Early Operative Versus Delayed or Nonoperative Treatment of Anterior Cruciate Ligament Injuries in Pediatric Patients.

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Abstract

[Indexed for MEDLINE] 9. Indian J Orthop. 2026 Jan 28;60(3):544-551. doi: 10.1007/s43465-026-01710-8. eCollection 2026 Mar. Peripheral Meniscus Augmentation in Medial Meniscus Posterior Root Tears: A Pictorial Review of Contemporary Centralization Techniques. Vasiliadis AV(1)(2), Giovanoulis V(3), Gkekas NK(4), Chytas D(5), Paraskevas G(6), Noussios G(2). Author information: (1)Department of Orthopaedic Surgery, Sports Trauma Unit, St. Luke's Hospital, K.Varnali 44, 55534 Thessaloniki, Greece. (2)Department of Physical Education and Sports Sciences at Serres, Aristotle University of Thessaloniki, 62110 Agios Ioannis-Serres, Greece. (3)Orthopedic Department, Centre Hospitalier de Versailles - Hopital Andre Mignot, 78150 Le Chesnay Rocquencourt, France. (4)Department of Orthopaedic Surgery, School of Health Sciences, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece. (5)Basic Sciences Laboratory, Department of Physiotherapy, University of Peloponnese, 23100 Sparta, Greece. (6)Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece. BACKGROUND: Medial meniscus posterior root tears (MMPRTs) frequently lead to meniscal extrusion, loss of hoop stress function and progressive medial compartment degeneration. Although transtibial pull-out root repair is the current gold standard, persistent extrusion remains common, prompting growing interest in adjunctive peripheral meniscal augmentation techniquesQuery. OBJECTIVE: To provide a pictorial overview of contemporary peripheral meniscal augmentation techniques used in conjunction with MMPRT repair, outlining their technical principles and biomechanical rationale. METHODS: PubMed was electronically searched for relevant articles. Titles, abstract and full texts were screened to identify eligible studies. RESULTS: This narrative pictorial review synthesizes current techniques described in the literature for addressing meniscal extrusion following MMPRT repair, including tunnel-based centralization, anchor-based augmentation, all-inside capsular reinforcement and open meniscotibial reconstruction. For each method, key arthroscopic portals, suture pathways, fixation strategies and reduction maneuvers are illustrated to clarify technical nuances and highlight potential advantages and limitations. CONCLUSION: Peripheral meniscal augmentation techniques improve meniscal reduction, restore hoop stress and reduce extrusion, with the tunnel-based method offering strong fixation but risking tunnel convergence, whereas anchor-based and all-inside approaches allowing targeted repair without tibial tunneling. Technique selection should be individualized; and as evidence evolves, peripheral augmentation may become a standardized adjunct to MMPRT repair to enhance long-term joint preservation. © Indian Orthopaedics Association 2026. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. DOI: 10.1007/s43465-026-01710-8 PMCID: PMC13031468