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Complete radial tears of the medial meniscus significantly decrease the meniscal tissue's ability to dissipate tibiofemoral loads and have been described as functionally similar to a total meniscectomy, predisposing patients to early osteoarthritis. At present, no consensus exists regarding the optimal surgical treatment of a radial meniscal tear. Current repair techniques have led to a reportedly high rate of incomplete healing or healing of the meniscus in a nonanatomic, gapped position, which compromises its ability to withstand hoop stresses. Improvement regarding the ability to repair and heal medial meniscus radial tears has the potential to result in enhanced preservation of the articular cartilage in the medial compartment of the knee. This technical description details a method for repairing radial tears of the medial meniscus using a transtibial 2-tunnel technique.

Meniscal root tears are increasingly recognized as an important pathology. Failure to recognize this pathology could lead to early onset osteoarthritis of the ipsilateral knee joint compartment similar to a total meniscectomy. Therefore, surgical treatment is necessary to restore meniscal function and to normalize contact pressures, when there is joint overload and sufficient remaining articular cartilage. This article details our anatomic posterior root repair procedure using a transtibial double tunnel pullout technique.