Meniscal Root Tears



Up to 8% reported in ACL reconstructions


Natural History


Very poor

- leads to mensical extrusion

- increased tibio-femoral contact pressure

- rapid early OA

- equivalent to total meniscectomy





- meniscal extrusion

- meniscal ghost sign on sagittal (missing meniscus)


MRI Meniscal Root tearMeniscal Root Tear MRIMRI Meniscal Root Tear 3




Have to look either posteromedial or posterolateral to identify


Meniscal Root TearMeniscal Root Tear


Surgical Management


1. Suture anchor repair

- posterior compartment cannula

- insert cannula into posterior tibial plateau

- pass sutures and tie


2. Transtibial pullout repair



- use ACL guide

- pass under ACL / PCL to get to root insertion

- camera through posterolateral  / posteromedial portal

- pass beath pin under vision

- pass endobutton drill under vision

- debride insertion

- pass sutures through meniscal root (either labral suture passer or rotator cuff suture passer)

- retrieve through tunnel with houston suture passer

- tie over endobutton


Meniscal Root RepairMeniscal Root RepairMeniscal Root Repair 3


Mensical Root Repair Endobutton DrillMensical Root Repair Drill HoleMensical Root Sutures