Summary

The new technique of meniscus root repair with triple loaded suture anchor will provide more stability, more healing rate, and more auxiliary procedures.

Abstract

Background

The result of the meniscal root repair (MRR) was that the repair is the best treatment option in the presence of an acute situation with no degenerative changes. The MRR could be restored, as well as the meniscus's hoop stress function, which is a key component in preventing osteoarthritis progression in the future. However, MRR techniques have still been developed, and both biomechanics and a lower incidence of failure repair are correlated with the suture anchor techniques.

Objectives
This technique is the only treatment that can be improved depending on knowledge and relies on better biomechanics and concepts of regeneration until the patient achieves better function and can return to usual activities without developing osteoarthritis.

Study Design & Methods
The surgeon deploys the soft anchor pulled the suture limbs and soft anchor suture becomes to secure fixation into the tibia tunnel. The Mini- First pass sutured at the 3 mm medial part of the medial meniscal root tear site. The second horizontal stitch is suture far from the first stitch approximately 5 mm. The Mini-First pass (FIRSTPASS MINI Suture Passer, Smith- Nephew) is loaded with a looped suture limb, allowing a loop to be passed up through the posteromedial part of the meniscal root. The lateral compression stitch is performed repeatedly step by step with the Mini-First pass. This suture limb is retrograde sutured far from the first horizontal stitch around 5 mm. The knot tying procedure should be tied sequence by first knot tying is the reduction stitch, second knot tying is the medial compression stitch as well as the last stitch is the lateral compression stitch. The first reduction is tied by knot pusher and set the post of the knot pusher at the medial suture limb of the reduction stitch. The knot tying should be the medial close to the intercondylar notch for preventing the knot will damage the medial femoral cartilage. The second knot tying is the medial compression stitch which the post of the knot pusher should be posterior part of the medial meniscal root. The last knot tying is the lateral compression with repeated the previous step by step.

Results

The triple loaded soft suture anchor construct provides significantly lower displacement and increased stiffness, as well as good biomechanical properties. In terms of contact surface healing, it occurred with the medial and lateral compression stitches and progressing to better knee function and meniscal root healing.

Conclusions

The triple loaded soft anchor repair technique offers a strong suture construction, less displacement, no need to access the posterior compartment of the knee, which contains the neurovascular bundle, improved contact surface healing, and is a familiar arthroscopic technique.