Abstract
This article describes an alternative method for outside–in repair of a longitudinal
meniscal tear through a needle hole, which will produce an almost negligible cutaneous
scar. The procedure is performed under arthroscopic set-up using an 18-gauge needle
preloaded with appropriate suture material. Insert the needle twice through the same
cutaneous entry hole to form a mattress loop across the torn meniscal segments. The
first insertion penetrates both segments and forms a loop. The second insertion then
engages the outer segment and forms another loop. Draw the free end of this second
loop into the joint and feed it into the first loop. Pull the first loop out from
the joint together with the trapped portion near the free end, until the whole suture
becomes a vertical mattress. Finally, tie a slipknot and several half hitches to close
the meniscal gap under the stitch. In a large bucket-handle tear, stitches should
be started at the middle and then alternating anteriorly and posteriorly 3 to 4 mm
apart. To ensure that no significant extracapsular structures are trapped in each
stitch, a 13-gauge needle can be used as a cannula sheath. This technique is economical
and technically safe and simple for reparable meniscal lesions, including the posterior
horn.
Key words
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References
- Meniscus.Arthroscopy. 2002; 18: 33-39
- Arthroscopic meniscal repair with use of the outside-in technique.Instruct Course Lect. 2000; 49: 195-206
- Meniscal repair using the outside-to-inside technique.Clin Sports Med. 1996; 15: 469-481
- Load to failure of common meniscal repair techniques.Arthroscopy. 1997; 13: 731-736
Article info
Identification
Copyright
© 2004 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
