Posterior Horn of Medial Meniscal Peripheral Capsular Lesion: The Arthroscopic Repair Technique Working in the Posterior Compartment

Abstract

A posterior horn of medial meniscal peripheral capsular is usually associated with the anterior cruciate ligament injury. The conventional repair technique with the camera in the anterolateral portal cannot precisely restore the slope capsular synovium to the original attachment point. We present the arthroscopic technique for improving the accuracy and quality of the repair by working in the posterior compartment. When the posterolateral portal is used as the viewing portal, the accuracy of repair is improved because we can assess the full extent of the lesion and lift the sagging peripheral tissue to the more central part.

Posterior knee arthroscopy facilitates the safe and effective all-inside repair of locked bucket-handle medial meniscal tear using a suture hook technique

“…Peripheral meniscal fragment sagging limits anatomical reductions, and so elevating this fragment improves repair and healing [13]. In the current study, the contact surface between tear borders was improved using a shuttle relay.…”

“…Even though the posterior approach improves visualization, most surgeons do not prefer using it. As a result, only a few reports are available on the use of this technique for repairing meniscal tears [11, 13, 17]. In the present study, it is hypothesized that the posterolateral transseptal portal gives surgeons an excellent view of the posteromedial compartment to repair locked BHMMTs.…”

Meniscal Ramp Lesion Repair by a Trans-septal Portal Technique

“…This technique allows exploring areas such as the entire periphery of the posterior horns of the menisci and posterior capsule, in which visualization is often limited even using the combination of conventional anterior and posterior portals with transnotch views. Kongmalai and Chernchujit 14 proposed a technique for ramp lesion repairs using a posterior trans-septal portal to improve the assessment of the lesion. We are in agreement with these authors, because complete arthroscopic visualization of the posterior part of the medial meniscus is only achievable through viewing from the creation of a posterior trans-septal portal.…”

Overview of posterior knee arthroscopy in the medial meniscal repair: Technical note

“…Some surgeons release the medial collateral ligament (MCL) percutaneously to open the medial compartment and prevent chondral injury 19 . However, adequate rasping of the meniscosynovial junction and meniscal surface at the most posterior areas of a teared meniscus is still challenging [20][21][22] . This technical note presents the posterior arthroscopy (using posterior portals with or without trans-septal J o u r n a l P r e -p r o o f view) as a decent method of access to zone A of the medial meniscus.…”