scholarly journals Outside-in Repair Technique for a Complete Radial Tear of the Lateral Meniscus

2018 ◽  
Vol 7 (3) ◽  
pp. e285-e288 ◽  
Author(s):  
Samuel R.H. Steiner ◽  
Scott M. Feeley ◽  
Jeffrey R. Ruland ◽  
David R. Diduch
2017 ◽  
Vol 26 (3) ◽  
pp. 793-798 ◽  
Author(s):  
Adrián Cuéllar ◽  
Ricardo Cuéllar ◽  
Jorge Díaz Heredia ◽  
Asier Cuéllar ◽  
Ignacio García-Alonso ◽  
...  

2020 ◽  
Vol 8 (3) ◽  
pp. e000940
Author(s):  
Patrick Alan Ridge ◽  
Alba Rial García

This case describes the clinical features and the favourable clinical outcome after a lateral meniscal allograft transplant and stifle stabilisation in a dog that suffered a significant injury to its stifle, which included irreparable injury to the lateral meniscus, cranial cruciate ligament rupture and medial collateral rupture. The lateral meniscus was extensively damaged having avulsed from its peripheral attachments and with a radial tear across 70 per cent of its mid-body. After four years, the owners reported that the dog continued with an active lifestyle and only occasionally required non-steroidal anti-inflammatory analgesics for sporadic episodes of mild lameness after vigorous exercise.


2015 ◽  
Vol 28 (1) ◽  
pp. 21-26
Author(s):  
Jae Ang Sim ◽  
Yong-Cheol Yoon ◽  
Sheen Woo Lee ◽  
Beom Koo Lee

2021 ◽  
Vol 1 (4) ◽  
pp. 263502542110142
Author(s):  
Anthony J. Ignozzi ◽  
Greg Anderson ◽  
David R. Diduch

Background: Recognizing and repairing a lateral meniscus complete radial tear is critical, as this tear pattern makes the meniscus nonfunctional for load sharing of axial forces, and the convex shape of the lateral tibial plateau increases contact pressure. Indications: The diagnosis of a lateral meniscus complete radial tear was supported by joint effusion, lateral joint line tenderness, positive McMurray test, and magnetic resonance imaging findings. Arthroscopy confirmed the complete radial tear. Technique Description: During the procedure, a self-capturing suture passer was used to pass a size 0 high-strength suture through the meniscus. To start the repair, the free ends of the suture were passed from top to bottom on both sides of the tear. These free ends were then crossed on the bottom of the meniscus to create an X configuration and passed from the bottom to top slightly further back from the first suture passes. A spinal needle and a chia were used from outside-in to create a side-to-side suture across the tear to reinforce the repair, and a knot was then tied on the outer capsule. The chia was used once again to shuttle the size 0 sutures to the exterior portion of the knee and the knots were tied on top of the capsule. Results: Postoperatively, patients are 25% weightbearing with a 0° to 90° range of motion restriction for 6 weeks, with no deep squatting for 3 months. With an isolated radial tear repair, the patient can expect to return to sport by 5 months. Radial tear repair outcomes demonstrate reduced lateral meniscus extrusion, complete meniscus healing in 86.4% of patients, and significantly improved International Knee Documentation Committee, Lysholm, and Tegner scores. Discussion/Conclusion: Repairing a complete radial tear of the lateral meniscus restores the function of the meniscus. This surgical technique provides a high rate of complete meniscus healing and excellent patient satisfaction.


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhiqiang Wang ◽  
Yan Xiong ◽  
Xin Tang ◽  
Qi Li ◽  
Zhong Zhang ◽  
...  

Abstract Background At present, most repair techniques for meniscal tears fix the meniscus directly over the capsule. This changes the normal anatomy and biomechanics and limits the activity of the meniscus during motion. We introduce an arthroscopic repair technique by suturing the true meniscus tissue without the capsule and subcutaneous tissue. Methods After confirmation of a tear, a custom-designed meniscal repair needle first penetrates percutaneously, crossing the capsular portion and the torn meniscus, and exits from the femoral surface of one side of the torn meniscus. Then a No. 2 PDS suture is passed through the needle and retrieved through the arthroscopy portal. Next, the needle is withdrawn to the synovial margin of the meniscus and is reinserted, exiting the femoral surface of the other side of the torn meniscus. The suture is pulled out through the same portal with a grasper. Finally, arthroscopic knotting is performed. Results We had 149 cases of meniscal tears repaired with this outside-in transfer all-inside technique since July 2016. Conclusions It is a simple, minimally invasive, and economical procedure that is appropriate for most parts of the meniscus except the posterior horn of the lateral meniscus, and it can be used to fix torn meniscus tissue firmly while also preserving the inherent activity of the meniscus.


2020 ◽  
Vol 8 (4) ◽  
pp. 232596712091456 ◽  
Author(s):  
Philipp W. Winkler ◽  
Guido Wierer ◽  
Robert Csapo ◽  
Caroline Hepperger ◽  
Bernhard Heinzle ◽  
...  

Background: Radial tears of the lateral meniscus frequently accompany acute anterior cruciate ligament (ACL) injuries and lead to increased joint stress and pathological meniscal extrusion (ME). The dynamic behavior of the lateral meniscus after radial tear repair with respect to ME has not been described. Purpose: To quantitatively assess dynamic lateral ME after all-inside radial tear repair. Study Design: Case series; Level of evidence, 4. Methods: Patients who underwent ACL reconstruction and all-inside radial tear repair of the lateral meniscus and had no history of contralateral knee injuries were included. Magnetic resonance imaging scans were acquired in loaded (50% of body weight) and unloaded conditions of both the injured and noninjured knees. A custom-made pneumatically driven knee brace was used for standardized knee positioning in 10° of flexion and with axial load application. Quantitative measures included the absolute lateral ME, meniscal body extrusion ratio, and Δ extrusion. Preoperative and postoperative unloaded extrusion data were compared by paired t tests. For postoperative data, the concomitant influence of the factors “leg” and “condition” were assessed through factorial analyses of variance. Results: A total of 10 patients with a mean follow-up of 47.9 months were enrolled. The intraclass correlation coefficient (ICC) confirmed good interrater reliability (ICC, 0.898) and excellent intrarater reliability (ICC, 0.976). In the unloaded injured leg, all-inside repair reduced ME from 3.15 ± 1.07 mm to 2.13 ± 0.61 mm (–32.4%; P = .033). Overall, load application led to a significant increase in ME (+0.34 mm [+21.8%]; P = .029). Significantly greater ME was observed in the injured knee (+1.10 mm [+93.2%]; P = .001) than in the noninjured knee. The condition × leg interaction was not significant ( P = .795), suggesting that the compression-associated increase in ME did not differ significantly between the injured and noninjured knees. Conclusion: Lateral ME depends on the knee status and loading condition. All-inside repair of radial meniscal tears led to a reduction of extrusion with no alteration in dynamic lateral ME. Meniscus-preserving therapy is recommended in the case of a radial lateral meniscal tear to preserve its dynamic behavior.


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