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(1) Background: Meniscal lesions are one of the most prevalent pathologies in orthopedics; meniscal root tears have been recognized as a specific subset with poor mid- to long-term results after standard treatment options (observation, physical therapy, arthroscopic partial meniscectomy) and frequent progression to osteoarthritis. Meniscal root repair has emerged as a new technique with promising results. We present a case report and review the current literature regarding the diagnosis, indications to repair, current techniques, alternatives and expected outcomes. (2) Case report: A 49-year-old woman, with a body mass index of 30 and no significant comorbidities or history of trauma, involved in moderate to heavy physical activity, presented with left knee pain at the internal meniscal line, which worsened over the last 4 months, despite an intra-articular steroid shot. Based on the magnetic resonance imaging (MRI), she was diagnosed with a type 2 medial meniscus posterior root tear and moderate internal compartment chondropathy (Outerbridge 2). She underwent side-to-side repair of the meniscal lesion and reattachment of the root through a bone tunnel over a button. Postoperatively, she was non-weight-bearing (NWB) for 6 weeks and with the knee immobilized at 30° of flexion. At 6 months’ follow-up, the patient was fully ambulant without crutches, with active knee flexion between 0° and 130°. (3) Conclusion: Meniscal root repair is reasonably accessible. It may provide additional benefits over current treatment options when used judiciously and with an adequate surgical technique.

Keywords: meniscus; root tear; repair; arthroscopy