Dataset Information

Arthroscopic minimum saucerization and inferior-leaf meniscectomy for a horizontal tear of a complete discoid lateral meniscus: Report of two cases.

ABSTRACT: INTRODUCTION:Treatment of a horizontal tear of a complete discoid lateral meniscus (DLM) is still controversial. Preserving peripheral rim as a normal shape of the meniscus with single-leaf resection is a conventional treatment, however meniscal function could not be fully restored. PRESENTATION OF CASE:A 28-year old woman and a 34-year old woman experienced knee pain and had restricted knee extension. MRI showed horizontal tears of complete DLM in both patients. Arthroscopic minimum saucerization preserving more than 10?mm peripheral rim and inferior-leaf meniscectomy was performed. Two years after the surgery, the patient had no pain and no restriction of ROM. MRI showed the remaining superior-leaf maintained about half its width and no progression of coronal/sagittal extrusion. DISCUSSION AND CONCLUSION:As resecting more meniscal tissue has been considered to be a cause of degeneration or extrusion of the meniscus, arthroscopic minimum saucerization, preserving more meniscal tissue than standard saucerization, and inferior-leaf meniscectomy can be an alternative treatment option of horizontal tears of complete DLM with satisfying clinical and radiological results.

SUBMITTER: Tsujii A

PROVIDER: S-EPMC6260367 | biostudies-other | 2018 Nov

REPOSITORIES: biostudies-other

ACCESS DATA

Publications

Arthroscopic minimum saucerization and inferior-leaf meniscectomy for a horizontal tear of a complete discoid lateral meniscus: Report of two cases.

Tsujii Akira A Matsuo Tomohiko T Kinugasa Kazutaka K Yonetani Yasukazu Y Hamada Masayuki M

International journal of surgery case reports 20181122

<h4>Introduction</h4>Treatment of a horizontal tear of a complete discoid lateral meniscus (DLM) is still controversial. Preserving peripheral rim as a normal shape of the meniscus with single-leaf resection is a conventional treatment, however meniscal function could not be fully restored.<h4>Presentation of case</h4>A 28-year old woman and a 34-year old woman experienced knee pain and had restricted knee extension. MRI showed horizontal tears of complete DLM in both patients. Arthroscopic mini ...[more]

PMID: 30481736

Similar Datasets

Project description:Arthroscopic repair of the posterior horn of the lateral meniscus (LM) from an anterolateral portal has a risk of popliteal artery injury. Here, we present an ultrasound-assisted, arthroscopic, all-inside repair technique for a posterior LM tear to reduce the risk of neurovascular injury. An ultrasound probe covered with a sterile sleeve is placed horizontally at the popliteal fossa by an assistant surgeon, and the popliteal artery and posterior LM are confirmed. From the anterolateral portal, an arthroscopic probe is inserted to push the posterior capsule of the lateral compartment, while an ultrasound image detects the tip of the probe. After the probe is confirmed not to be directed toward the popliteal artery, an all-inside suture device is introduced from the anterolateral portal. While the meniscus is penetrated, the surgeon can confirm by ultrasound images that the needle is directed away from the popliteal artery. The guide suture is pulled anteriorly to secure the anchors tightly, and an ultrasound confirms that the anchors are positioned behind the posterior portion of the LM. All sutures are secured under the assistance of ultrasound images, followed by arthroscopic confirmation of a properly secured LM by the all-inside repair technique. Technique Video Video 1 The arthroscopic view from the anterolateral portal shows a decreased volume of the lateral meniscus due to a previous surgical resection. The posterior lateral meniscus (LM) is pulled anteriorly over the center of the lateral compartment by probing. The posterior LM is repaired under the guidance of the ultrasound by having the assistant surgeon place the ultrasound probe, covered with a sterile sleeve, horizontally on the popliteal fossa to allow confirmation of the posterior portion of the LM and the popliteal artery. An all-inside suture device, the JuggerStitch, is introduced from an anterolateral portal, and the tip of the needle is observed in the ultrasound image. While penetrating the posterior LM, the direction of the needle is confirmed not to injure the neurovascular structures. The anchor of the JuggerStich is introduced at the posterior side of the LM and can be observed as a high echoic region. After introduction of two anchors, the sutures are pulled anteriorly through the anterolateral portal, and the knot is tightened. The ultrasound image shows that the two anchors are positioned on the capsule behind the posterior LM. The same procedures are then repeated. The location of the popliteal artery and the direction of the needle are confirmed by ultrasound every time. If the needle is directed toward the artery, it should be extracted and inserted again. A total of 4 sutures are performed to obtain stability of the LM under the assistance of ultrasound. The final arthroscopic examination shows the properly secured repair and the stabilized posterior LM by probing.

Dataset Information

Arthroscopic minimum saucerization and inferior-leaf meniscectomy for a horizontal tear of a complete discoid lateral meniscus: Report of two cases.

Publications

Arthroscopic minimum saucerization and inferior-leaf meniscectomy for a horizontal tear of a complete discoid lateral meniscus: Report of two cases.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets