An Arthroscopic-Assisted Radial Meniscal Tear Repair Using Reinforced Suture Tape Rebars and Suture Tapes

Abstract

A radial tear of the meniscus can lead to significant loss of meniscus function, resulting in deleterious cartilage changes. Repair of radial meniscus tears has several challenges, including suture pull-out, which can reduce healing success. We present an arthroscopic repair technique in a complete radial lateral meniscus tear using vertical reinforced bars (rebar) of suture tapes to reduce suture pull-out and approximate the radial tear.

Improved Outcomes After Reinforced Radial Meniscus Repair Augmented With Bone Marrow Aspirate Concentrate

“…Previous studies have evaluated the biomechanics and healing of this rebar repair mechanism and those similar to it. 17 , 34 , 35 , 36 , 37 , 38 Nakata et al. 35 and Tsujii et al.…”

“…Feltz et al. 37 described a very similar repair technique with suture tapes for radial meniscus tears. This group employed use of suture tape in addition to the rebar technique, which aimed to decrease cutout of sutures during repair.…”

“…The authors emphasized the need to consider meniscal collagen fiber orientation, illustrating that vertical sutures placed perpendicular to the collagen fibers seemed to reduce suture pull out. 37 …”

“…A study that used a novel technique referred to as the H-plasty for lateral meniscus posterior root tears used a similar backup suture repair method as in the rebar technique. 37 This technique only uses one horizontal stich as compared with the rebar technique, which uses 2 stitches. The study reported an average increase in both the Lysholm score and the IKDC Subjective Knee Form score in patients from the preoperative period to the final postoperative appointment, with a minimum follow-up of 18 months.…”

Combined Rip-Stop and Transtibial Pull-out Technique for Lateral Meniscus Radial Repairs

“…Advantages include better preservation of meniscal apposition under continued cyclic loading compared to other techniques, and the transtibial pull-out repair significantly normalizes tibiofemoral contact pressures. 2 , 7 , 8 , 9 , 10 , 11 , 12 , 13 Therefore we present our technique for repair of lateral meniscus radial tears, using a combined inside-out rip-stop suture technique with transtibial pull-out repair.…”