Functional outcomes of Arthroscopic Medial Meniscus Root Repair with a Centralization Suture Through Transtibial Pullout Technique

Articles in Press

Document Type : Original Article

Authors

1 Orthopedic surgery and traumatology department, Faculty of medicine, Minia University, Minia , Egypt

2 Department of orthopedic surgery faculty of medicine Minia university

Abstract

Background: Meniscal root tears compromise knee joint biomechanics and predispose to early articular cartilage degeneration and osteoarthritis if not addressed. Increased clinical emphasis has been placed on repairing medial root tears using arthroscopic methods such as transtibial pull-out sutures and InSite anchor fixation. Despite procedural success, persistent meniscal extrusion remains problematic. A novel centralization technique has been introduced to anatomically reposition the meniscus and optimize biomechanical restoration

Patients and methods: This is a prospective randomized controlled study including 30 patients who underwent root repair with one modified loop stitch as well as another centralization suture at zone 3 or junction between zone 3 and zone 4 according to Smigielski topographic classification through a different tunnel, postoperative evaluation was done using visual analogue scale of pain (VAS) and Lysholm score at a minimum follow-up of 2 years.

Results: there was a significant improvement in pain according to VAS score decreasing from a preoperative range of 8–9 (mean 8.530.5) to a postoperative score of 1 (mean 0.50.5), with this change being statistically significant (P < 0.0001). and significant enhancement according to Lysholm score postoperatively from 27.6 (23–30) to 89.5 (85–94) in (P < 0.0001).

in a mean follow-up period of 29.9 months. No complications reported in all cases.

Conclusion: adding an additional centralization suture through an extra tunnel decrease incidence of failure rate of root repair. This centralization suture looks like a protection plate after lag screw fixation of bone fractures, no implants used in this technique giving it an economic advantage.

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Minia Journal of Medical Research

Articles in Press, Accepted Manuscript
Available Online from 14 September 2025

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