial meniscectomy, and conservative treatment. Many studies have shown that partial medial meniscectomy and conservative treatment are ineffective in preventing or delaying osteoarthritis^23,26,33. MMPRT repair, however, can effectively alleviate pain symptoms and prevent or delay the progression of osteoarthritis. For patients with MMPRTs accompanied by severe medial.......

Materials

Name	Company	Catalog Number	Comments
Adjustable loop titanium plate	star	F06003978	Φ60
Aimer,tip,drctr ACL guide	smith&nephew	7205519
Angled bullet	smith&nephew	7207282
Arthroscopic sheath	smith&nephew	72200829	6 mm
Arthroscopy	smith&nephew	72202087	30° 4 mm
Beam guide	smith&nephew	72204925	5 mm x 3.6 m
Beam guide-arthroscopy end connector	smith&nephew	2143
Beam guide-panel connector	smith&nephew	2147
Blood-repellent belt	selani	tpe15100	15 cm x1 m
Blunt puncture cone	smith&nephew	4356	4 mm
Camera	smith&nephew	72200561	NTSC/PAL
Canulated drill	smith&nephew	13498	5 mm
Coupler	smith&nephew	72200315
Drill guide wire	smith&nephew	14396	2.4 mm
DYONICS POWER II	smith&nephew	72200873	100-24VAC, 50/60Hz
DYONICS POWERMAX ELITE	smith&nephew	72200616
Elite Knot Manipulating Full Loop	smith&nephew	72201213
Elite Premium Bankart Rasp	smith&nephew	72201660
Elite premium suture loop vertical grasper,blue handle	smith&nephew	7209494
Elite sliding suture cutter	smith&nephew	7209492
Endoscopic camera system	smith&nephew	72201919	560P NTSC/PAL
Handle	smith&nephew	7205517
HD monitor	smith&nephew	LB500031	27 inch
Hook probe	smith&nephew	3312
Incisor plus platinum shaver	smith&nephew	72202531	4.5 mm
Lumbar needle  AN-E/S II	tuoren	AN-E/S	1.6 x 80 mm
Micropunch,teardrop,left	smith&nephew	7207602
Micropunch,teardrop,right	smith&nephew	7207601
Micropunch,teardrop,straight	smith&nephew	7207600
PDS II	Johnson&Johnson	D6451	2-0
Pitbull Jr. Grasper	smith&nephew	14845
Shoulder Elavator	smith&nephew	13949