Medial Meniscus Root Reconstruction using Gracillis Tendon Autograft in Managing Medial Meniscus Posterior Root Tear: A Preliminary Case Series

Introduction: Medial Meniscus Posterior root tears (MMPRT) are defined as complete radial tear within 10 mm from the meniscus attachment or bony root avulsion. Currently, repair of meniscal root injuries is the treatment of choice with the aim of restoring joint kinematics, contact pressures, and delaying the development of OA. Although encouraging results have been reported, the repair techniques do not provide any biological substance to stimulate biological healing, remembering that the attachment of medial meniscus root to the tibial plateu contain a ligament-like structures, the usage of graft may recreate that ligamentous structure. Therefore the purpose of this case series is to describe the clinical outcome of medial meniscus root reconstruction in 3 cases of degenerative MMPRT. Method: Three patients was diagnosed with MMPRT by a history taking, physical examination and the use of non-contrast knee MRI. All of the patients underwent arthroscopic surgical reconstruction with 2 tunnel transtibial pullout repair (TPR) technique and the use of gracillis tendon autograft (3 mm in diameter, 6 cm in length) that is passed through the meniscus. The surgery was performed by one orthopaedic surgeon. Follow up was done at 3 month after the surgery. KOOS and VAS are used to assess both patient subjective outcome and pain score. Result and Discussion: Patients underwent reconstruction shows an improvement in KOOS and VAS score. The average improvement in total KOOS is 43% and VAS score is 6,3 points. From the study by Wendel et al. meniscus root reconstruction can provide reattachment to the anatomic footprint and cartilaginous graft to facilitate healing. Also in agreement with the study by Li et al arthroscopically assisted meniscus root reconstruction with gracillis autograft showed superior clinical outcome and meniscus root healing rate. Conclusion: Meniscus root reconstruction showed a promising result in managing patients with MMPRT. No serious complications are reported.