CLINICAL OUTCOME OF ARTHROSCOPIC REDUCTION AND FIXATION BY PULL THROUGH SUTURE TECHNIQUE IN TIBIAL SPINE FRACTURES

Background -Tibial spine avulsion fracture is bony avulsions of anterior cruciate Ligament (ACL) from its attachment on the anteromedial portion of the intercondylartibial eminence. If not treated well, Tibial spine fractures can lead to non-union or malunion, which can lead to signicant disability in the form of exion deformity,loss of extension, or instability. Aims And Objectives: This study was conducted with the aim of evaluating clinical outcome of arthroscopic reduction and xation of fractures by pull through suture technique and complications associated with the procedure. Thi Material And Method: s prospective with retrospective study analyzed 20 patients (16 males and 4 females), with mean age of 28.6 ± 9.8 years (range, 15-55). Patients were classied by Meyers and Mckeever type III (n=16) and IV (n=4) and were operated arthroscopically by pull through suture technique. They were followed over a mean period of 10±2.8 months. Postoperative assessment was done by using Lachman test, Lysholm knee score and international knee documentation Committee (IKDC) score. Objective assessment of anterior translation of tibia was done by using indigenously developed device named Laxometer. At the end of follow up,17 of 20 patient had no or minimal anterior transl Results: ation of tibia by Lachman test. The mean preoperative Lysholm score in 20 knees was 38 (range 29 to 55) and mean post-operative Lysholm score was 96 (range 83-100). At the end of follow up 17 of 20 (85%) patients accessed by IKDC score were normal/ nearly normal grade A/B and 3 patients were abnormal (grade C). All patients achieved union within 3 months (range 8 to 17 weeks). 20% patients had restricted range of motion. Arthroscopic pull Conclusion: through suture technique has good clinical outcomes in both type III and type IV fractures, and in all age groups (open and closed physis) with minimal complications. This was evidenced by no instability and residual ACL deciency, postoperatively at 1 year. Most patients have excellent recovery with full return of knee range of motion.

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Combined posteromedial or posterolateral PCL injuries: Anatomic repair and ligament bracing as a new treatment option - first results of a multicentre study

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00302 ◽

2020 ◽

Vol 8 (5_suppl4) ◽

pp. 2325967120S0030

Author(s):

Tobias J. Gensior ◽

Richard Glaab ◽

Pierre Hepp ◽

Johannes Zellner ◽

Bastian Mester ◽

...

Keyword(s):

Clinical Outcome ◽

Multicentre Study ◽

Treatment Option ◽

Lysholm Score ◽

Anatomic Repair ◽

One Stage ◽

Ligament Bracing ◽

Ikdc Score ◽

Tegner Score

Aims and Objectives: Acute, isolated PCL injuries can succesfully be managed non-operatively whereas combined PCL injuries usually require surgical management. Currently, there is a lack of evidence regarding the standard of treatment (repair vs. reconstruction, one-stage vs. two-stages procedures). Suture augmented repair leads to good and excellent results in cases of acute knee dislocations. This technique has not been investigated clinically in combined PCL injuries, yet. The aim of this multicentre study was to evaluate the clinical outcome after surgical repair with additional suture augmentation (ligament bracing) of all torn ligaments in acute combined pcl injuries (posteromedial or posterolateral). Materials and Methods: From 2016 to 2018, 25 patients with an acute combined PCL injury were treated with one stage anatomical repair and ligament bracing of the torn ligaments within 14 days at 6 trauma centres (5xGER, 1x SUI). Inclusion criteria: Follow-up min. 6 months, age > 18y. Exclusion criteria: ACL Injury, posteromedial AND posterolateral injury. During the follow-up evaluation, various scores were collected (International Knee Documentation Committee IKDC Score, Tegner Score , KOOS and Lysholm Score). Additional stress radiography was performed (TelosTM) postoperatively. Results: For now 14 combined PCL injuries (posteromedial or -lateral) with a follow-up of 20 months (range 8-33) were evaluated. 10 patients had a posteromedial (PCL + MCL/POL), 4 patients had a posterolateral (PCL + LCL) injury. 10 additional articular lesions were detected (6 meniscus tears, 4 grade IV chondral lesions) and 1 transitional peroneal nerve injury. The average IKDC score was 62.2±18.5, the average Lysholm score was 78±19.2, average KOOS 88.7±7.6. Median loss of activity in the Tegner score was 1 (range 0-5) point. Side-to-side pcl-stress-radiographs showed a difference at a mean of 4.8±3.0mm (range 1-10). 2 cases with symptomatic knee instability, both posterolateral, and 3 patients with knee stiffness needed reoperation. Interestingly, patients with posteromedial injuries showed predominantly good or excellent results according to Lysholm score and were graded as A (4/10) or B (2/10) whereas ligament bracing in posterolateral combined injuries had a high failure rate (Grade D 2/4). Conclusion: Primary anatomic repair and additional suture augmentation predominantly leads to good and excellent clinical results in cases of combined posteromedial PCL injuries. Patients with posterolateral injuries showed inferior clinical outcome and relatively high instability rates following ligament bracing. In conclusion, primary augmented suture repair seems to be a promising treatment option. The overall results of this study have to be evaluated for more exact recommendations.

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Is it worth to perform initial non-operative treatment for patients with acute ACL injury?: a prospective cohort prognostic study

Knee Surgery and Related Research ◽

10.1186/s43019-021-00094-3 ◽

2021 ◽

Vol 33 (1) ◽

Author(s):

Yong-Geun Park ◽

Chul-Won Ha ◽

Yong-Beom Park ◽

Sang-Eun Na ◽

Manyoung Kim ◽

...

Keyword(s):

Clinical Outcome ◽

Operative Treatment ◽

Prospective Cohort ◽

Acl Injury ◽

Lysholm Score ◽

Viable Option ◽

Lachman Test ◽

Clinical Evaluations ◽

Tegner Score

Abstract Purpose To evaluate the result of implementing an initial non-operative treatment program for an acute ACL injury and to find if the timing of initiating the non-operative treatment is significant. Methods This study included a prospective cohort of 85 consecutive patients with acute ACL injury who were treated according to the above strategy for the initial 3 months with 1-year follow-up. Clinical evaluations were made by Lysholm score, Tegner activity score, Lachman test (LT), pivot-shit test (PST), and the side to side difference (SSD) by KT-2000 arthrometer. The results were analyzed according to the timing of initiating the non-operative treatment. Results Initially, 84% of the patients showed LT and PST ≤ grade 1, and 16% with ≥grade 2. At 1-year follow-up, 77 patients (91%) with LT and PST ≤ grade 1 did not receive reconstruction as copers and 8 patients with LT or PST ≥ grade 2 required reconstruction (six patients received the operation and two refused). The patients with LT and PST ≤ grade 1 showed average Lysholm score 91.2, average SSD 2.5 mm, and mean Tegner score decreased from 6.9 (pre-injury) to 6.2. Patients who started the non-operative treatment within 2 weeks after injury revealed superior rates of grade 0 or 1 instability than those who commenced the treatment later than 2 weeks after injury (P = 0.043). Conclusions Implementing a non-operative treatment with brace in acute phase of ACL injury appears to be an effective and viable option to achieve a reasonable clinical outcome. We recommend earlier initiation of the non-operative treatment to obtain a better result in patients with acute ACL injury.

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A Comparison of Nonoperative and Operative Treatment of Type 2 Tibial Spine Fractures

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120975410 ◽

2021 ◽

Vol 9 (1) ◽

pp. 232596712097541

Author(s):

◽

Niyathi Prasad ◽

Julien T. Aoyama ◽

Theodore J. Ganley ◽

Henry B. Ellis ◽

...

Keyword(s):

Range Of Motion ◽

Complication Rate ◽

Cruciate Ligament ◽

Complication Rates ◽

Spine Fractures ◽

Level Of Evidence ◽

Tibial Spine ◽

Nonoperative Group

Background: Tibial spine fractures (TSFs) are typically treated nonoperatively when nondisplaced and operatively when completely displaced. However, it is unclear whether displaced but hinged (type 2) TSFs should be treated operatively or nonoperatively. Purpose: To compare operative versus nonoperative treatment of type 2 TSFs in terms of overall complication rate, ligamentous laxity, knee range of motion, and rate of subsequent operation. Study Design: Cohort study; Level of evidence, 3. Methods: We reviewed 164 type 2 TSFs in patients aged 6 to 16 years treated between January 1, 2000, and January 31, 2019. Excluded were patients with previous TSFs, anterior cruciate ligament (ACL) injury, femoral or tibial fractures, or grade 2 or 3 injury of the collateral ligaments or posterior cruciate ligament. Patients were placed according to treatment into the operative group (n = 123) or nonoperative group (n = 41). The only patient characteristic that differed between groups was body mass index (22 [nonoperative] vs 20 [operative]; P = .02). Duration of follow-up was longer in the operative versus the nonoperative group (11 vs 6.9 months). At final follow-up, 74% of all patients had recorded laxity examinations. Results: At final follow-up, the nonoperative group had more ACL laxity than did the operative group ( P < .01). Groups did not differ significantly in overall complication rate, reoperation rate, or total range of motion (all, P > .05). The nonoperative group had a higher rate of subsequent new TSFs and ACL injuries requiring surgery (4.9%) when compared with the operative group (0%; P = .01). The operative group had a higher rate of arthrofibrosis (8.9%) than did the nonoperative group (0%; P = .047). Reoperation was most common for hardware removal (14%), lysis of adhesions (6.5%), and manipulation under anesthesia (6.5%). Conclusion: Although complication rates were similar between nonoperatively and operatively treated type 2 TSFs, patients treated nonoperatively had higher rates of residual laxity and subsequent tibial spine and ACL surgery, whereas patients treated operatively had a higher rate of arthrofibrosis. These findings should be considered when treating patients with type 2 TSF.

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Outcomes of one-stage reconstruction for chronic multiligament injuries of knee

Knee Surgery and Related Research ◽

10.1186/s43019-020-00083-y ◽

2021 ◽

Vol 33 (1) ◽

Author(s):

Tarun Goyal ◽

Souvik Paul ◽

Sushovan Banerjee ◽

Lakshmana Das

Keyword(s):

Cruciate Ligament ◽

Lysholm Score ◽

Activity Level ◽

Type Ii ◽

Hamstring Tendons ◽

Peroneus Longus ◽

Type Iii ◽

Type Iv ◽

Ikdc Score

Abstract Purpose This article aims to evaluate patterns of chronic multiligament injuries and outcomes of treatment with single-stage reconstruction using autografts. Methods All patients with clinicoradiologically diagnosed multiligament knee injury (MKI) were included in this prospective observational study. As the time since injury was more than 6 weeks in all of the patients, they were categorized as having chronic MKI. Patients were assessed clinically for laxity, and the diagnosis was confirmed radiologically. Ipsilateral hamstring tendons were used for medial collateral ligament (MCL) or posterolateral corner reconstruction in a patient with Schenck knee dislocation (KD) type III. In these cases, the posterior cruciate ligament (PCL) and anterior cruciate ligament (ACL) were reconstructed by using the peroneus longus and contralateral hamstring tendons respectively. Ipsilateral hamstring tendons were used for ACL reconstruction and an ipsilateral peroneus longus tendon graft was used for reconstruction of the PCL in a KD type II injury. In two cases of KD type IV injury, the lateral laxity was only grade II and was managed conservatively; the rest of the ligaments were addressed like a KD type III injury. Outcome evaluation was done using a visual analogue scale (VAS) for pain, International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner activity level, preoperatively and postoperatively at 2 years’ follow-up. Results A total of 27 patients of mean age 33.48 ± 9.9 years with MKI were included in the study. The patients were classified as eight KD type II, 17 KD type III, and two KD type IV. The majority of the patients had associated meniscal (59.2%) or chondral (40.7%) injuries. At the 2 years’ follow-up visit, there were significant improvements in VAS score (p = 0.0001) IKDC score (p = 0.0001), Lysholm score (p = 0.0001), and range of motion (p = 0.001). None of the patients had residual laxity on clinical examination of the knee joint at the 2 years’ follow-up. All but two of the patients went back to their previous activity level. These two patients had progressive knee arthritis and needed knee arthroplasty. Conclusion Single-stage surgical reconstruction for chronic MKI has favourable functional outcomes. Level of evidence Level IV, case series.

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OV07 LAPAROSCOPIC HIATAL HERNIA MESH-SUTURE REPAIR

British Journal of Surgery ◽

10.1093/bjs/znab396.058 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Alexey Abolmasov

Keyword(s):

Hiatal Hernia ◽

Paraesophageal Hernia ◽

Suture Line ◽

Suture Technique ◽

Force Distribution ◽

Suture Repair ◽

Hernia Defect ◽

Hernia Mesh ◽

Pull Through

Abstract Aim “A new original laparoscopic operative technique was used to suture paraesophageal hernia (PEH) with the strips of mesh. Material and Methods The Mercilen (MercilenTM) mesh suture was used to close large hiatal hernia. The strips of mesh, instead of normal thread, were applied to close the gap between diaphragm’s crura in 12 patients with hernia defect more than 5 cm. Mesh suture were tighten as a simple laparoscopic intracorporeal knot. The surgical technique and surgical outcomes are presented. Results 12 patients underwent a laparoscopic PEH suturing with Mercilen strips of mesh. We recorded no recurrence or dysphagia at 6 and 12 months follow-up. Conclusions Mesh-sutured repairs of diaphragm’s hernia support the concepts of force distribution and resistance to suture pull through. The new original technique avoids using the sheet of mesh and enables to reduce the amount of dangerous complications connected with mesh and its fixation. Mesh-sutured closures of hiatal hernias seem to be safe and effective in tension closure of large hiatal defects. Further investigations are needed to evaluate the results. Using the mesh suture technique for the closure of large PEH, we protect the cruras from being cutting through. Besides, the mesh stripes and its knots produce tissue scarring around the esophagus making the suture line stronger.

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Revision Meniscal Repair - Failure rates, clinical outcome and patient satisfaction

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00223 ◽

2019 ◽

Vol 7 (6_suppl4) ◽

pp. 2325967119S0022

Author(s):

Andreas Fuchs ◽

Ferdinand Kloos ◽

Gerrit Bode ◽

Kaywan Izadpanah ◽

Norbert Südkamp ◽

...

Keyword(s):

Patient Satisfaction ◽

Clinical Outcome ◽

Revision Surgery ◽

Meniscal Repair ◽

Sports Participation ◽

Lysholm Score ◽

Failure Rates ◽

The Mean ◽

High Level

Aims and Objectives: Failure of isolated primary meniscal repair must be expected in 14% - 28%. Patients requiring revision surgery may benefit from revision meniscal repair, however, the results of revision meniscal repair remain unclear. The purpose of this study was therefore to evaluate the clinical outcome and failure rates of revision meniscal repair in patients with re-tears or failed healing after previous isolated meniscal repair in stable knee joints. Materials and Methods: A chart review was performed to identify all patients undergoing revision meniscal repair between 08/2010 and 02/2016. Only patients without concomitant procedures, without ligamentous insufficiency, and a minimum follow-up of 24 months were included. The records of all patients were reviewed to collect patient demographics, injury patterns of the meniscus, and details about primary and revision surgery. Follow-up evaluation included failure rates, clinical outcome scores (Lysholm Score, KOOS Score), sporting activity (Tegner scale), and patient satisfaction. Results: A total of 12 patients with a mean age of 22 ± 5 years were included. The mean time between primary repair and revision repair was 27 ± 21 months. Reasons for failed primary repairs were traumatic re-tears in 10 patients (83%) and failed healing in two patients (17%). The mean follow-up period after revision meniscal repair was 43 months. Failure of revision meniscal repair occurred in 3 patients (25%). In two of these patients, re-revision repair was performed. At final follow-up, the mean Lysholm Score was 95.2 with a range of 90-100, representing a good to excellent result in all patients. The final assessment of the KOOS subscores also showed good to excellent results. The mean Tegner scale was 6.8 ± 1.8, indicating a relatively high level of sports participation. Ten patients (83%) were either very satisfied or satisfied with the outcome. Conclusion: In patients with re-tears or failed healing after previous isolated meniscal repair, revision meniscal repair results in good to excellent knee function, high level of sports participation, and high patient satisfaction. The failure rate is comparable to isolated meniscal repair. Therefore, revision meniscal repair is worthwhile in order to save as much meniscal tissue as possible.

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Arthroscopic Transphyseal Anterior Cruciate Ligament Reconstruction in Adolescent Athletes

Journal of Orthopaedic Surgery ◽

10.1177/1602400307 ◽

2016 ◽

Vol 24 (3) ◽

pp. 307-311 ◽

Cited By ~ 8

Author(s):

Luca Dei Giudici ◽

Roberto Fabbrini ◽

Luca Garro ◽

Serena Arima ◽

Antonio Gigante ◽

...

Keyword(s):

Acl Reconstruction ◽

Cruciate Ligament ◽

Lysholm Score ◽

Leg Length ◽

Adolescent Athletes ◽

Ikdc Score ◽

The Mean ◽

Anterior Cruciate ◽

Tegner Activity Scale

Purpose To evaluate the 5-year outcome of arthroscopic transphyseal anterior cruciate ligament (ACL) reconstruction in 19 adolescent athletes. Methods 14 male and 5 female adolescent athletes aged 12 to 16 (mean, 13.9) years with Tanner stage 2 or 3 open physes underwent arthroscopic transphyseal ACL reconstruction by a single surgeon and were followed up for 5 years. Patients were evaluated using the numerical rating score (NRS) for pain, knee osteoarthritis outcome score (KOOS), International Knee Documentation Committee (IKDC) score, Tegner Activity Scale, and Lysholm Score, as well as the leg length discrepancy, femorotibial alignment, varus or valgus deformities, active and passive knee range of motion. Results At 5-year follow-up, physes were closed in all patients. The mean NRS for pain improved from 7.2 to 1.6; the KOOS improved from 55.3 to 88; the mean IKDC score improved from 34.5 to 84; the mean Tegner Activity Scale improved from 2.7 to 8.2 and was comparable with that before injury (8.4); and the mean Lysholm score improved from 36.3 to 84.6. All except 2 patients returned to their pre-injury level of sports activity after a mean of 25 weeks. The 2 exceptions had a 2+ Jerk test and a 3+ Lachman test; one of them also had positive signs for a lateral meniscal lesion. Both had sustained a second trauma not long before the 5-year follow-up. Two patients had reduced sensitivity in the anteromedial aspect of the proximal third of the tibia. One patient had leg length discrepancy of +1.5 cm owing to overgrowth response of the physis. Conclusion Transphyseal ACL reconstruction is a viable option for skeletally immature patients, with high reproducibility, a high rate of return to sport, and a low incidence of growth disturbance. Early surgery can prevent the onset of meniscal lesions and early osteoarthritis.

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Radiological changes of the operated and adjacent segments following cervical arthroplasty after a minimum 24-month follow-up: comparison between the Bryan and Prodisc-C devices

Journal of Neurosurgery Spine ◽

10.3171/2010.3.spine09445 ◽

2010 ◽

Vol 13 (3) ◽

pp. 299-307 ◽

Cited By ~ 36

Author(s):

Kyeong-Sik Ryu ◽

Chun-Kun Park ◽

Sung-Chul Jun ◽

Han-Yong Huh

Keyword(s):

Clinical Outcome ◽

Range Of Motion ◽

Posterior Longitudinal Ligament ◽

Occurrence Rate ◽

Cervical Arthroplasty ◽

Functional Spinal Unit ◽

Bryan Disc ◽

Radiological Changes ◽

Index Level

Object The purposes of this retrospective study were to determine the radiological changes at the index and adjacent levels after cervical arthroplasty using the Bryan disc and Prodisc-C disc after a minimum 24 months follow-up, and to demonstrate the possible clinical factors related to these changes. Methods Following single-level cervical arthroplasty using either the Bryan disc or Prodisc-C, the degree of facet degeneration and other radiological changes at the index and adjacent levels were assessed by observing radiographs and CT scans at a minimum 24 months after the operations. These findings were determined in relation to the clinical outcome, various perioperative factors, and prosthesis factors. Thirty-six patients were included in this investigation (19 in the Bryan disc group and 17 in the Prodisc-C group). Results At the index level, progression of facet arthrosis (PFA) was observed in 7 of 36 levels (1 level with the Bryan disc, 6 with the Prodisc-C). At adjacent levels, PFA was minimally observed. Heterotopic ossification (HO) was observed at 19 levels (11 with the Bryan disc, 8 with Prodisc-C). Progression of facet arthrosis at the index segments was positively related to malposition of the prosthesis on the frontal plane, and decreased postoperative functional spinal unit range of motion at the index level. Occurrence of HO was correlated with the preoperative calcification of the posterior longitudinal ligament at the operated level, regardless of prosthesis type. Clinical outcome and the occurrence of PFA or HO did not show any significant relationship. Conclusions This study demonstrates that the incidence of PFA at the index level is 19.4% after a minimum 24-month follow-up, and occurs more frequently in the Prodisc-C group. Progression of facet arthrosis is related to less functional spinal unit range of motion and anterior placement of the prosthesis. The occurrence rate of HO is high, regardless of the type of prosthesis, and it is significantly correlated with preoperative calcification of the posterior longitudinal ligament at the operated level.

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Surgical Treatment for Avulsion Fractures of the Anterolateral Ligament Associated with Periarticular Fractures of the Knee

The Journal of Knee Surgery ◽

10.1055/s-0041-1735311 ◽

2021 ◽

Author(s):

Xuelei Wei ◽

Zengliang Wang ◽

Yandong Lu ◽

Jie Sun ◽

John Riehl

Keyword(s):

Avulsion Fracture ◽

Pivot Shift ◽

Anterolateral Ligament ◽

Lysholm Score ◽

Pivot Shift Test ◽

X Rays ◽

Avulsion Fractures ◽

Ikdc Score ◽

The Mean

AbstractThe existence and anatomy of the anterolateral ligament (ALL) of the knee are a somewhat controversial topic in orthopaedic surgery. The fixation of the avulsion fracture of the ALL (Segond fracture), associated with periarticular knee fractures, is rarely given much consideration while the major fracture fragments are reconstructed. This study aims to confirm the existence of ALL and evaluate the clinical outcomes of surgical management for avulsion fractures, involving its insertion, when associated with periarticular knee fractures. Twenty-three patients (16 males and 7 females) with avulsion fractures of the ALL associated with periarticular knee fractures were fixed with a spider plate, cannulated screw, or suture anchor. Eight patients were diagnosed with distal femoral fracture, 10 with tibial plateau fracture, and 5 with tibial eminence avulsion fracture. All patients underwent X-rays at follow-up. Clinical and functional outcomes were assessed with the pivot-shift test, objective and subjective International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner activity scale. The ALL was found and identified as a distinct ligamentous structure in all patients. Prior to Segond repair, patients had significantly more instability, as determined by pivot-shift test, than seen postoperatively (p < 0.0001). At final follow-up, the mean subjective IKDC score was 83.2 ± 10.3. Fourteen patients were graded A, 6 were graded B, and 3 was graded C on the IKDC objective score. The mean Lysholm score was 85.4 ± 12.2. The mean Tegner score was 7.5 ± 1.2. This study confirmed that the ALL is a distinct structure in the anterolateral portion of the knee. The fixation of the avulsion fracture of the ALL associated with periarticular knee fractures can be an effective procedure without specific complications. Long-term and comparative follow-up studies are necessary to confirm the effects.

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Comparison of Clinical Efficacy Between Arthroscopically Assisted Gracilis Autograft With Suture Reinforcement Technique and Transtibial Pull-out Technique in Treating Medial Meniscus Posterior Root Tears

10.21203/rs.3.rs-942318/v1 ◽

2021 ◽

Author(s):

Si Si Nie ◽

Hongbo Li ◽

Jianyin He ◽

Guanxiang Liao ◽

Xuelei Ke ◽

...

Keyword(s):

Medial Meniscus ◽

Lysholm Score ◽

Reconstruction Technique ◽

Posterior Root ◽

Vas Score ◽

Pull Out ◽

Meniscal Root ◽

Meniscus Healing ◽

Ikdc Score

Abstract Background: To compare the short-term efficacy of the transtibial pull-out technique and gracilis autograft with suture reinforcement technique in the treatment of medial meniscus posterior root tears. Methods: A total of 64 patients with medial meniscus posterior root tears received reconstruction of the posterior root of the meniscus attachment point through the tibial tunnel between June 2018 and April 2019 were included in this study, patients were divided into 2 groups (transtibial pull-out technique group: 35 cases; gracilis autograft with suture reinforcement technique group: 29 cases) according to the different posterior meniscus root tear repair methods. Clinical outcomes were evaluated by the visual analogue scale (VAS) and Lysholm score and IKDC score, and the demographics and functional recovery of the knee were compared between the two groups.Results: Intraoperative and postsurgical complications such as infection were not found in the two groups, and there was a statistically significant improvement in the Lysholm score，IKDC score and VAS score (P<0.001; respectively). All the patients were very satisfied with the function of their knee at the last follow-up. However, compared with the transtibial pull-out repair group, the reinforced medial meniscal root reconstruction technique with gracilis autograft group were significant improvement in the meniscus healing rates and Lysholm score, IKDC score and VAS score at the end of follow-up (P<0.05; respectively).Conclusions: Compared with the transtibial pull-out technique, the reinforced medial meniscal root reconstruction technique with gracilis autograft is advantageous for treating these patients because it is a minimally invasive procedure with superior clinical outcome and meniscus healing rates.Levels of Evidence: Ⅲ, Case-control study Retrospective comparative study

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