Dr. Garcia demonstrates his new technique to further improve meniscus root repair called centralization / an extrusion stitch.

In this video, Dr. Grant H. Garcia demonstrates a highly focused look at an advanced add-on procedure for a chronic medial meniscus root repair utilizing a centralization / extrusion stitch. For patients with chronic root tears, the meniscus often shifts or slips outward off the edge of the joint by 4 to 4.5 millimeters (meniscal extrusion). This technique is specifically designed to pull that displaced tissue back into its correct position to prevent accelerated joint wear.

The quick procedural breakdown includes:

• Passing the Centralization Stitch: After the standard structural stitches are placed at the torn root, the surgeon uses a specialized suture lasso through a clear passport cannula. He passes a heavy-duty suture tape through the posteromedial capsule tissue of the meniscus in a wide horizontal mattress pattern.
• Drilling the Plateau Socket: While using a surgical probe to gently lift the meniscus out of the way, Dr. Garcia places a specialized drill guide directly underneath the meniscus body. He drills a small tunnel just off the inner edge of the tibial plateau.
• Shuttling and Reduction: A passing suture is fed down through the freshly drilled socket. The two trailing tails of the horizontal suture tape are caught and shuttled downward through the bone. As these lines are pulled tight from the bottom, they act like a leash, dragging the drifted body of the meniscus inward across the plateau surface.
• Dual Fixation: To finish the procedure, both the main meniscal root sutures and this secondary extrusion stitch are tensioned and locked down into the bone simultaneously. This combined construct creates an incredibly stable environment that successfully reduces tissue bulging and restores proper biomechanics.