Abstract
This Technical Note describes a surgical approach that combines circumferential fiber augmentation with transtibial pullout repair for the treatment of medial meniscal posterior root tears. To address the challenge of meniscal extrusion and subsequent joint space narrowing that predisposes to osteoarthritis, this technique uses an artificial ligament to add circumferential collagen fiber reinforcement to improve meniscal extrusion. This integrated approach is designed to address the limitations of conventional tibial pullout repairs by potentially providing better results in preventing meniscal extrusion. Despite the promising benefits, the complexity of this combined technique may present a learning curve for surgeons and require specialized training. This technique represents a significant advancement in the surgical treatment of medial meniscal posterior root tears and offers a promising solution to reduce the risk of osteoarthritis progression in affected patients.