Transosseous Medial Meniscal Root Repair Using a Modified Mason-Allen Suture Configuration

Lavender, Chad; Hanzlik, Shane; Caldwell, Paul E.; Pearson, Sara E.

doi:10.1016/j.eats.2015.07.028

Cited by 11 publications

(7 citation statements)

References 18 publications

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“…A number of techniques have been introduced to reduce the residual meniscal extrusion after the MMPRT repair. 15 , 16 , 17 , 18 , 19 , 20 , 21 Koga et al. 17 reported a novel technique using centralization suture.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Transtibial Pull-Out Repair of Medial Meniscus Posterior Root Tear With a Whip Running Suture Technique

Kim

Ryu

Park

et al. 2021

Arthroscopy Techniques

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Medial meniscus posterior root tear is a disruptive injury causing significant sequelae. Several techniques to repair and maintain the native function of the medial meniscus have been introduced, but limitations have been reported in terms of their results. In this current note, the authors introduce the arthroscopic transtibial pull-out repair with whip running suture technique, which may not only avoid the potential risk of meniscus cut-through by the suture material but also optimize the reduction of the extruded meniscus. By suturing the posteromedial capsule and peripheral meniscus, more medialization force can be directly applied to the extruded part of the meniscus, and normal hoop tension can be restored.

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Section: Discussionmentioning

confidence: 99%

Arthroscopic Transtibial Pull-Out Repair of Medial Meniscus Posterior Root Tear With a Whip Running Suture Technique

Kim

Ryu

Park

et al. 2021

Arthroscopy Techniques

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“…Furthermore, studies have found that poor prognostic factors after PMMR tears repair are modified outerbridge classification grade ≥3, chondral lesions, varus alignment >5°, older age, female sex, high BMI and medial meniscus extrusion [ 8 , 16 ]. To improve the poor prognosis of PMMR tears repair, studies on transtibial pull-out fixation have focused on the meniscus–suture interface using different fixation techniques, such as the modified Mason–Allen technique or two simple sutures [ 17 , 18 ]. However, to date, few studies have examined tibial fixation methods in PMMR repair.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical comparison of four tibial fixation techniques for meniscal root sutures in posterior medial meniscus root repair: A porcine study

Yeh

Hsu

et al. 2020

Journal of Orthopaedic Translation

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Objective This study hypothesized that the suture anchor of tibial fixation method of PMMR repair technique is the main factor which reduce the gap formation or over displacement of tear site in initial healing, and then investigated the fixation stability of 4 different tibial fixations through cyclic and ultimate failure load testing of meniscal root sutures. Methods Twenty-four porcine tibiae with intact medial meniscus roots were randomly assigned into 4 groups: transosseous suture, washer, suture anchor, or screw with washer. Each sample underwent cyclic loading followed by a load-to-failure test. Displacement, maximum load to failure, stiffness, and elongation at failure load were recorded. Results The maximum average load and displacement at failure for each of the repair groups were as follows: transosseous suture, 232.8 N and 12.16 mm; washer, 189.9 N and 21.5 mm; suture anchor, 140.6 N and 13.8 mm; and screw with washer, 167.9 N and 18.9 mm. The maximum stiffness values for each of the repair groups were as follows: transosseous suture, 19.5 ± 0.7 N/mm; washer, 21.5 ± 1.4 N/mm; suture anchor, 13.8 ± 0.7 N/mm; and screw with washer, 18.9 ± 3.9 N/mm. The mean elongation across the repairs for each of the repair groups after 1000 loading cycles was: transosseous suture, 3.74 ± 0.28 mm; washer, 3.04 ± 0.13 mm; suture anchor, 2.25 ± 0.33 mm; and screw with washer, 2.43 ± 0.19 mm. The mean elongation was significantly less with the suture anchor than with the other techniques ( p < .05). Conclusion Under physiological loading, our results indicate that a slower rehabilitation program with limited flexion and only partial weight bearing is advised when using a suture anchor because of the lower maximum load and stiffness. The translational potential of this article Tibial fixation using a washer or a screw with a washer is an effective and cost-saving technique when an option is required with high stiffness and low displacement at failure.

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“…The transosseous suture pullout technique is a commonly performed procedure for various knee surgeries, such as tibial spine fixation, 1 root repair, 2 and meniscal repairs. 3 , 4 , 5 Once these transosseous sutures are pulled out through the bone tunnel, they can be secured over a screw, washer, or an endobutton. 6 However, these fixation techniques of transosseous sutures require an implant, which adds to the cost of surgery.…”

Section: Introduction (With Video Illustration)mentioning

confidence: 99%

Implant-Free, Transtibial, Bone Bridge Fixation for Knee Surgery Including Tibial Spine and Meniscal Root Fixation

Joshi¹,

Basukala²,

Singh³

et al. 2020

Arthroscopy Techniques

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Fixation over bone bridge is commonly performed during transosseous pullout knee surgeries. This technique requires the drilling of 2 bony tunnels separately. Herein, we describe our technique in which bone bridge fixation is performed with a single bony tunnel. Our technique is described in 4 simple steps. Step 1: A short accessory tunnel is created from a point at least 1 cm away from the aperture of primary bone tunnel and opening into the lumen of the primary tunnel. Step 2: A shuttle suture (PROLENE) loop is passed from the accessory tunnel to the primary tunnel, and the loop is retrieved out of the primary tunnel using an 18-G epidural needle and arthroscopy probe. Step 3: Complimentary limbs of the pullout suture is then shuttled through the accessory tunnel using shuttle suture loop. Step 4: The knots are tied over the intervening bone bridge. Since the sutures are tied over the bone bridge, it has to be strong enough to provide support. This method of fixation is contraindicated when there is severe osteoporosis or if the tunnels are located in metaphysis. A supplemental video demonstration of the technique is included with this article.

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Transosseous Medial Meniscal Root Repair Using a Modified Mason-Allen Suture Configuration

Cited by 11 publications

References 18 publications

Arthroscopic Transtibial Pull-Out Repair of Medial Meniscus Posterior Root Tear With a Whip Running Suture Technique

Arthroscopic Transtibial Pull-Out Repair of Medial Meniscus Posterior Root Tear With a Whip Running Suture Technique

Biomechanical comparison of four tibial fixation techniques for meniscal root sutures in posterior medial meniscus root repair: A porcine study

Implant-Free, Transtibial, Bone Bridge Fixation for Knee Surgery Including Tibial Spine and Meniscal Root Fixation

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