No Risk of Tunnel Convergence in Combined ACL Reconstruction and Transtibial Lateral Meniscus Posterior Root Tear Repair. A Technical Note.

Lateral meniscus posterior root tears are frequently identified during anterior cruciate ligament reconstruction. These tears are associated with increased knee instability and altered biomechanics in knees deficient in the anterior cruciate ligament, leading to potential cartilage degeneration and compromised graft function if left untreated. Repairing lateral meniscus posterior root tears during anterior cruciate ligament reconstruction improves knee stability and biomechanics, while also yielding better patient-reported outcomes. The transtibial pullout technique is a popular and reliable method for repairing lateral meniscus posterior root tears. However, it poses a substantial risk of tibial tunnel convergence, which may complicate the surgery and compromise the clinical result. We describe a simple and reproducible technique that enables anatomic anterior cruciate ligament reconstruction and lateral meniscus posterior root tear repair with no risk of tibial tunnel convergence.