Vascular safety during arthroscopic all-inside meniscus suture. 2015

Akinobu Nishimura, and Aki Fukuda, and Ko Kato, and Kohzo Fujisawa, and Atsumasa Uchida, and Akihiro Sudo
Department of Orthopaedic and Sports Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan, meiten@clin.medic.mie-u.ac.jp.

OBJECTIVE The purpose of the study is to assess the orientation and distance of the popliteal artery (PA) from both the anteromedial and anterolateral portals. METHODS The records of 97 patients (100 knees) who underwent knee arthroscopy were reviewed. The shortest distance from the posterior tibial cortex to the PA on the lines from both the medial and lateral borders of the patellar tendon to the PA was evaluated by magnetic resonance imaging at full knee extension. The figure-of-four position was compared between patients with intact and deficient anterior cruciate ligaments (ACLs). The shortest distances from the posterior cruciate ligament (PCL) to the lines running from the medial and lateral borders of the patellar tendon to the PA were also measured. RESULTS The shortest distances from the posterior tibial cortex to the PA were significantly longer in the figure-of-four position than at full knee extension and during extension in the ACL-deficient than intact group. Distances did not significantly differ in the figure-of-four position. The PA was hidden from the anteromedial portal by the PCL, but remained vulnerable from the anterolateral portal. CONCLUSIONS All-inside meniscus suturing of the posterior horn of the lateral meniscus inserted through the anteromedial portal is safer when the knee is in the figure-of-four position than fully extended. Meniscus repairs should be completed before ACL reconstruction due to vascular positions and the ease of approach. METHODS Prospective correlation study, Level IV.

UI MeSH Term Description Entries
D007593 Joint Instability Lack of stability of a joint or joint prosthesis. Hypermobility, Joint,Instability, Joint,Laxity, Joint,Hypermobilities, Joint,Instabilities, Joint,Joint Hypermobilities,Joint Hypermobility,Joint Instabilities,Joint Laxities,Joint Laxity,Laxities, Joint
D007719 Knee Joint A synovial hinge connection formed between the bones of the FEMUR; TIBIA; and PATELLA. Superior Tibiofibular Joint,Joint, Knee,Joint, Superior Tibiofibular,Knee Joints,Superior Tibiofibular Joints,Tibiofibular Joint, Superior
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D008592 Menisci, Tibial The interarticular fibrocartilages of the superior surface of the tibia. Lateral Menisci,Medial Menisci,Menisci, Lateral,Menisci, Medial,Semilunar Cartilages,Tibial Menisci,Meniscus, Medial,Meniscus, Tibial,Tibial Meniscus,Cartilage, Semilunar,Cartilages, Semilunar,Lateral Meniscus,Medial Meniscus,Meniscus, Lateral,Semilunar Cartilage
D011150 Popliteal Artery The continuation of the femoral artery coursing through the popliteal fossa; it divides into the anterior and posterior tibial arteries. Arteria Poplitea,Artery, Popliteal,Popliteal Arteries
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000070600 Tibial Meniscus Injuries Injuries to the TIBIAL MENISCUS of the leg. Bucket Handle Tears,Flap Tears,Tibial Meniscus Tears,Torn Tibial Meniscus,Bucket Handle Tear,Flap Tear,Injuries, Tibial Meniscus,Injury, Tibial Meniscus,Meniscus Injuries, Tibial,Meniscus Injury, Tibial,Meniscus Tear, Tibial,Meniscus Tears, Tibial,Meniscus, Torn Tibial,Tear, Tibial Meniscus,Tears, Flap,Tears, Tibial Meniscus,Tibial Meniscus Injury,Tibial Meniscus Tear,Tibial Meniscus, Torn

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