Description of a surgical technique of medial meniscus root repair: a fixation technique with two simple stiches under an expected initial tension

  • Yuki Okazaki
  • Takayuki FurumatsuEmail author
  • Yuya Kodama
  • Yusuke Kamatsuki
  • Shin Masuda
  • Toshifumi Ozaki
Technical Note • KNEE - ARTHROSCOPY


The medial meniscus (MM) posterior root has an important role in the maintenance of knee kinematics and articular cartilage. Although transtibial pullout repair of the MM posterior root tear (MMPRT) has become the gold standard, it is associated with several suturing difficulties. The present technical note describes a simple fixation technique using two simple stiches under an expected initial tension. After the degree of knee flexion (20°) and an expected tension (30 N) are checked, tibial fixation is performed using a bioabsorbable interference screw with a spring tensioner. After that, a suture knot is made just below the screw in case the sutures are pulled toward the joint direction. Furthermore, a cancellous screw is inserted at a position 1-cm distal from the tibial tunnel for augmentation and is tightened. MMPRT usually occurs in middle-aged females who often have decreased bone quality. However, there is no risk of tibial fracture with our new technique because the bone does not need to be hit. Adopting the advances of fixation with a spring tensioner and Biosure RG instead of Double Spike Plate, we can determine an expected tension easily and safely. The present fixation technique allows reproducibility for many operators to determine an initial tension and might be a good candidate for arthroscopic repair of the MMPRT. Further follow-up studies including second-look arthroscopy and scoring will be necessary to show the clinical benefits of this technique.


Medial meniscus Posterior root tear Pullout repair Simple fixation technique Expected tension 



We thank Editage ( for English language editing.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Yuki Okazaki
    • 1
  • Takayuki Furumatsu
    • 1
    Email author
  • Yuya Kodama
    • 2
  • Yusuke Kamatsuki
    • 1
  • Shin Masuda
    • 1
  • Toshifumi Ozaki
    • 1
  1. 1.Department of Orthopaedic SurgeryOkayama University HospitalOkayamaJapan
  2. 2.Department of Orthopaedic SurgeryIwakuni Medical CenterIwakuniJapan

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