Dataset Information

Medial Meniscus Radial Tear: A Transtibial 2-Tunnel Technique.

ABSTRACT: Complete radial tears of the medial meniscus significantly decrease the meniscal tissue's ability to dissipate tibiofemoral loads and have been described as functionally similar to a total meniscectomy, predisposing patients to early osteoarthritis. At present, no consensus exists regarding the optimal surgical treatment of a radial meniscal tear. Current repair techniques have led to a reportedly high rate of incomplete healing or healing of the meniscus in a nonanatomic, gapped position, which compromises its ability to withstand hoop stresses. Improvement regarding the ability to repair and heal medial meniscus radial tears has the potential to result in enhanced preservation of the articular cartilage in the medial compartment of the knee. This technical description details a method for repairing radial tears of the medial meniscus using a transtibial 2-tunnel technique.

SUBMITTER: Nitri M

PROVIDER: S-EPMC5040555 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Medial Meniscus Radial Tear: A Transtibial 2-Tunnel Technique.

Nitri Marco M Chahla Jorge J Civitarese David D Bhatia Sanjeev S Moulton Samuel G SG LaPrade Christopher M CM LaPrade Robert F RF

Arthroscopy techniques 20160815 4

Complete radial tears of the medial meniscus significantly decrease the meniscal tissue's ability to dissipate tibiofemoral loads and have been described as functionally similar to a total meniscectomy, predisposing patients to early osteoarthritis. At present, no consensus exists regarding the optimal surgical treatment of a radial meniscal tear. Current repair techniques have led to a reportedly high rate of incomplete healing or healing of the meniscus in a nonanatomic, gapped position, which ...[more]

PMID: 27709054

Similar Datasets

Project description:Radial meniscus tears occur commonly as traumatic tears in younger patients, as well as in association with concomitant degenerative changes. Traditional management of these tears has centered around partial meniscectomy; however, there has been a more recent trend toward preserving the meniscus and attempting repair. Because of the gapping and displacement that frequently occurs with these tears, repair is often challenging and is done under high amounts of tension. The following article describes a technique using a traction suture to aid in maintaining reduction throughout repair. This is followed by the use of a combination of techniques to form a “super-hashtag” configuration of both vertical and horizontal mattress sutures, leading to a secure repair under little tension. Technique Video Video 1 Video demonstrating technique for repair of anterolateral radial meniscus tears using a traction suture and super-hashtag orientation. This video shows arthroscopic view from the anterolateral portal with the lateral femoral condyle at the top of the view, and the lateral tibial plateau at the bottom. A standard diagnostic arthroscopy is then performed. The video first demonstrates the identification of the tear at the junction of anterior and middle thirds of the lateral meniscus, which includes a large amount of gapping. A rasp is then used to abrade the synovium and tear to generate the best biologic healing response. The traction suture is then placed in the posterior limb of the tear with the use of the NovoStitch Pro Meniscal Repair System (Smith & Nephew, Andover, MA). This is performed by making one bite in the periphery of this limb, followed by another more centrally. Suture limbs are then brought out through the lateral portal to be used to pull traction and maintain reduction of the tear throughout the remainder of the repair. The anterior and posterior limbs are then secured to the capsule in reduced position with the use of vertical mattress sutures via a combination of all-inside, inside-out, and outside-in techniques. The same sutures are then used for tie-grip or rip-stop sutures for the horizontal mattress. The sutures are tied under the iliotibial band and directly at the capsule, while keeping the meniscus reduced with the traction suture. This is followed by placement of various horizontal mattress sutures over the tie-grip or rip-stop sutures, creating a “super-hashtag” repair. Our postoperative protocol includes keeping the patient non-weightbearing for 6 weeks following surgery with hinged knee brace locked in extension for the first 2 weeks. Range of motion will be strictly 0-90° for the first 4 weeks. Deep vein thrombosis prophylaxis is continued for 6 weeks postoperatively.

Dataset Information

Medial Meniscus Radial Tear: A Transtibial 2-Tunnel Technique.

Publications

Medial Meniscus Radial Tear: A Transtibial 2-Tunnel Technique.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets