Inside-Out Medial Meniscus Suture: An Analysis of the Risk of Injury to the Popliteal Neurovascular Bundle

The aim of this study was to study the clinical efficacy and prognostic factors after revision and reconstruction of anterior cruciate ligament. All the patients who underwent the first revision of anterior cruciate ligament (ACL) reconstruction in the department of sports medicine from January 2001 to December 2015 were collected. The demographic information, the first revision and reconstruction information of ACL, and the information during the first ACL reconstruction were collected. A total of 335 cases were included. Lysholm score, Tegner activity score, and IKDC subjective score at the last follow-up were significantly higher than those before operation. Compared with graft failure caused by sports injury, the postoperative scores of patients with revision due to life accidents or initial reconstruction techniques were significantly lower ( P < 0.05 ). The postoperative Lysholm score of patients with femoral canal drilling through the tibial canal was lower than that of patients with anterior internal approach. The postoperative IKDC score of patients who underwent medial meniscus suture at the same time was higher than that of patients without meniscus combined injury. ACL revision can improve the stability and function of knee joint. Compared with the revision caused by life accident or technical reasons of primary reconstruction surgery, the patients with graft failure caused by sports injury have better postoperative recovery. Medial meniscus suture and anterior internal approach drilling of the femoral bone canal have a statistically protective effect on the clinical function after ACL revision.

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Medial collateral ligament release during knee arthroscopy: key concepts

EFORT Open Reviews ◽

10.1302/2058-5241.6.200128 ◽

2021 ◽

Vol 6 (8) ◽

pp. 669-675

Author(s):

Vicente Carlos da Silva Campos ◽

Francisco Guerra Pinto ◽

Diogo Constantino ◽

Renato Andrade ◽

João Espregueira-Mendes

Keyword(s):

Medial Meniscus ◽

Knee Arthroscopy ◽

Cartilage Damage ◽

Joint Space ◽

Medial Compartment ◽

Collateral Ligament ◽

Tibiofemoral Joint ◽

Key Concepts ◽

Complete Access ◽

Inside Out

Complete access to the posterior medial compartment of the knee may represent a technical challenge during arthroscopy in patients with a tight tibiofemoral joint space. Medial collateral release reduces direct iatrogenic cartilage damage in the medial compartment of the knee through manipulation with instruments. We recommend performing medial collateral release in surgeries that access the posteromedial compartment (e.g. partial meniscectomy for ruptures of the posterior horn of medial meniscus or posterior root repairs) when the patient has a tight tibiofemoral joint space. There are two main techniques to perform medial collateral release: inside-out and outside-in. Regardless of the technique used, releasing medial ligament structures is a safe and effective method to be used in the diagnosis and treatment of injuries to the medial compartment. Cite this article: EFORT Open Rev 2021;6:669-675. DOI: 10.1302/2058-5241.6.200128

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