*smith&nephew

KNEE TECHNIQUE GUIDE

Meniscal Root Repair Using a Two-Tunnel

Technique
Robert F. LaPrade, MD, PhD

KNEE

HIP

SHOULDER

EXTREMITIES
Two-Tunnel Meniscal Root Repair Technique

The following technique guide was prepared under the guidance of Robert F. LaPrade, MD. Created under close collaboration
with the surgeon, it contains a summary of medical techniques and opinions based upon his training and expertise in the field,
along with his knowledge of Smith & Nephew’s products. Smith & Nephew does not provide medical advice and recommends that
surgeons exercise their own professional judgement when determining a patient’s course of treatment. This guide is presented for
educational purposes only. Prior to performing this technique, or utilizing any product referenced herein, please conduct a
thorough review of each product’s indications, contraindications, warnings, precautions and instructions as detailed in the
Instructions for Use provided with the individual components.

As Described By
Robert F. LaPrade, MD, PhD
Overview
The Steadman Clinic, Vail, CO
The meniscal roots are very important to overall joint health; however
THE STEADMAN CLINIC
Complex Knee & Sports meniscal root tears are often underdiagnosed or misdiagnosed and,
Medicine Surgeon in my experience, represent from 10% to 21% of overall tears seen
STEADMAN-PHILIPPON on MRI scans. It has been reported that a posterior horn medial
RESEARCH INSTITUTE meniscus root tear is equivalent to a subtotal medial meniscectomy,1, 2
Chief Medical Officer
Co-Director of the Sports
while a lateral meniscus root tear where the meniscofemoral ligament
Medicine Fellowship Program is also torn is likewise contributing to a meniscal deficient state.3
Director of the International
Research Scholar Program
In patients with a meniscal root tear who have fairly normal articular
cartilage of the ipsilateral compartment, Grade II chondromalacia
or less, an attempt should be made for a meniscal root repair.4
In particular, meniscal root repairs can be especially beneficial to
patients with fairly normal articular cartilage and who have evidence
of spontaneous osteonecrosis of the knee (SONK) (medial femoral
condyle).5
Biomechanical studies have validated that a meniscal root tear, or a
radial root tear within 1cm of the meniscal root attachment, can be
reattached to the tibia and can significantly restore joint contact area
and joint forces.2, 4 In addition, it has been reported that a meniscal
root repair that is performed in a non-anatomic position, which usually
means a medial meniscus root tear that is subluxed posteromedially,
is equivalent to a subtotal meniscectomy.6, 7 Therefore, all attempts
should be made to try to release any adhesions causing meniscal root
tears to be retracted in order to allow them to be located in the most
anatomic position possible.8
There is no distinct upper age for a meniscal root repair. This should
depend upon the patient’s activity level, general overall health,
associated comorbidities, joint alignment, and the degree of ipsilateral
compartment chondromalacia. In patients who are otherwise active
and who sustain a meniscal root tear, consideration should be made
to performing a repair.

K N E E TEC HN I Q U E G U I DE 05486 V1
Introduction
A meniscus root tear is defined as either an avulsion of the meniscal root from its
attachment point or a radial root tear within 1cm of the root attachment. There are
five types of meniscal root tears, with the most common being a Type 2 radial
root tear.9
Most patients present with complaints of posterior knee pain, or of feeling
a pop, when they are at maximal knee flexion. In traumatic cases, patients
often have multi-ligament injuries or an ACL tear.10, 11 An MRI can be especially
useful to determine the presence of a meniscus root tear because it can show
detachment of the root on the axial cuts, extrusion on the coronal cuts, and
a ‘ghost sign’ present on the sagittal images, which would indicate there is a
lack of meniscal tissue due to the root tear and/or medial or lateral meniscal
extrusion.4, 12 Concurrent with an MRI, the patient should have a standing
AP view, a Rosenberg view to assess for joint line narrowing, and a long-leg
alignment x-ray to assess for malalignment. Concurrent injuries often include a
chondral lesion, which is most commonly found with a posterior horn root tear
of the medial meniscus, or with an ACL tear, which most commonly affects the
posterior horn lateral meniscus root attachment.11

Indications and Contraindications

for Meniscal Root Repairs
Meniscal root tear repairs should be considered in all patients who have a fairly
normal activity level, knee ipsilateral compartment chondromalacia Grade II
or less, and in those who may have a concurrent ligament reconstruction with
evidence of extrusion of the meniscus. Contraindications would be patients who
have advanced arthritis, grade 3 to 4 (which is not correctible with a cartilage
repair procedure), severe malalignment, and in those with apparent extrusion
of the root tear due to associated arthritis. In addition, all patients who have
significant associated comorbidities that would preclude adequate healing or the
ability to follow a focused postoperative rehabilitation program will not be good
candidates for meniscal root repairs. Studies have demonstrated that patients
have both improved clinical and radiographic outcomes with repairs compared
to partial meniscectomies for root tears.13, 14, 15, 16 Overall, the transtibial repair
technique has been validated as an effective method to restore the meniscal
root.17, 18, 19

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 Patient Positioning Prior to the Surgical Incisions
It is recommended that the patient’s operative leg is placed into a leg holder
positioned at the upper thigh, with the contralateral knee placed in an abduction
stirrup to both remove it from the operative field and adequately pad the leg
and peroneal nerve. This
is particularly important for
medial meniscal root repairs,
which may require the use of
a posteromedial arthroscopic
portal. The foot of the operating
table should be flexed to 90°
to allow for positioning of the
knee, with the table height
adjusted as necessary based
on the surgeon’s preference.
The patient should then be
sterilely draped off and given
prophylactic antibiotics prior to
surgical incisions (Figure 1). Figure 1: Right knee

Arthroscopic Portal Placement

Standard arthroscopic portals can be
made anteriorly. Anterolateral and
anteromedial portals can be made
adjacent to the patellar tendon and
at the normal positions, which allows
surgeons to perform a standard
arthroscopic evaluation of the knee.
An accessory medial or lateral portal
can also be placed, depending upon
the position of the root tear, to allow
for placement of an arthroscopic
grasper or other instruments as
necessary (Figure 2).

Figure 2: Right knee

4 K N E E TEC HN I Q U E G U I DE 05486 V1
 Patients who have a tight medial compartment, limiting the placement
of a suture passer from the anterior portals, may require the use of a
posteromedial portal in order to pass a suture through the meniscal
substance by accessing the root tear through the posteromedial aspect of
the knee. This has been found to be the most common location for passing
the root repair sutures when one is initially performing meniscal root repairs.

Establishing the Anterolateral Portal

The anterolateral portal is established first and placed anterolaterally, just
distal to the patellar tendon and patellar junction, to allow arthroscope
positioning which minimizes placement through the retropatellar fat pad.
This is performed with the use of a #11 blade. The blade should enter into the
joint totally such that the arthroscopic instruments can be easily positioned
between the medial and lateral portals without difficulty.

Establishing an Anteromedial Portal

After the anterolateral portal is established, the arthroscopic camera should
be inserted into the joint and the joint insufflated with normal saline. The
arthroscope should then be positioned within the intercondylar notch. If there
is an acute injury, some flushing out of the blood effusion may be necessary.
The camera should then be positioned such that the 30° position is looking
directly towards the anteromedial portal, and an arthroscopy needle should
be used to localize the placement of this portal under direct vision. The portal
should be placed just above the meniscal tissue and as close to the medial
edge of the patellar tendon as possible. It is important not to place this portal
too proximal because this can make it difficult to access the posteromedial
aspect of the joint. A diagnostic arthroscopy can now be performed to assess
the status of the suprapatellar pouch, patellofemoral joint, medial and lateral
compartments, and to assess if any other intraarticular pathology needs to
be treated.

KNE E T EC H NIQUE G UID E 05486 V1 5

 Assessing for a Medial Meniscus Root Tear
The best way to access the posteromedial aspect of the medial meniscal
posterior root attachment is to place the arthroscopic camera directly medial to
the posterior cruciate ligament and then to view directly down on the meniscal
root attachment (Figure 3). The surgeon can position the knee in an extended
and valgus position in the leg holder, and then directly probe the meniscal
attachment to confirm that the root tear is present. In many cases, the root tear
is easily visible prior to placing the probe; however, the probe can help to assess
the range of mobility in the meniscal root attachment, and to assess whether
there is significant scarring that is retracting it into a nonanatomic posteromedial
position.6 The medial meniscal root attachment is approximately 1cm posterior
to the apex of the medial tibial eminence (Figure 4). Radial root tears should be
positioned medially based upon how far medial the radial tear occurred from the
root attachment.

Figure 3

Figure 4

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 Preparation of Repair Bed on Tibia
Once the presence and reparability of the meniscal root tear is confirmed, and
other significant pathology in the joint has been identified and treated as indicated,
the next step is to prepare the bony bed for the meniscal root attachment on
the posteromedial aspect of the tibia (Figure 5). A 4.5mm DYONICS™ PLATINUM™
Incisor Blade and 4.5mm DYONICS Curved Incisor Plus Elite Blade can be used to
remove any scar tissue that may limit visualization.
A curette in the Meniscal Root Repair System can be used to decorticate the bony
area in the posterolateral aspect of the medial tibial plateau where the meniscal
root attachment is planned to be re-approximated (Figure 6). It is important to
ensure that this area of decorticated bone extends to the posterior aspect of the
tibia in order to maximize bony healing of the meniscal root repair.

Figure 5 Figure 6

Preparation of the Meniscal Body

Except in very acute cases, most meniscal root repairs have to be released from
scar tissue. The Rotary Scissors 20° right and Rotary Scissors 20° left can be very
effective for releasing the scar tissue on both the inferior and superior surface
of the meniscus. This can usually be accomplished by placing the camera in the
anterolateral portal and accessing the meniscus from the anteromedial portal. In
rare cases, a posteromedial portal may need to be placed in order to allow for the
release of any scar tissue. During this step it is important to leave some capsule
still attached to the meniscus to ensure that there is good meniscal substance
present for the repair. The meniscus should be regularly grasped with a standard
grasper to verify the level of mobility created by the release. Once it is determined
that the meniscus is sufficiently released, the next step is to prepare the tunnels.

4.5mm *DYONICS™ 4.5mm Curved *ACUFEX™ *ACUFEX™ *MENISCAL ROOT

INCISOR™ Plus *DYONICS INCISOR Rotary Scissors Rotary Scissors Repair System
PLATINUM Blade Plus Elite Blade 20° Hooked, Right 20° Hooked, Left 7193J001
72203013 72200494 010815 010814

KNE E T EC H NIQUE G UID E 05486 V1 7

 Two-tunnel Drill Preparation
The two-tunnel meniscal root repair
technique utilizes two separate tunnels
placed approximately 5mm apart in order
to best ensure meniscal tissue apposition
against the decorticated tibia.20 The
Smith & Nephew Curved Aimer Guide
is used to drill the first tunnel with a
2.8mm two-piece drill set, this will be
the posterior tunnel for the repair.
Figure 7
Using the grasper to place the meniscus
at the desired position, the surgeon can
verify that there is no significant tension on the meniscus at this location,
and then position the drill guide tip at this location (Figure 7).
The guide pin and sheath are then reamed and the position verified (Figure 8).
Ideally, the sheath tip should be placed so that it is level with the tibial surface.
It is best to have the sheath right at the level of the bone because the
monofilament loop can be cut when it is pulled down the sheath when
the sheath is protruding into the joint. Any bony or soft tissue debris
around the sheath tip can be cleaned off with the shaver at this time.

Figure 8

*Curved Aimer *Curved Aimer

Guide, Left Guide, Right
71935074 71935075

8 K N E E TEC HN I Q U E G U I DE 05486 V1
 The Offset Guide Device is then used to pass the second sheath and drill. The
Offset Guide has offsets of between 5-7mm to allow it to be positioned in a manner
that allows for the ideal placement of the second tunnel. Once the tunnel is drilled
and it is in the desired location, the drill can be removed and the sheath position
can be assessed (Figure 9). Once both sheaths are placed, attention can be
turned to passing sutures through the meniscus tear (Figure 10).

Figure 9 Figure 10

Passing the First Suture

The FIRSTPASS™ ST Suture Passer
is used to pass the sutures
through the posterior horn of
the meniscus. The sutures
should be passed through good
substance and good tissue in the
posterior horn of the meniscus,
as far posterior as possible and
leaving about a 3mm to 4mm
lateral tissue bridge posteriorly.
In general, the device is placed
4-5mm medial to the edge of
the meniscus to ensure there
is sufficient tissue to hold the
Figure 11
sutures (Figure 11).

*MENISCAL ROOT **FIRSTPASS ST

Repair Offset Guide Suture Passer,
71935076 self-capture
22-4038

KNE E T EC H NIQUE G UID E 05486 V1 9

 It is very important to ensure that the sutures that are passed into the
meniscus do not have a soft tissue bridge in the retropatellar fat pad because
this could result in the meniscal sutures pulling out when the sutures are
passed down the tibia. Therefore, a ring grasper is used to pull the sutures
out over a CLEAR-TRAC™ 5.5x72mm Threaded Cannula located in either the
anteromedial or anterolateral arthroscopic portal. Once it is verified there is
no soft tissue bridge, a monofilament is passed up the more posterior sheath,
which is then concurrently pulled out through the cannula that has the sutures
in the meniscus (Figure 12). The suture ends are then passed through the
monofilament loop to allow it to be shuttled down the tibial tunnel. Prior to
pulling the monofilament loop down the tibia, the sheath should be removed
from the tibia with small pliers to ensure that the loop is not cut by the end of
the sheath when the sutures are passed. Once the sheath has been removed
with the pliers, the monofilament can then be used to slowly pull the sutures
down through the posterior tunnel. A probe should then be used to ensure that
the sutures are in the desired location around the meniscus substance. Once
this step is completed, the second suture can be passed.

Figure 12

*CLEAR-TRAC™
5.5x72mm
Threaded Cannula
72200907

10 K N E E TEC HN I Q U E G U I DE 05486 V1
 Passing the Second Suture
In a similar fashion to passing the first suture, the FIRSTPASS™ ST Suture
Passer passing device is utilized to pass the suture through the substance of
the posterior horn of the meniscus, in an anterior position compared to the
previous suture. This suture is then pulled out anteriorly. After verification that
there are no soft tissue bridges through the arthroscopic portal, a monofilament
loop is passed up the second sheath (Figure 13). The loop is then pulled out
the passing cannula and the metal sheath in the tibia is removed with pliers.
The second suture can then be shuttled down the tibia. One should probe the
sutures and ensure that they are circumferentially around the desired location
of the meniscus root tear. The meniscus can then be probed and the knee can
be flexed and extended to verify that the meniscus tissue has been sufficiently
released and not tethered to posterior scar tissue, such that an early range of
motion protocol can be performed.

Figure 13

Use of an Anteromedial Arthroscopic Portal

In some circumstances it can be difficult to access the posterior horn medial
meniscus anteriorly with the passing suture device. In those circumstances, a
small anteromedial accessory portal can be made. An arthroscopy needle is
used to localize this portal, and a small poke hole is made through the skin and
joint capsule, through which a grasper is placed. The grasper can then be used
to position the meniscus substance into the desired location of the FIRSTPASS™
ST Suture Passer device.

KNE E T EC H NIQUE G UID E 05486 V1 11

 How to Deal with a Tight Medial Compartment
In some instances, it may be difficult to pass the devices into the medial
compartment due to some tightness. In those circumstances, an arthroscopy
needle can be used to gently place 7-10 poke holes in the meniscofemoral
portion of the superficial medial collateral ligament, close to its femoral
attachment site, to allow for an increased amount of medial compartment
gapping. Medial compartment gapping of about 1mm to 1.5mm is usually
sufficient to allow for adequate access from the anterior portals.

Posterior Portal Access for Medial Root Tears

In some circumstances, it may not be possible to repair the meniscus root from
the anterior portals. When this occurs, a posteromedial portal can be made
and an ACCU-PASS™ Suture Shuttle crescent device can be placed through
the posterior horn of the meniscus and a monofilament shuttled through the
meniscus and then pulled out an anterior portal. A suture can then be placed
into the monofilament when the device is removed posteromedially. The sutures
can also be shuttled out anteriorly, through an arthroscopic cannula, to ensure
there is no soft tissue bridge. The sutures are then individually shuttled down the
tibial tunnels, and this step repeated when necessary.

Posterolateral Meniscal Root Tears

In the majority of cases, a posterior horn lateral meniscus root tear is associated
with an ACL tear.11 In those circumstances, the root tear can be arthroscopically
visualized from the anterolateral arthroscopic portal, and most of the work
performed from the anteromedial portal. The 4.5mm DYONICS™ Curved Incisor
Plus Elite Shaver is ideal for preparing the root repair location. It is important to
recognize that the lateral meniscal root attachment is only about 12mm posterior
to the posterior aspect of the anterior root attachment, and 4-5mm posterior
to the apex of the lateral tibial eminence. Therefore, this is much more easily
accessed than the posterior horn medial meniscus root when an ACL is torn.
Performing the lateral root repair prior to placing the ACL graft is recommended
in order to access this root and easily reposition it. In most circumstances,
the meniscal tissue can be accessed directly from the two anterior portals,
although a small accessory lateral portal can be made after localization with
an arthroscopy needle and using a grasper to deliver the meniscal tissue into
a meniscal passing device, if necessary.

*ACCU-PASS™ *4.5mm DYONICS™ *4.5mm Curved

Suture Shuttle INCISOR™ Plus DYONICS INCISOR
7210426 PLATINUM Blade Plus Elite Blade
72203013 72200494

12 K N E E TEC HN I Q U E G U I DE 05486 V1
 Postoperative Rehabilitation†
Meniscal root tears have been found biomechanically to have significant stress
on them when the knee is maximally flexed, especially past 90° (Figure 14).
Therefore, meniscal root sutures should be tied with the knee flexed to 90° to
ensure that motion can be performed to at least 90° initially. The rehabilitation
protocol requires that the patient is non-weight bearing for six weeks, with knee
flexion limited from 0° to 90° for the first two weeks. After two weeks, flexion
is increased as tolerated. After the six-week postoperative time frame, patients
may slowly initiate a partial protective weight bearing program and wean off of
crutches when they can ambulate without a limp.

Figure 14

In patients with ipsilateral compartment malalignment, who did not also have
a concurrent osteotomy, consideration may be given to an unloader brace for
four months postoperatively. Leg presses past 70° during the first four months
postoperatively should be avoided, as should cross-legged sitting, deep squats
and squatting and lifting, due to the significant stress that is placed on the
posterior horn of the meniscus repair with these maneuvers. In general, it takes
five to seven months for the meniscus root repair to be sufficiently healed and
for patients to resume impact activities (if these are indicated based on other
associated pathology and the patient’s desired activity level).
† The views and opinions expressed for postoperative care are solely those of
the surgeon(s) and do not reflect the views of Smith & Nephew. In no event
shall Smith & Nephew be liable for any damages whatsoever (including, without
limitation, damages for loss of business profits, business interruption, loss of
business information, or other pecuniary loss) arising out of the use of or inability
to use the expressed views.

KNE E T EC H NIQUE G UID E 05486 V1 13

 Pearls to Avoid Technical Difficulties:
• Engage the pin collar into the sheath prior to reaming
• Put the knee through a range of motion prior to tying the root repair sutures
and with traction on the sutures to ensure the root repair does not have too
much tension on it, and to verify that an adequate release of scar tissue was
performed
• Pull the tibial metal sheath out prior to pulling the monofilament loop down
the tibia
• Release enough scar to allow for the root tear to be positioned correctly

Curved Aimer Guide Alignment

Medial Meniscus Lateral Meniscus
Right Knee Curved Aimer Guide, Left Curved Aimer Guide, Right
Left Knee Curved Aimer Guide, Right Curved Aimer Guide, Left

Special Considerations for Meniscal Root Repairs

• Patients with significant varus alignment, with a posteromedial root tear, and
minimal chondromalacia of the ipsilateral compartment should consider a
concurrent proximal tibial osteotomy (PTO)
• When there are posterior horn medial meniscus root tears associated with
a PCL tear and a planned PCL reconstruction, place both the PCL and root
repair guide pins and verify position with fluoroscopy prior to reaming either
of the pins21
• When there are bilateral root tears, ensure the sheaths do not converge
• For a concurrent ACL reconstruction and a meniscal root tear, place the
root repair tunnels and suture prior to reaming the ACL tibial tunnel; tie the
sutures after securing the ACL graft in the femoral tunnel

14 K N E E TEC HN I Q U E G U I DE 05486 V1
References

1. Allaire R, Muriuki M, Gilbertson L, et al. Biomechanical consequences of a tear of the posterior root of the
medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am 2008; 90: 1922-31.
2. Padalecki JR, Jansson KS, Smith SD, et al. Biomechanical consequences of a complete radial tear adjacent
to the medial meniscus posterior root attachment site: in situ pull-out repair restores derangement of joint
mechanics. Am J Sports Med 2014; 42: 699-707.
3. L aPrade CM, Jansson KS, Dornan G, et al. Altered tibiofemoral contact mechanics due to lateral meniscus
posterior horn root avulsions and radial tears can be restored with in situ pull-out suture repairs. J Bone Joint
Surg Am 2014; 96: 471-9.
4. Bhatia S, LaPrade CM, Ellman MB, et al. Meniscal root tears: significance, diagnosis, and treatment. The
American journal of sports medicine 2014; 42: 3016-30.
5. Robertson DD, Armfield DR, Towers JD, et al. Meniscal root injury and spontaneous osteonecrosis of the
knee: an observation. J Bone Joint Surg Br 2009; 91: 190-5.
6. LaPrade CM, Foad A, Smith SD, et al. Biomechanical consequences of a nonanatomic posterior medial
meniscal root repair. Am J Sports Med 2015; 43: 912-20.
7. Starke C, Kopf S, Grobel KH, et al. The effect of a nonanatomic repair of the meniscal horn attachment on
meniscal tension: a biomechanical study. Arthroscopy 2010; 26: 358-65.
8. Johannsen AM, Civitarese DM, Padalecki JR, et al. Qualitative and quantitative anatomic analysis of the
posterior root attachments of the medial and lateral menisci. Am J Sports Med 2012; 40: 2342-7.
9. L aPrade CM, James EW, Cram TR, et al. Meniscal root tears: a classification system based on tear
morphology. Am J Sports Med 2015; 43: 363-9.
10. Feucht MJ, Bigdon S, Mehl J, et al. Risk factors for posterior lateral meniscus root tears in anterior cruciate
ligament injuries. Knee Surg Sports Traumatol Arthrosc 2015; 23: 140-5.
11. M
 atheny LM, Ockuly AC, Steadman JR, et al. Posterior meniscus root tears: associated pathologies to assist
as diagnostic tools. Knee Surg Sports Traumatol Arthrosc: official journal of the ESSKA 2015; 23: 3127-31.
12. C
 hoi SH, Bae S, Ji SK, et al. The MRI findings of meniscal root tear of the medial meniscus: emphasis on
coronal, sagittal and axial images. Knee Surg Sports Traumatol Arthrosc 2012; 20: 2098-103.
13. C
 hung KS, Ha JK, Yeom CH, et al. Comparison of Clinical and Radiologic Results Between Partial
Meniscectomy and Refixation of Medial Meniscus Posterior Root Tears: A Minimum 5-Year Follow-up.
Arthroscopy 2015; 31: 1941-50.
14. C
 hung KS, Ha JK, Ra HJ, et al. A meta-analysis of clinical and radiographic outcomes of posterior horn
medial meniscus root repairs. Knee Surg Sports Traumatol Arthrosc 2016; 24: 1455-68.
15. F eucht MJ, Kuhle J, Bode G, et al. Arthroscopic transtibial pullout repair for posterior medial meniscus root
tears: a systematic review of clinical, radiographic, and second-look arthroscopic results. Arthroscopy 2015;
31: 1808-16.
16. Han SB, Shetty GM, Lee DH, et al. Unfavorable results of partial meniscectomy for complete posterior medial
meniscus root tear with early osteoarthritis: a 5- to 8-year follow-up study. Arthroscopy 2010; 26: 1326-32.
17. Ellman MB, LaPrade CM, Smith SD, et al. Structural Properties of the Meniscal Roots. Am J Sports Med 2014;
42: 1881-7.
18. Kopf S, Colvin AC, Muriuki M, et al. Meniscal root suturing techniques: implications for root fixation. Am J
Sports Med 2011; 39: 2141-6.
19. L aPrade RF, LaPrade CM, James EW. Recent advances in posterior meniscal root repair techniques. J Am
Acad Orthop Surg. 2015 Feb;23(2):71-6.
20. L aPrade CM, LaPrade MD, Turnbull TL, et al. Biomechanical evaluation of the transtibial pull-out technique
for posterior medial meniscal root repairs using 1 and 2 transtibial bone tunnels. Am J Sports Med. 2015
Apr;43(4):899-904.
21. LaPrade CM, Smith SD, Rasmussen MT, et al. Consequences of tibial tunnel reaming on the meniscal roots
during cruciate ligament reconstruction in a cadaveric model, Part 2: The posterior cruciate ligament. Am J
Sports Med 2015; 43: 207-12.

KNE E T EC H NIQUE G UID E 05486 V1 15

Ordering Information
To order the items used in this technique, call +1 800 821 5700 in the US
or contact an authorized Smith & Nephew representative.
Prior to performing this technique or utilizing any product referenced
herein, please conduct a thorough review of each product’s indications,
contraindications, warnings, precautions and instructions as detailed in
the Instructions for Use provided with the individual components.

MENISCAL ROOT Repair System

Reference # Description

7193J001 MENISCAL ROOT Repair System*
System includes:
71935072 ACUFEX™ DIRECTOR MRR Angled Bullet*
71935073 ACUFEX DIRECTOR MRR Drill Guide Handle*
71935071 Open Curette S*
71935076 MENISCAL ROOT Repair Offset Guide*
71935074 Aimer Guide Curve – Left*
71935075 Aimer Guide Curve – Right*
Disposable Kits:
71935070 MENISCAL ROOT Repair Pack with ULTRABRAID™ Suture*
71935068 MENISCAL ROOT Repair Pack with ULTRATAPE™ Suture*
71935360 MENISCAL ROOT Repair Instruments Pack*

Indications for Use

The FIRSTPASS ST Suture Passer is intended for medical purposes to manipulate tissue
in orthopedic surgery.
Smith & Nephew DYONICS Disposable Endoscopic Blades are indicated for resection
of soft and osseous tissues in both large and small articular cavities.

Supporting healthcare professionals for over 150 years

*Manufactured by: **Manufactured by: www.smith-nephew.com ™Trademark of Smith & Nephew.
Smith & Nephew, Inc. ArthroCare Corporation T +1 978 749 1000 ©2016 Smith & Nephew.
150 Minuteman Road 7000 West William Cannon Drive US Customer Service: All rights reserved.
Andover, MA 01810 USA Austin, TX 78735 USA +1 800 343 5717 Printed in USA. PN 82354 Rev. A , 05486 V1 11/16