“X-Square” Technique For Radial Meniscal Root Tear
Samitivej Srinakarin Hospital, Bangkok, THAILAND
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Summary: The transtibial pull-out-based technique is improved by adding the "X-Square" area fixation to create a near-anatomical meniscus footprint, even compression pressure distribution, and more vascular channel to assist cartilage healing.
The meniscus is essential for shock absorption, load distribution, proprioception, joint stabilization, and protection of the articular cartilage. Meniscal root tear render increases tibiofemoral pressure leading to osteoarthritis. The commonly performed transtibial pull-out-based (TPB) technique provides either a point or line of contact which is not a native footprint.
We propose the “X-Square” area fixation technique to the double TPB. The design logic is to create a near-anatomical meniscus footprint. Two tunnels and two diagonal lines are added to the double TPB to create a square footprint with an X figure. The four tunnels and six lines that formed the X-Square resulted in the even compression pressure distribution and more vascular channels for mesenchymal cells from the tibial metaphysis to assist cartilage healing. Besides, the near-anatomical area created provides a better meniscus reposition to minimize the pressure per unit of the meniscus surface area.
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