Background: Medial meniscus posterior root tears (MMPRTs) frequently lead to meniscal extrusion, loss of hoop stress function and progressive medial compartment degeneration. Although transtibial pull-out root repair is the current gold standard, persistent extrusion remains common, prompting growing interest in adjunctive peripheral meniscal augmentation techniquesQuery.
Objective: To provide a pictorial overview of contemporary peripheral meniscal augmentation techniques used in conjunction with MMPRT repair, outlining their technical principles and biomechanical rationale.
Methods: PubMed was electronically searched for relevant articles. Titles, abstract and full texts were screened to identify eligible studies.
Results: This narrative pictorial review synthesizes current techniques described in the literature for addressing meniscal extrusion following MMPRT repair, including tunnel-based centralization, anchor-based augmentation, all-inside capsular reinforcement and open meniscotibial reconstruction. For each method, key arthroscopic portals, suture pathways, fixation strategies and reduction maneuvers are illustrated to clarify technical nuances and highlight potential advantages and limitations.
Conclusion: Peripheral meniscal augmentation techniques improve meniscal reduction, restore hoop stress and reduce extrusion, with the tunnel-based method offering strong fixation but risking tunnel convergence, whereas anchor-based and all-inside approaches allowing targeted repair without tibial tunneling. Technique selection should be individualized; and as evidence evolves, peripheral augmentation may become a standardized adjunct to MMPRT repair to enhance long-term joint preservation.
Keywords: Meniscal posterior anchoring; Meniscotibial ligament repair; Meniscus centralization; Meniscus extrusion; Posteromedial capsule repair.
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