Posterior Meniscal Root Repair Using a Meniscal Suture Device

Moreirão

et al. 2021

Self Cite

The medial meniscal root tear, a particular meniscal injury at the level of its posterior bone insertion, leads to a loss of impact absorption and load distribution capacity, similar to total meniscectomy. Therefore, its repair is fundamental for knee joint longevity. This type of injury often occurs in middle-aged patients with lower limbs varus malalignment, which results in mechanical overloading of the medial compartment and induces premature cartilage wear out. The success of meniscal root repair, with meniscal bone reinsertion, depends on the correction and realignment of varus deformities greater than 5 for physiological levels. In this situation, corrective tibial osteotomy combined with meniscal repair is indicated. Our goal is to describe the step-by-step technique of the valgus opening wedge tibial osteotomy combined with the arthroscopic reinsertion of the posterior meniscal root in tibia during the treatment of a patient with varus deformity and medial meniscus root tear.

Section: Meniscal Root Repair (With Video Illustration)mentioning

confidence: 99%

Section: Technical Notementioning

confidence: 99%

Section: Technical Notementioning

confidence: 99%

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Posterior Root Repair of Medial Meniscus Combined With Valgus Opening Wedge Tibial Osteotomy

Moreirão

et al. 2021

Self Cite

“…20 Since 2019, we have been using a Meniscus 4 A-II repair device (Síntegra Surgical, Pompéia -SP, Brazil), which allows meniscal suture to be performed continuously. [21][22][23][24] The purpose of this article is to describe the steps of continuous meniscal suture, in a format similar to an hourglass, for the treatment of radial lesions in the medial or lateral menisci. In Fig 1A to E, we can observe how the technique is configured.…”

mentioning

confidence: 99%

Continuous Meniscal Suture in Radial Meniscal Tear: The Hourglass Technique

Albuquerque

et al. 2021

Self Cite

The key to preventing early knee osteoarthritis is meniscal preservation. The main functions of the meniscus are impact absorption, mechanical load transmission, lubrication, joint stability, and proprioception. Radial lesions that extend to the joint capsule are called complete radial tears. This type of injury compromises 2 of the main meniscal functions, which are impact absorption and load distribution, which is equivalent, from a biomechanical perspective, to a total meniscectomy. In the recent past, the treatment of choice for this type of injury was partial meniscectomy. However, several studies have observed progressive joint degeneration after this type of treatment. Recently, different types of meniscal sutures involving radial lesions of the meniscus have been developed. It is believed that such repairs may bring a decrease in future osteoarthritis in this patient profile. The purpose of this article is to describe the steps of continuous meniscal suture for the treatment of radial tears of the medial and lateral menisci.T he key to preventing early knee osteoarthritis is meniscal preservation. 1 This statement is based on the main functions of the meniscus, which are impact absorption, mechanical load distribution, lubrication, joint stability, and proprioception. [2][3][4][5] The patterns of meniscal injury are diverse. They can be longitudinal, horizontal, oblique, radial, and complex. Radial lesions that extend to the joint capsule are called complete radial lesions. This type of injury compromises 2 of the main meniscal functions, which are impact absorption and distribution, which is equivalent, from a biomechanical perspective, to a total meniscectomy. This is because the meniscus loses its tensile strength, in addition to predisposing to meniscal extrusion. 6,7 Tears of the meniscal may lead to increased magnitude and changed distribution of mechanical stress contributing to the spontaneous subchondral bone osteonecrosis. 8 Radial tears are commonly related to trauma in young patients and are often associated with other joint injuries,

“…Our group uses a device capable of performing meniscal repairs in different ways, such as inside-out (horizontal and vertical), meniscal root repair, and meniscal repair outside-in. The device is called “Meniscus 4-AII.” 9 , 10 , 11 Our objective is to describe a continuous outside-in meniscal repair technique, especially indicated for anterior horn and meniscus body tears.…”

mentioning

confidence: 99%

Outside-in Continuous Meniscal Suture Technique of the Knee

Pádua

et al. 2020

Self Cite

The meniscus is largely responsible for the health and longevity of the knee. It has diverse functions, being fundamental in load absorption and distribution and even in joint stability. To preserve meniscal functions and prevent the occurrence of osteoarthritis after meniscectomy, several meniscal repair techniques have been developed. To perform meniscal repair in anterior horn, the outside-in technique is the most used. There are few devices for performing them, with most of the surgical techniques described using needles. Our group uses a device capable of performing meniscal repair in different ways. Our objective is to describe a continuous outside-in meniscal repair technique, especially indicated for anterior horn and meniscus body tears, with the “Meniscus 4-All suture device.” The continuous outside-in meniscal suture technique using this device is easy to perform, inexpensive, fast, and reproducible, minimizing the risk of soft-tissue entrapment. In addition, it allows the surgeon to perform meniscal repair in the posterior horn in extensive injuries with the same repair device, just switching to inside-out technique.