The FasT-Fix Repair Technique for Ramp Lesion of the Medial Meniscus

Abstract

IntroductionThis technical note describes a new arthroscopic technique to repair the peripheral attachment lesion of the posterior horn of the medial meniscus. The operation was performed under arthroscopy using a standard anterior portal.Surgical TechniqueA FasT-Fix needle was inserted obliquely close to the tibial plateau and the first implant was inserted into the joint capsule depending on its bending angle underneath the meniscus. The second implant was inserted through 1/3 periphery of the meniscus into the meniscocapsular area. The pre-tied self-sliding knot was tensioned to achieve secure fixation of the posterior meniscal peripheral attachment at the original attachment point.Materials and MethodsFrom August 2011 to February 2014, 23 knees were diagnosed as ramp lesion, underwent meniscal repair using FasT-Fix technique.ResultsAll patients were followed up for average 14 months. The Lysholm score improved from preoperative 64.4±4.52 to postoperative 91.2±4.60.ConclusionsWe believe that the FasT-Fix technique via the standard anterior portal can be a more convenient and less traumatic alternative for repair of the peripheral attachment lesion of the posterior horn of the medial meniscus in the anterior cruciate ligament deficient knee.

Ramp Lesions

“…Most investigators choose to use their standard ACL rehabilitation protocol. 6,10,31,37 In the case of isolated ramp lesions, a standard meniscal repair rehabilitation protocol should be followed. 31 Most protocols agree that early knee motion is beneficial; however, knee hyperflexion is associated with anterior tibial translation, which can increase the stress on the repair.…”

Posterior Horn of Medial Meniscal Peripheral Capsular Lesion: The Arthroscopic Repair Technique Working in the Posterior Compartment

“…The most recent repair technique for this lesion was described by Li et al in 2015. 4 They believed that using the FasT-Fix via the standard anterior portal was more convenient and less traumatic. However, there are some drawbacks of their technique: not only the chance of missing the hidden lesion from only anterolateral portal for exploration, but also the risk of implant breakage, or migration of the FasT-Fix implant.…”

“…Most of them usually visualize the tear with the camera in the anterolateral portal and repair the lesion with a suture hook technique. Recently, in 2015, Li et al 4 proposed the repair technique with FasT-Fix via the standard anterior portal. They claimed that this technique is more convenient and offers a less traumatic alternative compared with a traditional method.…”

Repairing Posteromedial Meniscocapsular Separation: A Technique Using Inside-Out Meniscal Repair Needles

“…Another approach uses rotator cuff repair devices through the posteromedial (PM) portal. 6,7 We have modified the inside-out repair technique slightly and present our technique for repairing these peripheral meniscocapsular separations. We believe that this technique is easy, reproducible, and efficient in repairing posteromedial meniscocapsular separation.…”

“…Most authors now agree that posteromedial meniscocapsular separations need to be repaired. [1][2][3][4][5][6][7][8] Posteromedial meniscocapsular separation is typically associated with ACL injuries. 4 The incidence of such lesions has been reported from 16.6% to as high as 23.2%.…”