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Introduction This study focuses on the tibial tunnel in the pull-out repair of medial meniscus posterior root tears (MMPRTs), with attention to the distal hole as the anatomical vector. Little research has explored this aspect, as previous studies have mainly emphasized the proximal hole as the attachment point. Methods The anatomical vector was identified by analyzing magnetic resonance images of 84 healthy knees. Clinical nine cases that underwent pull-out repair using the anatomical tibial tunnel (AT) with open wedge high tibial osteotomy (OWHTO) were evaluated to investigate the interference between plate screws and AT, and longitudinal changes in tibial tunnel diameter. Results Almost all distal holes of the tibial tunnels were plotted on the anterolateral surface of the tibia. The distal hole of the anatomical vector was more lateral in the 'body mass index of more than 22 kg/m2' and 'currently with sports' groups. In only one clinical case, the AT interfered with the proximal anterior screw. The tibial tunnel diameter was significantly reduced in the AT group compared with the medial tibial tunnel (MT). Conclusions The anatomical vector pointed to the anterolateral surface of the tibia and tended to point outward due to potential overload. Compared with the MT, the AT is expected to reduce the killer turn of the posterior root, promoting early tibial tunnel filling, and improving interference issues with screws in OWHTO. The AT can be an option for pull-out repair of MMPRTs.
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http://dx.doi.org/10.7759/cureus.89122 | DOI Listing |
Oper Orthop Traumatol
September 2025
Sektion Sportorthopädie, TUM Universitätsklinikum, Ismaninger Str. 22, 81675, München, Deutschland.
Objective: Anatomical reconstruction of the posterior cruciate ligament (PCL) with suture tape augmentation to enhance primary stability.
Indications: Acute or chronic PCL ruptures, either isolated or as part of multiligamentous injuries, in cases of symptomatic instability or failure of conservative treatment.
Contraindications: Fixed posterior drawer, active infection, bony avulsion.
Arch Orthop Trauma Surg
September 2025
Department of Orthopedics and Traumatology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
Introduction: Tunnel widening following anterior cruciate ligament (ACL) reconstruction remains a significant clinical concern. Polyether ether ketone (PEEK) screws offer favorable biomechanical properties and MRI compatibility; however, they lack osteoconductivity, which may contribute to tunnel widening. This study investigated whether hydroxyapatite (HA)-coated polyether ether ketone (PEEK) screws reduce tibial tunnel widening compared to uncoated PEEK screws, considering the osteoconductive properties of HA.
View Article and Find Full Text PDFAm J Sports Med
September 2025
Twin Cities Orthopedics, Edina, Minnesota, USA.
Background: Meniscal extrusion has been reported to be present in >50% of knees after medial meniscus root repair. Meniscal extrusion has also been reported to be a risk factor for the progression of osteoarthritis and poorer patient-reported outcomes by impairing the ability of the meniscus to absorb hoop stress.
Purpose: To determine whether the addition of a centralization suture to 2-tunnel transtibial root repair reduces postoperative medial meniscal extrusion in patients with type 2 posterior medial meniscus root (PMMR) tears.
Cureus
July 2025
Division of Radiology, Keiju Medical Center, Nanao, JPN.
Introduction This study focuses on the tibial tunnel in the pull-out repair of medial meniscus posterior root tears (MMPRTs), with attention to the distal hole as the anatomical vector. Little research has explored this aspect, as previous studies have mainly emphasized the proximal hole as the attachment point. Methods The anatomical vector was identified by analyzing magnetic resonance images of 84 healthy knees.
View Article and Find Full Text PDFArthroscopy
August 2025
Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
Remnant preservation is one specific anterior cruciate ligament (ACL) reconstruction technique that has been explored to improve outcomes and involves retaining, as opposed to debriding, the "remnant" or native ACL tibial stump at the time of reconstruction. The ACL remnant tissue contains important mechanoreceptors and nerve endings, and preservation of this tissue is thought to enhance biological healing within the bone tunnels, graft ligamentization, maturation, synovialization, proprioception, and reduce the risk of tunnel enlargement. Remnant preservation may also offer several technical advantages such as creation of a biological sleeve for the graft and improved anatomic graft placement.
View Article and Find Full Text PDF