An All-Inside Repair for Full Radial Posterior Lateral Meniscus Tears

Abstract

There is controversy about the treatment for unstable full radial posterior lateral meniscus tears, particularly that involving the posterior root. Some surgeons have advocated repairing these types of meniscus tears using various techniques, but their methods are somewhat technical. We developed the technique for an all-inside repair for full radial posterior lateral meniscus tears using the Meniscal Viper (Arthrex, Naples, FL). A doubled thread is passed through 1 edge of the radial tear by the Meniscal Viper and is kept in place without tying the knot. The Meniscal Viper is used again to set a new thread, repeating the same procedure to another edge of the tear. At this step, 2 doubled threads are passed through each stump of the tear, and both a loop end and 2 free ends of each thread are located outside of the joint. Then, 2 doubled threads pass the third thread into its own loop, pulling it out. Finally, the third thread becomes the mattress suture over the radial tear site and is fastened by sliding knot techniques. This procedure makes it easy to strictly, smoothly, and less invasively shorten the gap by drawing each stump of the meniscus in the direction of the circumference.

Comparative Outcomes of Radial and Bucket-Handle Meniscal Tear Repair: A Propensity-Matched Analysis

“…6,32 A number of techniques have been developed for repairing radial meniscal tears since attention has increasingly turned toward meniscal preservation. 8,33,40,41…”

All-Inside Suture Repair for Isolated Radial Tears at the Midbody of the Lateral Meniscus

“…These devices, including Knee Scorpion (Arthrex, Naples, FL), NovoStitch suture passer (Ceterix, Menlo Park, CA), and Meniscal Viper (Arthrex, Naples, FL), can avoid complications caused by implants used in conventional all-inside repair and prevent bunching of the meniscus to the capsule, unlike conventional transcapsular suture techniques. It is believed that AIS techniques could normalize the morphology and movement of the meniscus,7, 8 which is advantageous for meniscal healing. Moreover, AIS is a less-invasive technique because additional skin incision is not necessary.…”

“…Compared with conventional transcapsular suture techniques (e.g., inside-out/outside-in techniques, all-inside techniques with implants), AIS techniques can avoid bunching of the meniscus to the capsule. Therefore AIS techniques are considered suitable for normalization of the morphology and movement of the meniscus after repair, which can be advantageous for meniscal healing 7, 8. Only one report has described AIS repair for radial tears at the midbody of the lateral meniscus, 7 showing that sufficient short-term results could be obtained, although most patients had incomplete discoid menisci.…”

Lateral Meniscus Repair Using Posterolateral Portal: Suture Hook Technique

“…[4][5][6] Although a number of surgical techniques have been described, they can be very technically demanding. [4][5][6][7][8] The aim of this Technical Note was to present a safe and effective method to repair longitudinal tears of the lateral meniscus using an accessory posterolateral portal.…”