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Repairing Complete Radial Tears of the Lateral Meniscus: Arthroscopic All-Inside Double Vertical Cross-Suture Technique Is Effective and Safe With 2-Year Follow-Up at Minimum

  • Shih-Han Yeh
    Affiliations
    Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan

    Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Department of Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Department of Orthopedic Surgery, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan, Taiwan
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  • Fang-Wei Hsu
    Affiliations
    Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan

    Department of Orthopedic Surgery, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan, Taiwan

    Orthopedics Department of Kuang Tien General Hospital, Taichung, Taiwan
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  • Kun-Hui Chen
    Affiliations
    Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan

    Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Department of Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Department of Orthopedic Surgery, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan, Taiwan
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  • En-Rung Chiang
    Affiliations
    Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan

    Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Department of Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Department of Orthopedic Surgery, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan, Taiwan
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  • Ming-Chau Chang
    Affiliations
    Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan

    Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Department of Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Department of Orthopedic Surgery, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan, Taiwan
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  • Hsiao-Li Ma
    Correspondence
    Address correspondence to Hsiao-Li Ma, M.D., Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Department of Surgery, School of Medicine, National Yang-Ming University, and Department of Surgery, School of Medicine, National Yang Ming Chiao Tung University, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan.
    Affiliations
    Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan

    Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Department of Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Department of Orthopedic Surgery, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan, Taiwan
    Search for articles by this author
Published:November 24, 2021DOI:https://doi.org/10.1016/j.arthro.2021.11.025

      Purpose

      To assess the failure rate and clinical outcomes of the all-inside, double-vertical, cross-suture technique in repairing complete radial tears of the lateral meniscus.

      Method

      We retrospectively reviewed records of patients with this injury on whom the present technique was employed at our institution between 2011 and 2018, with at least 24 months of follow-up. Six months postoperatively, the meniscus healing and extrusion status were evaluated through magnetic resonance imaging. Preoperative and postoperative knee function, measured through IKDC, Lysholm knee, and Tegner activity scale scores, were compared.

      Results

      In total, 27 patients underwent the procedure. The preoperative mean (standard deviation) IKDC score, Lysholm knee score, and Tegner activity scale scores were 53.4 ± 5.3, 63.2 ± 9.3, and 4 ± .7, respectively. At the last follow-up (≥24 months postoperatively), these scores increased to 92.1 ± 2.6, 90.8 ± 4.2, and 6.1 ± 1.3, respectively (all P < .05). Complete healing of the meniscus was observed in 23 patients, and 4 patients had meniscus retear or nonhealing. The overall retear or nonhealing rate was 14.8%. Healing rates between those with isolated radial tears (87.5%) and those with combined anterior cruciate ligament rupture (84.2%; P = .826) were comparable. No difference was observed in the progression of coronal and sagittal meniscus extrusion (P = .133 and .797, respectively).

      Conclusion

      In patients with complete radial tears of the lateral meniscus, the arthroscopic all-inside double vertical cross-suture repair technique resulted in an 85.2% healing rate, improvements in functional outcomes and activity levels, and no identifiable progression of meniscus extrusion. The all-inside double vertical cross-suture technique is effective and safe for the repair of radial tears of the meniscus.

      Level of evidence

      Level IV, retrospective case series.
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