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JRPMS Vol 7, No 3, September 2023, p.69-75

doi: 10.22540/JRPMS-07-069

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Original Article

An Antegrade Soft Anchor in a Retrograde Drilling for Medial Meniscus Root Repair with High Tibial Osteotomy: A Modified Approach to Avoid Tunnel Collision

Sandeep N. Deore, Sachin Kale, Aditya Gunjotikar, Nikhil Isaacs, Ajinkya Achalare, Sonali Das

  • Department of Orthopedics, D.Y. Patil Medical College, Navi Mumbai, Maharashtra, India

Keywords: All-suture Anchor, Medial Meniscus Root Tear, Medial Open Wedge High Tibial Osteotomy, Retrograde Drilling, Varus Deformity


Abstract

Objectives: Coexistence of varus deformity of knee and Medial Meniscus Posterior Root Tear (MMPRT) is known to have a rapid progression to medial compartment arthritis. Medial open wedge high tibial osteotomy (MOWHTO) with transtibial suture pullout for MMPRR is currently a preferred technique, although it is technically demanding. We describe a combination of technique of root repair with an all-suture soft anchor along with MOWHTO. Methods: In this prospective study, 25 patients of proximal tibial varus of more than five degrees with MMPRT and up to grade 2 medial compartment osteoarthritis (Kellgren-Lawrence classification) were operated at a single tertiary center. Arthroscopic root repair was performed with an all-suture anchor, followed by standard MOWHTO using a titanium locking plate. Functional and radiological outcomes were evaluated at 2-year follow-up. Results: Mean deformity (femorotibial angle) improved from 12 degrees varus pre-operatively to 5 degrees valgus at 2-year follow-up. Mean MPTA increased from 80.6 to 87.2 degrees. There was statistically significant improvement in mean pre-operative Lysholm score of 32 to 85 at 2-year follow-up. Conclusions: MMPRT repair with an all-suture anchor along with MOWHTO is a relatively easier and reproducible single stage technique, giving good functional and radiological outcomes at 2-year follow-up.