Suture anchor and transtibial pullout refixation of the posterior medial meniscus root tears restore tibiofemoral contact pressure and area to intact meniscus levels.

Purpose: To compare the load distributed to the medial tibial articular cartilage after refixation of posterior medial meniscus root tears between the suture anchor and transtibial pullout techniques in posterior medial meniscus root tears.

Methods: Twelve Thiel's embalmed human cadaveric knees are used and divided into three groups (four knees in each group): (1) intact meniscus (IM), (2) fixation with suture anchor technique (SA) and (3) fixation with transtibial pullout technique (TP). Each group applies an axial compression load up to 1500 N by Instron E 10000 at two knee flexion angles (0° and 60°). A Tekscan 4000 pressure sensor is used to record the contact pressure and the contact area for each testing condition.

Results: The contact pressure and the contact area between the three conditions are not significantly different at 0° and 60° knee flexion angles. The peak contact pressure and contact area are 3734.8 ± 2642.2 kPa, 288.2 ± 115.0 mm², 4510 ± 2930.5 kPa, 204.4 ± 36.8 mm² and 5328.8 ± 2607.7 kPa, 219.2 ± 84.7 mm² in IM, SA and TP, respectively.

Conclusion: Both suture anchor and transtibial pullout refixation of PMMRT can restore contact pressure and contact area similar to the intact meniscus. This finding suggests that either technique can be reliably used in clinical practice to preserve joint function and potentially reduce the risk of osteoarthritis progression following posterior medial meniscus root tear repairs.

Level of evidence: Level III.