Effectivity of the Outside-In Pie-Crusting Technique and an All-Inside Meniscal Repair Device in the Repair of Ramp Lesions

Kawada, Koki; Furumatsu, Takayuki; Tamura, Masanori; Xue, Haowei; Higashihara, Naohiro; Kintaka, Keisuke; Yokoyama, Yusuke; Ozaki, Toshifumi

doi:10.1016/j.eats.2022.11.002

Cited by 8 publications

(7 citation statements)

References 11 publications

(11 reference statements)

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“…After the exclusion process detailed in Figure 1 , a total of 32 studies were included in our current concept review. Among these articles, 30 described an all‐inside suture technique [ 2 , 4 , 8 , 9 , 10 , 12 , 16 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 31 , 33 , 35 , 37 , 38 , 39 , 41 , 42 , 43 , 45 , 47 ]. Thirteen of them were related to an all‐inside suture through anterior arthroscopic portals [ 10 , 11 , 14 , 16 , 24 , 25 , 26 , 28 , 31 , 33 , 37 , 38 , 43 , 48 ] while eleven were related to an all‐inside suture through one posteromedial portal [ 4 , 8 , 12 , 16 , 21 , 22 , 41 , 42 , 43 , 44 , 47 ].…”

Section: Resultsmentioning

confidence: 99%

“…Among these articles, 30 described an all‐inside suture technique [ 2 , 4 , 8 , 9 , 10 , 12 , 16 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 31 , 33 , 35 , 37 , 38 , 39 , 41 , 42 , 43 , 45 , 47 ]. Thirteen of them were related to an all‐inside suture through anterior arthroscopic portals [ 10 , 11 , 14 , 16 , 24 , 25 , 26 , 28 , 31 , 33 , 37 , 38 , 43 , 48 ] while eleven were related to an all‐inside suture through one posteromedial portal [ 4 , 8 , 12 , 16 , 21 , 22 , 41 , 42 , 43 , 44 , 47 ]. Ten of the all‐inside suture studies through a posteromedial portal described the technique using a hook suture passer device [ 4 , 12 , ...…”

Section: Resultsmentioning

confidence: 99%

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How to repair medial meniscal ramp lesions: A systematic review of surgical techniques

Pizza,

Urda,

Sanchez

et al. 2024

J. exp. orthop.

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Purposeto provide a comprehensive overview of all the surgical techniques published in the literature for repairing meniscal ramp lesions focusing on the technical aspects and the pros and cons of every procedure. Such lesions can be managed using various approaches, each of this with its specific advantages and disadvantages.MethodsPubmed Central, Scopus, and EMBASE databases were systematically reviewed according to the preferred reporting items for systematic reviews and meta‐analysis (PRISMA) guidelines for studies on surgical techniques for repairing meniscal ramp lesions through May 2023. Overall, 32 articles matched the selection criteria and were included in the study.ResultsDebridement alone may be sufficient for small stable meniscal ramp lesions but, for tears in the menisco‐capsular junction that affect the stability of the medial meniscus, it seems reasonable to repair it, even though the clinical results available in literature are contrasting. All‐inside sutures through anterior portals seems to be an effective solution for meniscal ramp lesions with MTL tears. All‐inside sutures through posteromedial portals are particularly useful for large meniscal ramp lesions, in which an inside‐out suture can also be performed.ConclusionMeniscal ramp lesions can be managed using various approaches, each of this with its specific advantages and disadvantages. Further research is required to determine the optimal technique that can be considered as the gold standard and can provide the better results.Level of EvidenceLevel III, systematic review.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

How to repair medial meniscal ramp lesions: A systematic review of surgical techniques

Pizza,

Urda,

Sanchez

et al. 2024

J. exp. orthop.

View full text Add to dashboard Cite

show abstract

“… 34 , 35 , 36 Its use also facilitates the repair of ramp injuries with all-inside devices from the standard anterior portals. 37 , 38 In ramp injuries in which the meniscotibial ligament is affected, to use all-inside devices, Labarre et al. 39 placed a suture under the medial meniscus and across the meniscotibial ligament.…”

Section: Discussionmentioning

confidence: 99%

Meniscal Ramp Lesion Repair Without the Need for a Posteromedial Portal

Gómez Cáceres,

Mariño,

Martínez Malo

et al. 2024

Arthroscopy Techniques

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“…Subsequently, an outside-in pie-crusting technique was performed to enlarge the medial knee compartment (Fig. 1 A–C) [ 14 ]. The presence of MMPRTs was confirmed and classified according to the system proposed by LaPrade et al [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Longitudinal changes in medial meniscus extrusion and clinical outcomes following pullout repair for medial meniscus posterior root tears: a 3-year evaluation

Kawada,

Furumatsu,

Yokoyama

et al. 2024

Eur J Orthop Surg Traumatol

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Purpose We aimed to evaluate the longitudinal changes in medial meniscus extrusion (MME) and clinical scores at multiple time points up to 3 years after pullout repair for medial meniscus posterior root tears (MMPRTs). Methods This retrospective case series study included 64 patients who underwent pullout repair for MMPRTs and four MRI evaluations (preoperatively and at 3 months, 1 year, and 3 years postoperatively). MME was measured during the same time points. Clinical scores were assessed four times: preoperatively and at 1, 2, and 3 years postoperatively. Additionally, a multivariate analysis was performed on the change in MME (ΔMME) from the preoperative measurement point to 3 years postoperatively. Results The ΔMME per month from the preoperative measurement point to 3 months postoperatively, from 3 months to 1 year postoperatively, and from 1 to 3 years postoperatively were 0.30, 0.05, and 0.01 mm/month, respectively. All clinical scores significantly improved 3 years postoperatively (p < 0.001). In a multiple regression analysis for ΔMME from the preoperative measurement point to 3 years postoperatively, sex significantly affected the outcome (p = 0.039). Conclusion Following pullout repair for MMPRTs with well-aligned lower extremities, although MME progression could not be entirely prevented, the rate of progression decreased over time, and clinical scores improved. In particular, MME progressed markedly during the first 3 months postoperatively. Additionally, sex had a significant influence on MME progression, suggesting that males may be able to expand the indications of pullout repair for MMPRTs.

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Effectivity of the Outside-In Pie-Crusting Technique and an All-Inside Meniscal Repair Device in the Repair of Ramp Lesions

Cited by 8 publications

References 11 publications

How to repair medial meniscal ramp lesions: A systematic review of surgical techniques

How to repair medial meniscal ramp lesions: A systematic review of surgical techniques

Meniscal Ramp Lesion Repair Without the Need for a Posteromedial Portal

Longitudinal changes in medial meniscus extrusion and clinical outcomes following pullout repair for medial meniscus posterior root tears: a 3-year evaluation

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