Modified Centralization Technique of Tibial Side Capsulodesis for Radial Tear of Incomplete Discoid Lateral Meniscus

Abstract

An incomplete discoid lateral meniscus is often associated with radial tears, which cause meniscal extrusion and result in poor healing outcomes. Centralization has recently been used as a surgical method to reduce extrusion. However, various repair techniques use single point of fixation sutures exclusively on the femoral side, potentially hindering healing. In this study, a method is devised in which 2 anchor sutures are placed on the tibia and guided out of the capsule from the tibial side of the meniscus, and another anchor is placed distally to tighten the meniscotibial ligament in a plane. This method supports the repaired site against hoop stress by tightening the meniscotibial ligament and is considered a physiological repair because the sutures are confirmed to the tibial side of the meniscus rather than on the femoral side. Furthermore, an inside-out suture of the torn area with a fibrin clot derived from the bone marrow aspirate, rich in tissue-healing components, is also performed.