Meniscus Root Tear Arthroscopic Reinsertion using Fiber-Tape.

The video presents a modification of the technique for transosseous reinsertion of the posterior root of the medial meniscus using a Fiber-Tape and a cortical fixation with a Swivel-Lock. We have found that using 2 cinch configuration 2-0 sutures in the root can compromise fixation, due to tissue ripping and low pull-out strength. We usually find medial root lesions in middle-aged women that present bad quality tissue in the posterior horn of the meniscus, as opposed to lateral root tears in young patients after acute injuries associated to ACL tears. We have found that using a Fiber-Tape with 6 passes in the posterior root gives adequate pull-out strength in this lesion. Suture management can be bothersome. We recommend using a cannula and retrieving one of the suture limbs through the antero-lateral portal and working with the other limb. We also found that tying the sutures over a cortical button could not be completely reliable in terms of maintaining suture tension and appropriate root reduction. We are now using a Swivel-Lock and checking for proper tension at final fixation with the scope.