Medial meniscus root tear with bone fragment:

Repair technique

1/30/2019

Nicholas Colyvas, MDClinical ProfessorDepartment of Orthopaedic Surgeryorthosurg.ucsf.edu

Patient

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36-year old male police officer

Injury while kicking in a door, two months prior

Pain and some swelling

Exam showed some medial meniscal signs

No instability or other findings

MRI Coronal

-Posterior horn largely absent

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MRI Coronal

Root attachment absent

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MRI Coronal

Some extrusion

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MRI Coronal

Posterior horn meniscus flipped

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MRI Sagittal

Extensive Ghost Sign

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MRI Sagittal

Extensive Ghost Sign

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MRI Sagittal

Flipped meniscus

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MRI Axial

Not an ideal cut, but flipped PH noted

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Video

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Surgery Notes

• Fragment was both a bony avulsion root tear and meniscocapsular tear at the PH

• Bony surfaces on both fragment and tibia bed well prepared, as well as meniscocapsular surfaces

• PH mattress suture used to secure meniscocapsular section and provide additional fixation for root

• Anchor (swivelock) used for transtibial fixation – more reliable tension maintenance.

• Notch microfracture performed at completion

• Patient returned to full activity and work at 4 months post-op

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