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Vertical Continuous Meniscal Suture Technique.

ABSTRACT: Meniscal injuries are common in the population, representing the major cause of functional impairment in the knee. Vertical longitudinal injuries of the meniscus can be stable or unstable. When extensive, they are commonly unstable and can lead to clinical signs of significant functional disability. Vertical longitudinal injuries have the best prognosis for repair, especially when occurring in the meniscal periphery, called the red-red zone. A recently developed type of meniscal suture device called Meniscus 4 A-II enables the surgeon to perform a meniscal suture from the inside-out continuously, reducing surgical time. Because it allows the surgeon to use a single and inexpensive device to repair the entire injury, costs are significantly reduced. Here, an approach to carry out continuous meniscal repair with vertical sutures is described. This technique warrants excellent stability to the meniscal repair, increasing the chances of a successful outcome. We believe that the popularization of the repair technique from the inside out using the Meniscus 4-All device will help many surgeons around the world save menisci that otherwise would have a great chance of being excised, since it is a cheap, reproducible, and easy-to-handle device.

SUBMITTER: Rocha de Faria JL

PROVIDER: S-EPMC7528575 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Continuous Meniscal Suture Technique of the Knee.

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Posterior Meniscal Root Repair Using a Meniscal Suture Device.

Project description:A greater understanding of the deleterious consequences that a meniscal root tear brings to the knee joint and how its surgical repair can be advantageous over the previously used treatment strategies brings the need for the development of surgical techniques that make the procedure less complex and more reproducible. When meniscal root rupture occurs, a mechanical overload occurs in the affected compartment similar to a total meniscectomy. Several authors have concluded that meniscal root reinsertion significantly improves postoperative outcomes and patient satisfaction, regardless of age or laterality of the meniscal injury. The Meniscus 4 A-II device (Rio de Janeiro, Brazil) allows stitching at the root of the medial and lateral menisci. In this article, we describe the surgical repair technique for posterior-medial and -lateral meniscal root tears using this meniscal suture device. This technique is fast and effective.

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Full-Thickness Radial Medial Meniscal Tear: Fixation With Inside-Out Technique With Tibial Knotless Suture Anchors.

Project description:Complete radial tears of the meniscus render the entirety of the meniscus functionally incompetent (known as an ameniscal state); therefore, attempts at repair are essential. Although various techniques have been described, repair failures continue to frequently occur, especially with the medial meniscus. Inside-out repair and anchoring of the preserved meniscus to both the capsule and tibia may offer the advantage of a more robust repair. The objective of this Technical Note is to describe a method of repair for complete radial tears of the medial meniscus using a combination of inside-out sutures and secondary reinforcement to the tibia using all-suture knotless anchors.

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Interrupted versus continuous suture technique for biliary-enteric anastomosis: randomized clinical trial.

Project description:BackgroundBiliary-enteric anastomosis (BEA) can be performed using continuous or interrupted suture techniques, but high-quality evidence regarding superiority of either technique is lacking. The aim of this study was to compare the suture techniques for patients undergoing BEA by evaluating the suture time as well as short- and long-term biliary complications.MethodsIn this single-centre randomized clinical trial, patients scheduled for elective open procedure with a BEA between 21 January 2016 and 20 September 2017 were randomly allocated in a 1:1 ratio to have the BEA performed with continuous suture (CSG) or interrupted suture technique (ISG). The primary outcome was the time required to complete the anastomosis. Secondary outcomes were BEA-associated postoperative complications with and without operative revision of the BEA, including bile leakage, cholestasis, and cholangitis, as well as morbidity and mortality up to day 30 after the intervention and survival.ResultsAltogether, 82 patients were randomized of which 80 patients received the allocated intervention (39 in ISG and 41 in CSG). Suture time was longer in the ISG compared with the CSG (median (interquartile range), 22.4 (15.0-28.0) min versus 12.0 (10.0-17.0) min, OR 1.26, 95 per cent c.i. 1.13 to 1.40; unit of increase of 1 min; P < 0.001). Short-term and long-term biliary complications were similar between groups. The incidence of bile leakage (6 (14.6 per cent) versus 4 (10.3 per cent), P = 0.738) was comparable between groups. No anastomotic stenosis occurred in either group.ConclusionContinuous suture of BEA is equally safe, but faster compared with interrupted suture.Registration numberNCT02658643 (http://www.clinicaltrials.gov).

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