Medial Meniscus Root Tear With Bone Fragment: Repair Technique

Description

In this instructional video, Dr. Nicholas Colyvas, a Clinical Professor in Orthopedic Surgery at UCSF, discusses a surgical technique for repairing a medial meniscus root tear with an accompanying bony avulsion in a 36-year-old male patient, a police officer. The procedure begins with a detailed examination of the patient's knee, which was injured during an incident involving a kick to a door, leading to pain and swelling. Imaging reveals a posterior horn meniscus tear along with signs of a root tear. Dr. Colyvas emphasizes the importance of imaging analysis, noting the presence of a 'ghost sign' indicating the absence of the posterior horn in MRI views.



The surgical technique involves carefully manipulating a flipped meniscus fragment back into place while trephinating the capsule to enhance blood flow and healing potential. The preparation of both the meniscus and the bony surfaces is critical for a successful fixation, leading to the introduction of suture techniques that secure the meniscus properly to the tibia. Dr. Colyvas demonstrates the use of standard root repair methods and highlights the addition of horizontal sutures and microfracture techniques to facilitate healing. He comments on the uniqueness of the case due to the bony avulsion and provides insights into the importance of thorough preparation and fixation strategies.



Finally, he reports on the successful outcome of the surgery, with the patient resuming full activities, including his role in law enforcement, within four months post-operation.

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