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

Steiner, Samuel R.H.; Feeley, Scott M.; Ruland, Jeffrey R.; Diduch, David R.

doi:10.1016/j.eats.2017.09.006

Cited by 17 publications

(10 citation statements)

References 10 publications

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“…13,[16][17][18] Many studies describe methods to repair radial tears of the midbody of the meniscus and posterior root tears. 2,[4][5][6][7]10,11 However, the literature lacks methods to repair a radial tear neighboring a posterior root. In past surgical studies, these radial tears were solely treated with a PM, which caused the development of medial compartment arthritis.…”

Section: Discussionmentioning

confidence: 99%

“…T he meniscus is composed of collagen fibers that act to distribute stresses, absorb shock, and provide joint stability for the knee. [1][2][3] The posterior root of the meniscus, which has a ligament-like structure, anchors the meniscus to the tibial plateau. 4 Radial tears transect circumferential fibers, disrupting the ability of the meniscus to withstand hoop stress.…”

mentioning

confidence: 99%

“…2,3 Radial tears along the meniscus mid-body can be treated with a partial meniscectomy (PM) or repaired using methods like the inside-out repair, the outside-in repair, and the all-inside repair. 2,3,[5][6][7][8] However, these repairs only alleviate symptoms to varying degrees 3,4 and are unable to restore the meniscus to its original function. 4 Root tears are surgically treated with a PM or reattached to the tibial plateau with a transtibial pull-out repair (TTPR) or suture anchor technique.…”

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confidence: 99%

“…Disposable root repair kit that contains (1) Knee Scorpion Suture Passer to pass suture;(2) FlipCutter to drill the tibial tunnel;(3) guidewire to guide suture passing; (4) 0 FiberLink Suture, which is used to make the cinch suture through the meniscus; (5) Push/Tap for 4.75-mm SwiveLock used to secure suture anchor to the tibia; and (6) 4.75-mm SwiveLock to load suture anchor.…”

mentioning

confidence: 99%

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Transtibial Pull-Out Repair of Converted Radial Tear Adjacent to Medial Meniscus Root

Yin¹,

Gogh²,

Youn³

et al. 2020

Arthroscopy Techniques

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Radial tears increase tibiofemoral contact pressure and disrupt the ability of the meniscus to withstand hoop stress, leading to earlier-onset osteoarthritis. Repair of radial tears is problematic because they have a lower healing rate and lack a single gold standard technique. However, when a radial tear is proximal to the root, there is an opportunity to convert it into a root tear. This is ideal because root tears fixed through a transtibial tunnel technique have improved clinical outcomes and reduced rates of osteoarthritis. This Technical Note and accompanying video describe a method for repairing a radial tear near the meniscus root by converting a radial tear to a root tear followed by a pull-out root repair through a transtibial tunnel. This method restores the meniscus root, allowing it to withstand hoop stress. Our technique uses a disposable root repair kit that includes a FlipCutter, a Knee Scorpion Suture Passer, a 4.75-mm SwiveLock anchor tap, a SutureLasso, a PassPort Cannula, 0 FiberLink sutures, and TigerLink sutures.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Transtibial Pull-Out Repair of Converted Radial Tear Adjacent to Medial Meniscus Root

Yin¹,

Gogh²,

Youn³

et al. 2020

Arthroscopy Techniques

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“…If not treated appropriately, they can quickly lead to chondrolysis of the lateral knee compartment. 1 If these tears are not repaired, the lateral compartment is subjected to unfavorable dynamic contact mechanics similar to those resulting from a partial or even total lateral meniscectomy in the case of full radial tears. 2,3 Meniscal preservation with suture repair is currently considered the gold standard of treatment, with very good longterm results.…”

mentioning

confidence: 99%

Lateral Meniscus Repair Using Posterolateral Portal: Suture Hook Technique

Abreu

Moura

Queirós

et al. 2019

Arthroscopy Techniques

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Lateral meniscus lesions result in loss of meniscus hoop stresses and can lead to lateral compartment overload and early degenerative changes. Arthroscopic suture repair provides good long-term results. However, posterior vertical tears in the peripheral area of the meniscus can be technically challenging to resolve. This Technical Note describes the suture hook technique using an accessory posterolateral portal. We believe it is a safe, effective method for repairing full vertical tears of the lateral meniscus.

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Meniscal repair: The current state and recent advances in augmentation

Bansal

Floyd

Kowalski

et al. 2021

Journal Orthopaedic Research

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Meniscal injuries represent one of the most common orthopedic injuries. The most frequent treatment is partial resection of the meniscus, or meniscectomy, which can affect joint mechanics and health. For this reason, the field has shifted gradually towards suture repair, with the intent of preservation of the tissue. “Save the Meniscus” is now a prolific theme in the field; however, meniscal repair can be challenging and ineffective in many scenarios. The objectives of this review are to present the current state of surgical management of meniscal injuries and to explore current approaches being developed to enhance meniscal repair. Through a systematic literature review, we identified meniscal tear classifications and prevalence, approaches being used to improve meniscal repair, and biological‐ and material‐based systems being developed to promote meniscal healing. We found that biologic augmentation typically aims to improve cellular incorporation to the wound site, vascularization in the inner zones, matrix deposition, and inflammatory relief. Furthermore, materials can be used, both with and without contained biologics, to further support matrix deposition and tear integration, and novel tissue adhesives may provide the mechanical integrity that the meniscus requires. Altogether, evaluation of these approaches in relevant in vitro and in vivo models provides new insights into the mechanisms needed to salvage meniscal tissue, and along with regulatory considerations, may justify translation to the clinic. With the need to restore long‐term function to injured menisci, biologists, engineers, and clinicians are developing novel approaches to enhance the future of robust and consistent meniscal reparative techniques.

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

Cited by 17 publications

References 10 publications

Transtibial Pull-Out Repair of Converted Radial Tear Adjacent to Medial Meniscus Root

Transtibial Pull-Out Repair of Converted Radial Tear Adjacent to Medial Meniscus Root

Lateral Meniscus Repair Using Posterolateral Portal: Suture Hook Technique

Meniscal repair: The current state and recent advances in augmentation

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