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💠 Centralization for reducing medial meniscal extrusion after root tear repair appears effective but is technique-dependent: a systematic review

👥 Fardis Vosoughi, Iman Menbari Oskouie, Mahdi Gouravani, Alireza Arvin, Asma Mafhoumi*, Luke V. Tollefson, Robert F. LaPrade

📔 The Bone & Joint Journal (Q1) - Top 5% SNIP

🗓 November 2025

🗂 Systematic Review

📄 Abstract:

Aims: This systematic review examined whether meniscal centralization techniques—specifically posteromedial suture anchor (PMA) and posteromedial transtibial pull-out repair (PMP)—when added to conventional medial meniscus root repair, affect outcomes in patients with meniscal extrusion (MME).
Methods: A systematic search of PubMed, Embase, Scopus, and Web of Science identified studies using centralization techniques alongside root repair in cases of medial meniscus root tear with extrusion. Data on technique, outcomes, and meniscal extrusion changes were extracted.
Results: Eleven studies (totaling 474 patients) were included. Five studies used PMA, five used PMP, and one used both. Comparative studies found no benefit with PMP, while PMA showed significant advantages. In the PMA group, mean reductions in MME ranged from –1.2 mm to –0.2 mm. The PMP group showed inconsistent outcomes, some even showing increased extrusion (MD from –0.50 mm to +1.46 mm). Both techniques improved clinical scores, but the PMA technique consistently reduced extrusion.
Conclusion: Compared to isolated root repair, meniscal centralization procedures can significantly improve clinical outcomes and reduce meniscal extrusion—but effectiveness depends on the surgical technique, with PMA showing more consistent benefits.

🔗 https://doi.org/10.1302/0301-620X.107B11.BJJ-2025-0018.R2

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