Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2026; 93(1):53-58 | DOI: 10.55095/achot2026/001

There Is No Clinical and Radiological Difference between Suspensory and Cortical Button Fixation at the Treatment of Medial Meniscus Posterior Root Tear

GÜNEŞ SARIKAYA¹, AHMET EMRE PAKSOY², ÖMER KARAŞAHİN³, MEHMET KÖSE⁴, MATTHİE P OLLİVİER⁵, BARIŞ KOCAOĞLU⁶

¹ Balikesir City Hospital, Orthopedics and Traumatology Clinic, Balikesir, Turkey

² Atatürk University, Department of Orthopedics and Traumatology, Erzurum, Turkey

³ Erzurum City Hospital, Infectious Diseases and Microbiology Clinic, Erzurum, Turkey

⁴ Altinbaş University Hospital Medical Park Bahçelievler, Orthopedics and Traumatology Clinic, Istanbul, Turkey

⁵ Department of Orthopedics and Traumatology, Sainte-Marguerite Hospital Aix Marseille University, France

⁶ Department of Orthopedi

^cs and Traumatology Clinic, Faculty of Medicine, Acibadem University, Istanbul, Turkey

The purpose of this prospective study was to compare the two surgical techniques; (Transosseous Fixation with the Suspensory Fixation System technique and Pull Out Suture Repair) for clinical and radiologic scores and to investigate the effects on meniscal extrusion in Medial Meniscus Posterior Root Tear (MMPRT).



This was a prospective single-center study. Patients undergoing MMPRT were divided into two groups. Group 1 patients were repaired with Transosseous Fixation with The Suspensory Fixation System technique while Group 2 patients were repaired with Pull Out Suture Repair with Cortical Button. Lysholm and Tegner Score, Visual Analog Scale (VAS), meniscus extrusion on magnetic resonance imaging (MRI) and K-L grade were recorded preop and postop at minimum one year follow-up.



Meniscal extrusion on MRI increased in both groups at 12 months postoperatively compared to preoperative evaluation, but this increase was not statistically significant in both methods (Group 1: p = 0.670, Group 2: p = 0.211). There was no statistically significant difference in the pre-postoperative change in Lysholm knee score, Tegner activity score and meniscal extrusion on MRI in Group 1 compared to Group 2 (p = 0.575, p = 0.257 and, p = 0.141 respectively). Both Lysholm Knee Score (Group 1: p = 0.001, Group 2: p = 0.001) and Tegner Activity Score (Group 1: p = 0.008, Group 2: p < 0.001) increased statistically significantly at 12 months postoperatively compared to preoperative evaluation in Group 1 and Group 2. No patient in either group underwent total knee arthroplasty(TKA) at one-year follow-up.



The Suspensory Fixation System technique in MMPRT repair has been shown to be a feasible treatment method with similar functional and radiologic results compared to Pull Out Suture Repair with Cortical Button. At short-term follow-up, the addition of a suspensory device to the conventional transtibial pullout repair did not result in a statistical difference on meniscal extrusion on MRI.

Keywords: transtibial pullout repair, meniscal root repair, meniscal extrusion, meniscus, posterior root tear.

Received: May 26, 2025; Revised: May 26, 2025; Accepted: January 13, 2026; Published: March 1, 2026  Show citation