Advertisement

The Meniscal Ossicle Revisited: Etiology and an Arthroscopic Technique for Treatment

      Abstract

      We describe a new arthroscopic technique for repair of meniscal ossicles in support of the theory that meniscal ossicles are traumatic in nature. Using a standard inferolateral portal, the arthroscope is passed under the posterior cruciate ligament to permit visualization of the “root” of the medial meniscus with a matching donor lesion on the tibia. A limited debridement should be performed of the donor site as well as the posterior horn of the meniscus if it has healed over with fibrocartilage to allow bone-to-bone healing. A posteromedial working portal is made at an angle amenable to the repair and a 6-mm cannula is placed. A Beath passing pin commonly used for anterior cruciate ligament reconstruction is used to pass suture for the outside-inside-out repair. The pin is passed through the cannula in the posterior medial portal. The root of the medial meniscus and the avulsed ossicle are pierced with the Beath pin and tensioned, after which the pin is drilled into the matching donor site and out through the tibia. Two passes are used to create a mattress suture through the ossicle, and the suture is tied over a bone bridge on the anterolateral tibia.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Liu S.H.
        • Osti L.
        • Raskin A.
        • Merlo F.
        • Bocchi L.
        Meniscal ossicles.
        Arthroscopy. 1994; 10: 296-298
        • Schnarkowski P.
        • Tirman P.F.J.
        • et al.
        Meniscal Ossicle.
        Radiology. 1995; 196: 47-50
        • Berg E.E.
        The meniscal ossicle.
        Arthroscopy. 1991; 7: 241-243
        • Glass R.S.
        • Barnes W.M.
        • Kells D.U.
        • Thomas S.
        • Campbell C.
        Ossicles of the knee menisci.
        Clin Orthop. 1975; 111: 163-171
        • Le Minor J.M.
        • Kempf J.F.
        Intrameniscal ossicle of the knee.
        Fr J Orthop Surg. 1989; 3: 491-495
        • Richmond J.C.
        • Sarno R.C.
        Arthroscopic treatment of medial meniscal avulsion fractures.
        Arthroscopy. 1988; 4: 117-120
        • Hall F.M.
        • Hochmann M.G.
        Medial Segond-type fracture.
        Skeletal Radiol. 1997; 26: 553-555