Dual-Tunnel Pullout Repair for the Extruded Medial Meniscus in Patients With Posterior Root Tear

Medial meniscus (MM) posterior root tear significantly disrupts knee biomechanics and often leads to rapidly progressing MM extrusion and knee joint osteoarthritis. Herein, we describe an arthroscopic repair technique—the dual-tunnel pullout repair—tailored to the treatment of MM posterior root tear with MM extrusion. We avoided the use of anchors, thereby emphasizing the cost-effectiveness and simplicity of augmentation of the meniscotibial ligament. This dual-tunnel approach enhances stability, minimizes meniscal extrusion, and decreases tension in the repaired MM, which facilitates accelerated rehabilitation. We discuss the surgical technique, advantages, limitations, and clinical implications, highlighting its utility in improving patient outcomes while addressing the challenges associated with traditional methods. This technique offers surgeons an effective and reproducible strategy for posterior root repair of the extruded MM.