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Meniscal root repair (MRR) techniques have recently gained popularity, especially following an increased knowledge of meniscal root on knee biomechanics. In fact, previous studies have suggested that the integrity of posterior meniscal root is essential for maintaining circumferential meniscal hoop tension (1,2). In cases of posterior root injuries, the transmission of the circumferential hoop tension is impaired, and the menisci tend to be extruded and displaced anteriorly and posteriorly. This can lead to increased tibiofemoral contact pressures that have been reported to be equivalent to a complete meniscectomy (3). These changes are responsible for accelerated degenerative changes within the knee joint. Recently, the effectiveness of meniscal root repair has been demonstrated to restore the loading profiles to the intact knee, for both medial and lateral meniscus (3-6). The key of an effectiveness MRR is represented by an anatomical repair using a consistent root reattachment, using several surgical techniques with different methods of suturing the meniscal root. Previous studies have demonstrated that the number and size of sutures used during MRR could have a role to obtain a suboptimal construct, resisting to elongation during biomechanical tests (7-8). In addition, three simple stitches have been effective during MRR, reducing displacement of the posterior medial meniscal root in response to cyclic loading after transtibial pull-out repair (7). Whereas human menisci have been characterised relatively well in several studies, mostly MRR biomechanical studies were CORRESPONDING AUTHOR Lawrence Camarda Department of Orthopaedic Surgery (DiChirOnS) University of Palermo Via del Vespro, Palermo, Italy Phone: +39 091 655 4140 Fax: +39 091 655 4111 E-mail: lawrence.camarda@unipa.it

Posterior meniscal root repair: a biomechanical comparison between human and porcine menisci