2017 ISAKOS Biennial Congress ePoster #1318


Repair of Radial Meniscus Tears with the Transtibial Two Tunnel Technique: A Comparative Cohort Study with 2-Year Minimum Follow-Up

Mark Cinque, Redwood City, CA UNITED STATES
Andrew Geeslin, MD, Burlington, VT UNITED STATES
Jorge Chahla, MD, PhD, Hinsdale, IL UNITED STATES
Grant J Dornan, MS, Vail, CO UNITED STATES
Robert F. LaPrade, MD, PhD, Edina, MN UNITED STATES

Steadman Philippon Research Institute, Vail, Colorado, UNITED STATES

FDA Status Not Applicable


Transtibial repair of radial meniscus tears produces comparable outcomes to vertical meniscus tear repairs, and superior outcomes when compared to radial tear meniscectomies.

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Radial meniscus tears disrupt the circumferential fibers and thereby compromise meniscal integrity. Historically, radial tears were often treated with meniscectomy due to an incomplete understanding of the biomechanical consequences of these tears, limited information regarding the biomechanical performance of repairs, and the technical difficulty associated with repair. A paucity of studies on the outcomes of repair of radial meniscal tears are available.

Purpose/Hypothesis: The purpose of this study was to determine the outcomes of a two-tunnel transtibial repair of radial meniscus tears and compare these results to the outcomes of patients who underwent repair of vertical meniscus tears with a minimum of two-year follow-up. The hypothesis was that radial and vertical meniscal tear repair outcomes were comparable.


Patients that underwent a two-tunnel transtibial pullout repair for a radial meniscus tear were included in this study and compared to patients with an inside-out repair of vertical meniscus tears. Subjective questionnaires were administered pre-operatively and at a minimum of two years follow-up, including the Lysholm score, the Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) score, the Short Form-12 (SF-12) physical component summary (PCS), the Tegner Activity scale and patient satisfaction. ANCOVA models were used to compare postoperative outcome scores between meniscus repair groups while accounting for baseline score. Adjusted mean effects relative to the radial repair group were reported with 95% confidence intervals.


Twenty-seven patients that underwent two-tunnel transtibial pullout repairs for radial meniscal tears and 33 patients who underwent an inside-out vertical meniscus tear repair were available for follow-up at an average of 3.5 years (range, 2.0-5.4 years). No preoperative outcome score significantly differed between the groups. There were no significant group differences for any of the two-year postoperative outcomes scores. Relative to the vertical repair group, the repaired radial tear group exhibited an adjusted average of -0.2 (95% CI: -5.4, 4.9), -0.6 (-6.6, 5.5) and +5.1 (-3.9, 14.0) points on the SF-12 PCS, WOMAC and Lysholm scales, respectively.


The two-tunnel transtibial pullout technique for repair of radial meniscal tears produces similar clinical outcomes when compared to repairs of vertical tears at an average 3.5 years follow-up.