scholarly journals Chondral Injury After Inside-Out Meniscal Suture Repair Using Meniscal Sutures

2019 ◽  
Vol 13 (1) ◽  
pp. 72-75 ◽  
Author(s):  
Takatomo Mine ◽  
Riri Hayashi ◽  
Koichiro Ihara ◽  
Hiroyuki Kawamura ◽  
Ryutaro Kuriyama ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Meniscal Repair ◽  
Chondral Lesion ◽  
Suture Repair ◽  
Medial Condyle ◽  
Tibiofemoral Joint ◽  
Meniscal Suture ◽  
Chondral Injury ◽  
Inside Out

Chondral injury after arthroscopic meniscal suture repair is rare. We present a case of chondral injury due to the migration of suture after meniscal repair. The aberrant suture that remained temporarily at the medial tibiofemoral joint may have led to the chondral lesion of the femoral medial condyle and the tibial medial plateau at the weight-bearing portion.

Comparison of all-inside meniscal repair devices with matched inside-out suture repair

2011 ◽  
Vol 27 (2) ◽  
pp. 133-134
Author(s):  
Claudio Rosso ◽  
K. Kovtun ◽  
W. Dow ◽  
B. Mckenzie ◽  
A. Nazarian ◽  
...  
Keyword(s):  
Meniscal Repair ◽  
Suture Repair ◽  
Inside Out

All-Inside Meniscal Repair Devices Compared With Their Matched Inside-Out Vertical Mattress Suture Repair

2014 ◽  
Vol 42 (9) ◽  
pp. 2226-2233 ◽  
Author(s):  
Claudio Rosso ◽  
Sebastian Müller ◽  
Daniel M. Buckland ◽  
Tanja Schwenk ◽  
Simon Zimmermann ◽  
...  
Keyword(s):  
Meniscal Repair ◽  
Suture Repair ◽  
Mattress Suture ◽  
Vertical Mattress ◽  
Inside Out

scholarly journals The modified cross-suture technique for unilateral pulled-out anchor during all-inside meniscal repair

2019 ◽  
Author(s):  
Jianlong Ni ◽  
Zhibin Shi ◽  
Lihong Fan ◽  
Ning Guo ◽  
Haoyu Wang ◽  
...  
Keyword(s):  
Healing Rate ◽  
Suture Anchor ◽  
Meniscal Repair ◽  
Pivot Shift Test ◽  
Suture Repair ◽  
Observation Group ◽  
Meniscal Suture ◽  
Anterior Cruciate ◽  
Clinical Healing

Abstract Background: In consideration of meniscal repair has received increasingly more attention, but for inexperienced doctors, various technical errors may occur when meniscal suture repair is performed, particularly during all-inside meniscal suture repairing. When the errors is happened intraoperatively, how to minimize the loss under the effectiveness of treatment is a topic worth studying. Methods: From May 2014 to May 2017, 28 cases diagnosed with injures of meniscus and anterior cruciate ligaments were enrolled in the study as observation group. All cases underwent anterior cruciate ligament (ACL) reconstruction concurrently. All meniscus injuries were repaired with an all-inside meniscal repair technique, and 1-3 needles of unilateral suture anchor pulling out occurred intraoperatively. The method of modified cross-suture was used to remedy the error of anchor pulling out and to eventually complete the effective repair. During postoperative follow-up, the range of motion, Lachman test and pivot shift test were confirmed by physical examination. The clinical healing of meniscus was evaluated according to the Barrett standard. Meniscus healing status was also confirmed with magnetic resonance imaging (MRI). The function of the knee joint was evaluated with the IKDC, Lysholm and Tegner scores. Results: 25 cases of observation group and 28 cases of control group received complete follow-up with an average follow-up of 18.4±5.2 months. All operations were finished by the same surgeon. At the follow-up one year after operation, the average knee ROM of two groups were 125.2±4.3 degrees and 124.7±3.8 degrees, the clinical healing rate of the meniscus of two groups were 92.0% (23/25) and 92.9% (26/28), the MRI healing rate of the menniscus of two groups were 72.0% (18/25) and 71.4% (20/28), the IKDC, Lysholm and Tegner scores of two groups were 90.52±2.8, 89.17±3.1, 6.81±1.7 and 91.42±1.9, 90.32±3.4, 7.02±1.4, the differences were not statistically significant (P>0.05). Conclusions: The method of modified cross-suture is effective for arthroscopic remediation for unilateral suture anchor pulling out of an all-inside meniscal repair system.

Deteriorating Outcomes after Meniscal Repair Using the Meniscus Arrow in Knees Undergoing Concurrent Anterior Cruciate Ligament Reconstruction

2005 ◽  
Vol 33 (8) ◽  
pp. 1138-1141 ◽  
Author(s):  
Gregory P. Lee ◽  
David R. Diduch
Keyword(s):  
Success Rate ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Meniscal Repair ◽  
Suture Repair ◽  
Meniscus Arrow ◽  
Anterior Cruciate ◽  
Inside Out

Background An increased awareness of the degenerative changes that occur in the knee after meniscectomy has led to efforts to salvage the injured meniscus. Numerous devices have been developed in an effort to provide the dual benefits of a durable meniscal repair and minimal invasiveness. Hypothesis The Meniscus Arrow is comparable to conventional inside-out suture repair in accomplishing long-term healing of meniscal tears. Study Design Case series; Level of evidence, 4. Methods This study is an extended follow-up of an original series of 32 patients withoutcomes analysis. All patients underwent meniscal repair with exclusive use of the arrow. All repairs were performed in the context of a concomitant anterior cruciate ligament reconstruction. Follow-up assessment included physical examination, arthrometry, the International Knee Documentation Committee instrument, and the Knee Disorders Subjective History visual analog scale. Intermediate follow-up at a mean of 2.3 years yielded a success rate of 90.6%. The mean follow-up in the present study has been extended to 6.6 years. Results The extended follow-up analysis revealed a substantial attrition in the success rate of this series of patients undergoing meniscal repair with the arrow. A 90.6% success rate at a mean follow-up of 2.3 years deteriorated to 71.4% at 6.6 years. Conclusion This study provides the longest follow-up in the literature of any of the all-inside meniscal repair implants. The Meniscus Arrow demonstrated long-term meniscal healing rates inferior to those found in the literature for inside-out suture repair techniques.

A Biomechanical Evaluation of All-Inside 2-Stitch Meniscal Repair Devices With Matched Inside-Out Suture Repair

2013 ◽  
Vol 42 (1) ◽  
pp. 194-199 ◽  
Author(s):  
Arun J. Ramappa ◽  
Alvin Chen ◽  
Benjamin Hertz ◽  
Michael Wexler ◽  
Leandro Grimaldi Bournissaint ◽  
...  
Keyword(s):  
Meniscal Repair ◽  
Suture Repair ◽  
Biomechanical Evaluation ◽  
Inside Out

Comparison of All-Inside Meniscal Repair Devices With Matched Inside-Out Suture Repair

2011 ◽  
Vol 39 (12) ◽  
pp. 2634-2639 ◽  
Author(s):  
Claudio Rosso ◽  
Konstantin Kovtun ◽  
William Dow ◽  
Brett McKenzie ◽  
Ara Nazarian ◽  
...  
Keyword(s):  
Cyclic Loading ◽  
Meniscal Repair ◽  
Suture Repair ◽  
Initial Displacement ◽  
Displacement Response ◽  
Significant Difference ◽  
Mode Of Failure ◽  
Load To Failure ◽  
Suture Failure ◽  
Inside Out

Background: All-inside meniscal repairs are performed with increasing frequency because of the availability of newly developed devices. A comparison of their biomechanical characteristics may aid physicians in selecting a method of meniscal repair. Hypothesis: All-inside meniscal repairs will be superior to their inside-out controls in response to cyclic loading and load-to-failure testing. Study Design: Controlled laboratory study. Methods: Sixty-six bucket-handle tears in matched porcine menisci were repaired using the Ultra FasT-Fix, Meniscal Cinch, Ultrabraid No. 0, and FiberWire 2-0 sutures. Initial displacement, cyclic loading (100, 300, and 500 cycles), and load-to-failure testing were performed. The displacement, response to cyclic loading, and mode of failure were recorded. The stiffness was calculated. Results: The Meniscal Cinch demonstrated a significantly higher initial displacement than the other methods tested ( P = .04). No significant difference was found among the methods in response to cyclic loading. The inside-out FiberWire repair demonstrated the highest load to failure (120.8 ± 23.5 N) and was significantly higher than both the Meniscal Cinch (64.8 ± 24.1 N, P < .001) and the Ultra FasT-Fix (88.3 ± 14.3 N, P = .002). It was not significantly higher than the inside-out Ultrabraid suture repair (98.8 ± 29.2 N). The inside-out FiberWire repair had the highest stiffness (28.7 ± 7.8 N/mm). It was significantly higher than the Meniscal Cinch (18.0 ± 8.8 N/mm, P = .01). The most common mode of failure in all methods was suture failure. Conclusion: An inside-out suture repair affords surgeons the best overall biomechanical characteristics of the devices tested (initial displacement, response to cyclic loading, and load to failure). For an all-inside repair, the Ultra FasT-Fix reproduces the characteristics of its matched inside-out suture repair more closely than the Meniscal Cinch. Clinical Relevance: Inside-out sutures and all-inside devices have similar responses to cyclic loading.

scholarly journals Increased Construct Stiffness With Meniscal Repair Sutures and Devices Increases the Risk of Cheese-Wiring During Biomechanical Load-to-Failure Testing

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110156
Author(s):  
Sebastian Müller ◽  
Tanja Schwenk ◽  
Michael de Wild ◽  
Dimitris Dimitriou ◽  
Claudio Rosso
Keyword(s):  
Characteristic Curve ◽  
Meniscal Repair ◽  
Suture Fixation ◽  
Contributing Factors ◽  
Mode Of Failure ◽  
Load To Failure ◽  
Pull Through ◽  
Optimal Stiffness ◽  
The Impact ◽  
Inside Out

Background: Cheese-wiring, the suture that cuts through the meniscus, is a well-known issue in meniscal repair. So far, contributing factors are neither fully understood nor sufficiently studied. Hypothesis/Purpose: To investigate whether the construct stiffness of repair sutures and devices correlates with suture cut-through (cheese-wiring) during load-to-failure testing. Study Design: Controlled laboratory study. Methods: In 131 porcine menisci, longitudinal bucket-handle tears were repaired using either inside-out sutures (n = 66; No. 0 Ultrabraid, 2-0 Orthocord, 2-0 FiberWire, and 2-0 Ethibond) or all-inside devices (n = 65; FastFix360, Omnispan, and Meniscal Cinch). After cyclic loading, load-to-failure testing was performed. The mode of failure and construct stiffness were recorded. A receiver operating characteristic curve analysis was performed to define the optimal stiffness threshold for predicting meniscal repair failure by cheese-wiring. The 2-tailed t test and analysis of variance were used to test significance. Results: Loss of suture fixation was the most common mode of failure in all specimens (58%), except for the Omnispan, which failed most commonly because of anchor pull-through. The Omnispan demonstrated the highest construct stiffness (30.8 ± 3.5 N/mm), whereas the Meniscal Cinch (18.0 ± 8.8 N/mm) and Ethibond (19.4 ± 7.8 N/mm) demonstrated the lowest construct stiffness. The Omnispan showed significantly higher stiffness compared with the Meniscal Cinch ( P < .001) and Ethibond ( P = .02), whereas the stiffness of the Meniscal Cinch was significantly lower compared with that of the FiberWire ( P = .01), Ultrabraid ( P = .04), and FastFix360 ( P = .03). While meniscal repair with a high construct stiffness more often failed by cheese-wiring, meniscal repair with a lower stiffness failed by loss of suture fixation, knot slippage, or anchor pull-through. Meniscal repair with a stiffness >26.5 N/mm had a 3.6 times higher risk of failure due to cheese-wiring during load-to-failure testing (95% CI, 1.4-8.2; P < .0001). Conclusion: Meniscal repair using inside-out sutures and all-inside devices with a higher construct stiffness (>26.5 N/mm) was more likely to fail through suture cut-through (cheese-wiring) than that with a lower stiffness (≤26.5 N/mm). Clinical Relevance: This is the first study investigating the impact of construct stiffness on meniscal repair failure by suture cut-through (cheese-wiring).

Outcomes of Inside-out Meniscal Repair in the Setting of Multiligament Reconstruction in the Knee

2017 ◽  
Vol 45 (9) ◽  
pp. 2098-2104 ◽  
Author(s):  
Jorge Chahla ◽  
Chase S. Dean ◽  
Lauren M. Matheny ◽  
Justin J. Mitchell ◽  
Mark E. Cinque ◽  
...  
Keyword(s):  
Failure Rate ◽  
Meniscal Repair ◽  
Postoperative Outcome ◽  
Control Group ◽  
Failure Rates ◽  
Significant Difference ◽  
Outcome Scores ◽  
Inside Out ◽  
Repair Group

Background: Limited evidence exists for meniscal repair outcomes in a multiligament reconstruction setting. Purpose/Hypothesis: The purpose of this study was to assess outcomes and failure rates of meniscal repair in patients who underwent multiligament reconstruction compared with patients who underwent multiligament reconstruction but lacked meniscal tears. The authors hypothesized that the outcomes of meniscal repair associated with concomitant multiligament reconstruction would significantly improve from preoperatively to postoperatively at a minimum of 2 years after the index surgery. Secondarily, they hypothesized that this cohort would demonstrate similar outcomes and failure rates compared with the cohort that did not have meniscal lesions at the time of multiligament reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: Inclusion criteria for the study included radiographically confirmed skeletally mature patients of at least 16 years of age who underwent multiligamentous reconstruction of the knee without previous ipsilateral osteotomy, intra-articular infections, or intra-articular fractures. Patients were included in the experimental group if they underwent inside-out meniscal suture repair with concurrent multiligament reconstruction. Those included in the control group (multiligament reconstruction without a meniscal tear) underwent multiligament reconstruction but did not undergo any type of meniscal surgery. Lysholm, Western Ontario and McMaster Universities Osteoarthritis Index, Short Form–12 physical component summary and mental component summary, Tegner activity scale, and patient satisfaction scores were recorded preoperatively and postoperatively. The failure of meniscal repair was defined as a retear of the meniscus that was confirmed arthroscopically. Results: There were 43 patients (16 female, 27 male) in the meniscal repair group and 62 patients (25 female, 37 male) in the control group. Follow-up was obtained in 93% of patients with a mean of 3.0 years (range, 2.0-4.7 years). There was a significant improvement between all preoperative and postoperative outcome scores ( P < .05) for both groups. The meniscal repair group had significantly lower preoperative Lysholm and Tegner scores ( P = .009 and P = .02, respectively). There were no significant differences between any other outcome scores preoperatively. The failure rate of the meniscal repair group was 2.7%, consisting of 1 symptomatic meniscal retear. There was no significant difference in any postoperative outcome score at a minimum 2-year follow-up between the 2 groups. Conclusion: Good to excellent patient-reported outcomes were reported for both groups with no significant differences in outcomes between the cohorts. Additionally, the failure rate for inside-out meniscal repair with concomitant multiligament reconstruction was low, regardless of meniscus laterality and tear characteristics. The use of multiple vertical mattress sutures and the biological augmentation resulting from intra-articular cruciate ligament reconstruction tunnel reaming may be partially responsible for the stability of the meniscal repair construct and thereby contribute to the overall improved outcomes and the low failure rate of meniscal repair, despite lower preoperative Lysholm and Tegner scores in the meniscal repair group.

The ICEROSS concept: A discussion of a philosophy

1993 ◽  
Vol 17 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Ö. Kristinsson
Keyword(s):  
Soft Tissue ◽  
Weight Bearing ◽  
Skin Care ◽  
Custom Made ◽  
The Subject ◽  
Distal Direction ◽  
Inside Out

Prefabricated ICEROSS (Icelandic Roll On Silicone Socket) sockets have been in use in Iceland since early 1986. Use of custom-made silicone sockets began several years earlier, and a paper devoted to the subject was presented at the 1984 AOPA Assembly by the author of this article. The ICEROSS system is primarily used for suspension. At the same time the author believes it considerably improves the weight-bearing capability of the prosthesis and the interface between prosthesis and user. After being turned inside out and rolled over the stump, the silicone sleeve forces skin in a distal direction, stabilising soft tissue and minimising pistoning. Both prosthetist and user may experience some problems initially, although most can be overcome by careful socket design and skin care.

scholarly journals Case Report of a Medial Femoral Condyle Fracture in a Unicompartmental Oxford Knee Replacement Surgery

2019 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Femoral Condyle ◽  
Intraoperative Complications ◽  
Weight Bearing ◽  
Full Range ◽  
Postoperative Rehabilitation ◽  
Medial Condyle ◽  
Case Presentation ◽  
Replacement Surgery ◽  
Stable Osteosynthesis ◽  
Condyle Fracture

Introduction: The unicompartmental Oxford prosthesis has been used as a goodalternative for medial unicompartmental osteoarthritis because it is associated with earlyrehabilitation and a low rate of intraoperative complications. This case describes a rarecomplication during the procedure. Case Presentation: We present an intraoperative fracture of the medial condyle in a 70-year-old woman that was treated with 6.5 mm cannulated screws with a compressiontechnique. The patient remained in a non-weight bearing protocol for 6 weeks andreached a full range of mobility at 3 months. Complete radiological consolidation and agood functional outcome were observed. Conclusion: Intraoperative fractures benefit from a stable osteosynthesis that allows freerange of mobility and does not delay postoperative rehabilitation.

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