Arthroscopic all-inside repair of challenging meniscus tears. 2023

Bálint Zsidai, and Sahil Dadoo, and Michael A Fox, and Janina Kaarre, and Camila Grandberg, and Justin J Greiner, and Volker Musahl
Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, Pittsburgh, 15203, USA; Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 40530, Sweden. Electronic address: balint.zsidai@gu.se.

Meniscus tears are prevalent in isolation and in combination with anterior cruciate ligament (ACL) injury. Meniscus lesions can be difficult to access and often display complex tear patterns, which result in technical challenges for the operating surgeon during surgical treatment. The aim of this video article is to demonstrate technical tips and tricks for performing all-inside repair of challenging meniscus tears. The presented techniques are indicated in young, physically active patients with symptomatic tears of the lateral and medial menisci, with or without concomitant ACL injury. The procedure is performed using standard anterolateral and anteromedial arthroscopic portals for direct visualization of complex meniscus tear patterns and all-inside instrument access. A suture passing device is used for the placement of suture loops for meniscus root repair. All-inside repair devices are used to repair the radial meniscal tears along the native circumferential fibers using a horizontal mattress suture configuration, with curved devices to achieve optimal access to challenging tears affecting the anterior and posterior aspects at the mid-body of the meniscus. Repair of radial tears at the avascular zone of the meniscus may be augmented with an autologous fibrin clot delivered using an arthroscopic cannula.

UI MeSH Term Description Entries
D007718 Knee Injuries Injuries to the knee or the knee joint. Injuries, Knee,Injury, Knee,Knee Injury
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
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000070598 Anterior Cruciate Ligament Injuries Sprain or tear injuries to the ANTERIOR CRUCIATE LIGAMENT of the knee. ACL Injuries,ACL Tears,Anterior Cruciate Ligament Injury,Anterior Cruciate Ligament Tear,Anterior Cruciate Ligament Tears,ACL Injury,ACL Tear,Injuries, ACL,Injury, ACL,Tear, ACL,Tears, ACL
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
D001182 Arthroscopy Endoscopic examination, therapy and surgery of the joint. Arthroscopic Surgical Procedures,Surgical Procedures, Arthroscopic,Arthroscopic Surgery,Surgery, Arthroscopic,Arthroscopic Surgeries,Arthroscopic Surgical Procedure,Arthroscopies,Procedure, Arthroscopic Surgical,Procedures, Arthroscopic Surgical,Surgeries, Arthroscopic,Surgical Procedure, Arthroscopic

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