Adinun Apivatgaroon, M.D., Bancha Chernchujit, M.D.

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A Medial Meniscal Root Pullout Repair With the Use of a Tibial Tunnel Suturing Technique Adinun Apivatgaroon, M.D., Bancha Chernchujit, M.D. Arthroscopy Techniques Volume 5, Issue 3, Pages e595-e599 (June 2016) DOI: 10.1016/j.eats.2016.02.005 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 Images show the intra-articular finding from the anterolateral viewing portal of the right knee, supine position, and 90° knee flexion. (A) Medial meniscal root tear (red arrow). (B, C) Identification, preparation, and creation of the tibial tunnel (TT) under direct visualization. Arthroscopy Techniques 2016 5, e595-e599DOI: (10.1016/j.eats.2016.02.005) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 Images show the steps in the suturing medial meniscal root through the tibial tunnel. (A) The Nitinol is passed through the tibial tunnel and the medial meniscus in the retrograde direction. (B, C) The Nitinol is pulled with a No. 2 Ethibond suture through the posteromedial portal (PM). Arthroscopy Techniques 2016 5, e595-e599DOI: (10.1016/j.eats.2016.02.005) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Images show the complete first pullout suture. (A-C) Repeated suture in the anterior-posterior direction with the Nitinol and a 2-0 polydioxanone suture using a shuttle relay technique. (D) The meniscus after pulling both limbs of the first No. 2 Ethibond through the tibial tunnel portal. Arthroscopy Techniques 2016 5, e595-e599DOI: (10.1016/j.eats.2016.02.005) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 Images show the second pullout suture. (A, B) The same steps as of Figures 2 and 3 with the Nitinol and the second No. 2 Ethibond in the medial-lateral direction. (C) The double pullout sutures in the cruciate configuration (red arrow). Arthroscopy Techniques 2016 5, e595-e599DOI: (10.1016/j.eats.2016.02.005) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 The 4 limbs of 2 Ethibond sutures are pulled and secured with the EndoButton to the anterior cortex of the tibia. Arthroscopy Techniques 2016 5, e595-e599DOI: (10.1016/j.eats.2016.02.005) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions