All-Inside Technique for Ramp Lesion Repair: Arthroscopic Suture With Knee Scorpion Suture Passer

ABSTRACT: Ramp lesions are peripheral tears of the posterior horn of the medial meniscus that involve the meniscocapsular attachments. They are commonly associated with anterior cruciate ligament injury and frequently not diagnosed. There are several suture techniques for ramp lesions. However, most have a long learning curve to be performed adequately and to minimize the risks of neurovascular lesions, cartilage injury, as well as damage to the meniscotibial ligament and meniscus. Thus, as an alternative to minimize costs and provide adequate ramp lesion repair, we present a simple, easy-to-reproduce technique using a Scorpion Suture Passer and all-inside sutures, without the need to leave devices inside the knee, causing no additional lesions and making it less costly than conventional methods. Our technique, which consists of a biomechanically strong suture, with no internal devices, is cheaper, allows several sutures with the same thread and produces satisfactory clinical results. Technique Video Video 1 All-inside suture of the ramp lesion of the medial meniscus with a Scorpion knee passer. All passes were performed with an arthroscopic view of the intercondylar notch with the arthroscope entering the anterolateral portal. Step 1: Demonstrates a 40 × 12 needle to initially calculate the ideal posteromedial portal height. Note the meniscocapsular dissociation (ramp lesion). Step 2: ideal entry point for the posteromedial portal for this technique. Step 3: Lesion debridement. Step 4: First pass (capsule) of the high-strength thread. Step 5: Second pass (meniscus) of the high-strength thread. Step 6: Knot pusher for final tightening. Avoid tightening without the pusher since the suture may fray.

SUBMITTER: Brito de Alencar Neto J 

PROVIDER: S-EPMC9705918 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature