A suture technique for easier reduction and repair of bucket-handle meniscal tears while using the all-inside devices

Çetinkaya, Engin; Kuyucu, Ersin; Gül, Murat; Lapcın, Osman; Albayrak, Kutalmis; Gürsu, Sarper

doi:10.1051/sicotj/2016035

Cited by 7 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, recent studies suggest that good and even excellent results are obtained for chronic lesions [17,18]. Reducing the BHMMT and reducing it in place during the repair process are challenging but essential steps for successfully repairing this type of injury [19,20].…”

Section: Discussionmentioning

confidence: 99%

Long-term clinical results of using a posteromedial all-inside and anteromedial inside-out approach to repair unstable or irreducible bucket-handle medial meniscal tears

et al. 2023

View full text Add to dashboard Cite

Background In irreducible bucket-handle medial meniscal tears (BHMMTs), the displaced central fragment is rotated 180° or more, meaning reduction is impossible without derotation of the tear. In chronic cases, the rotated meniscus is deformed and degenerated; thus, the issue of reproducibility and repairability arises. This study presents the clinical outcomes of chronic irreducible and unstable locked BHMMTs. Radiological outcomes were also evaluated using magnetic resonance imaging (MRI). Methods This is a retrospective study of 37 patients with 11 cases of irreducible BHMMT and 26 cases of reducible but unstable chronic BHMMT who underwent operations between 2011 and 2016. Posterior arthroscopy was performed after temporary meniscus fixation using a provisional needle fixation technique. After the posterior repair with vertical mattress sutures was completed using an all-inside technique, the classic outside-in technique was performed for the anterior third of the meniscus. The Lysholm, International Knee Documentation Committee (IKDC), and Tegner activity scores were obtained from all patients before surgery and at the latest follow-up. Radiological evaluations were performed using MRI before surgery and at 6 months postoperatively. Results Between 2011 and 2016, a total of 37 consecutive patients with irreducible and chronic BHMMTs underwent surgery. The average postoperative follow-up was 7.2 ± 1.4 years (mean ± SD). Postoperative Lysholm (89.57 ± 2.7) and IKDC (87.22 ± 3.2) scores improved significantly at the last follow-up when compared with the pre-operative scores (38.44 ± 4.5 and 23.52 ± 7.8, respectively). According to the Tegner activity scale, patients’ postoperative activity levels remained unchanged compared to preoperative levels at the last follow-up. Conclusion Posterior knee arthroscopy with the all-inside posterior suture and inside-out anteromedial suture technique presented in this study yielded excellent clinical outcomes when used to repair chronic irreducible or unstable BHMMTs. Level of evidence: Level IV.

show abstract

Section: Discussionmentioning

confidence: 99%

Long-term clinical results of using a posteromedial all-inside and anteromedial inside-out approach to repair unstable or irreducible bucket-handle medial meniscal tears

et al. 2023

View full text Add to dashboard Cite

show abstract

“…We used a combined inside-out and all-inside modality with multiple suturing techniques to ensure stable and adequate fixation. This approach was approved as being appropriate by many researchers 1,2,[12][13][14][15] ; however, some authors have recorded better outcomes with all-inside repairs when compared with inside-out repairs. 12 Our assertion was similar to those of Yilmaz et al, 13 who found out that combined CHRONIC ISOLATED BUCKET-HANDLE MENISCAL TEAR e5 inside-out and all-inside meniscal repair technique is a successful and cost-effective treatment method in bucket-handle meniscus tears.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Procedure for Chronic Isolated Bucket-Handle Meniscal Tears

Alabi

C้hernchujit

Kanokvaleewong

et al. 2021

Arthroscopy Techniques

View full text Add to dashboard Cite

Arthroscopic treatment is the treatment of choice in bucket-handle meniscal tears (BHMTs). Following BHMT, however, surgery failure rates are approximately 20% in the literature. Achieving the healing of BHMT is difficult. This is worse in chronic situations because the torn meniscus is deformed, leading to nonanatomical reduction. Some authors have reported greater failure rates, especially in the early postoperative period. In isolated BHMTs, the failure rate is greater because of inadequate and incomplete repairs due to the tight medial compartment. Multiple techniques for possible reduction of failure rate have been described. We describe an arthroscopic technique for treating chronic isolated BHMT using the technique of subcutaneously releasing the posterior fibers of the medial collateral ligament to provide adequate space for arthroscopy, meniscal reduction, and repair. A combined inside-out and all-inside repair technique was used to enhance anatomic reduction, stable fixation, surface fixation (rather than the usual suture-points fixation), and biologic healing in repairable chronic BHMTs.

show abstract

“…By placing the reduction suture, a clear view of the posterior meniscus is obtained to facilitate repair. Other techniques 13,14,19,20 had been described to reduce the tear. The current technique reduces the torn segment with an all-inside repair.…”

Section: Discussionmentioning

confidence: 99%

An Approach to Chronic and Displaced Bucket Handle Meniscal Tear—Assessment, Repair (Push-and-Pull Technique), or Salvage

Tan

Loh

2021

Arthroscopy Techniques

View full text Add to dashboard Cite

Meniscal repairs are preferred to meniscectomies to preserve meniscal function and mitigate the risk of degeneration. However, repair of a chronic and displaced bucket handle tear of the meniscus can be technically challenging. We introduce a systematic method for assessment, reduction, repair, or salvage in this situation with an aim of reducing operating time and improving the chance of a favorable outcome. This technique describes repair of a bucket handle tear on the medial meniscus with displacement into the intercondylar notch. An arthroscopic probe is used for reduction and suture tension (push-and-pull technique) when using an all-inside suture device (FAST-FIX 360 repair system; Smith & Nephew) on the middle and posterior part of the tear. The anterior part of the tear is repaired with an outside-in method. If reduction is not possible, then a salvage reduction and hybrid repair is carried out instead. Postoperatively, patients will be nonweight-bearing on the operated limb, and range of motion restricted from 0 to 90 for 6 weeks, with the aim of resuming running by 6 months.

show abstract

A suture technique for easier reduction and repair of bucket-handle meniscal tears while using the all-inside devices

Cited by 7 publications

References 11 publications

Long-term clinical results of using a posteromedial all-inside and anteromedial inside-out approach to repair unstable or irreducible bucket-handle medial meniscal tears

Long-term clinical results of using a posteromedial all-inside and anteromedial inside-out approach to repair unstable or irreducible bucket-handle medial meniscal tears

Arthroscopic Procedure for Chronic Isolated Bucket-Handle Meniscal Tears

An Approach to Chronic and Displaced Bucket Handle Meniscal Tear—Assessment, Repair (Push-and-Pull Technique), or Salvage

Contact Info

Product

Resources

About