Transtibial Pull Out Method Versus Suture Anchor Method for Meniscus Extrusion

NCT ID: NCT06906783

Last Updated: 2025-05-04

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 46 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-10-01
• Study Completion Date: 2026-02-01

Brief Summary

The concept of meniscal extrusion has recently been recognized as an important pathological condition associated with meniscal dysfunction. Meniscal extrusion is the medial or lateral displacement of the meniscus beyond the edges of the tibial plateau. Some meniscal extrusions are physiologic, but large degrees of extrusion are thought to be pathologic.

Meniscal extrusion can vary in extent from minimal physiological extrusion to extrusions exceeding 10 mm. The generally accepted threshold value is considered to be 3 mm.

To date, the gold standard for measuring meniscal extrusion is T2-weighted MRI. MRI is valuable not only due to its ability to define other meniscal or knee pathologies but also because it provides good sensitivity and specificity.

Surgical treatment of meniscal extrusion is preferred in young, active, symptomatic patients and individuals with acute injuries. The treatment approach may vary depending on the underlying cause. One of these methods is centralization surgery, which aims to achieve the anatomical reduction of the extruded meniscus.

The aim of this study is to compare the functional outcomes of transtibial pull-out and suture anchor techniques used in centralization surgery and to contribute to standardization.

Conditions

Meniscal Extrusion; Meniscus Injury

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Transtibial Pull Out Method

Group Type: ACTIVE_COMPARATOR

Transtibial Pull Out Method

Intervention Type: PROCEDURE

The Transtibial Pull-Out Repair is a surgical technique used to fix posterior root tears of the meniscus, particularly in the medial meniscus. This method restores the hoop stress mechanism of the meniscus, which is essential for knee stability and function.

Suture Anchor Method

Group Type: ACTIVE_COMPARATOR

Suture Anchor Method

Intervention Type: PROCEDURE

The Suture Anchor Technique is an alternative to the Transtibial Pull-Out Method for repairing posterior meniscal root tears, especially in the medial meniscus. Instead of using a tibial tunnel, this technique fixes the meniscal root directly to the native footprint using suture anchors.

Interventions

Transtibial Pull Out Method

The Transtibial Pull-Out Repair is a surgical technique used to fix posterior root tears of the meniscus, particularly in the medial meniscus. This method restores the hoop stress mechanism of the meniscus, which is essential for knee stability and function.

Intervention Type: PROCEDURE

Suture Anchor Method

The Suture Anchor Technique is an alternative to the Transtibial Pull-Out Method for repairing posterior meniscal root tears, especially in the medial meniscus. Instead of using a tibial tunnel, this technique fixes the meniscal root directly to the native footprint using suture anchors.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Presence of meniscal extrusion greater than 3 mm on MRI scans
• Symptomatic complaints in the knee with extrusion

Exclusion Criteria

• Malalignment greater than 5 degrees
• Presence of Kellgren-Lawrence grade 3-4 osteoarthritis

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Ataturk University

OTHER

Sponsor Role: lead

Responsible Party

Muhammet Celik

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Ahmet E Paksoy, Assoc.Prof.

Role: STUDY_DIRECTOR

Ataturk University

Locations

Ataturk University Hospital

Erzurum, Yakutiye, Turkey (Türkiye)

Site Status: RECRUITING

Countries

Turkey (Türkiye)

Central Contacts

Muhammet Celik, primary investigator, MD

Role: CONTACT

drcelik@outlook.com

905392087998

Facility Contacts

Muhammet Celik, Principal Investigator, MD

Role: primary

drcelik@outlook.com

905392087998

References

Yan X, Sahu S, Li H, Zhou W, Xiong T, Chen S, Li C, Hao L. Arthroscopic meniscal posterior root repair combined with centralization reduces medial meniscus extrusion associated with posterior root tears: One-year clinical outcomes. Knee Surg Sports Traumatol Arthrosc. 2025 Aug;33(8):2825-2832. doi: 10.1002/ksa.12533. Epub 2024 Nov 14.

Reference Type: RESULT

PMID: 39543774 (View on PubMed)

Zhou Y, Yang Q, Kang J, Xu J, Chen M, Wu C. Clinical effect of medial meniscus posterior root repair combined with centralization technique in the treatment of medial meniscus posterior root tears. BMC Musculoskelet Disord. 2024 Nov 30;25(1):982. doi: 10.1186/s12891-024-08125-2.

Reference Type: RESULT

PMID: 39616323 (View on PubMed)

Other Identifiers

ATAUNIORTHO

Identifier Type: -

Identifier Source: org_study_id