The popliteus tendon provides a safe and reliable location for all-inside meniscal repair device placement

Ouanezar, Hervé; Blakeney, William G.; Latrobe, Charles; Saithna, Adnan; Fernandes, Levi Reina; Delaloye, Jean Romain; Thaunat, Mathieu; Sonnery‐Cottet, Bertrand

doi:10.1007/s00167-018-4889-3

Cited by 19 publications

(18 citation statements)

References 49 publications

(81 reference statements)

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“…For lateral meniscal repair anterior to the popliteal hiatus, some authors suggested using the popliteus tendon for meniscal repair device placement, and preliminary data have been reported [10,11]. Nevertheless, this technique has several disadvantages.…”

Section: Discussionmentioning

confidence: 99%

“…Although lateral meniscal tears anterior to the popliteal hiatus is quite common in clinical practice, to our best knowledge, there is still very limited data in the literature regarding optimal arthroscopic repair technique for these lesions [9][10][11]. Since July 2015, we started to perform a modified arthroscopic all-inside repair using spinal needle and suture hook for lateral meniscal tears anterior to the popliteal hiatus.…”

Section: Introductionmentioning

confidence: 99%

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A Modified Arthroscopic All-inside Repair for Lateral Meniscal Tears Anterior to the Popliteal Hiatus: A Retrospective Case Series with Minimum 2-Year Follow-Up

Zhuo¹,

Zhu²,

Pan³

et al. 2020

Preprint

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BackgroundTo determine the clinical and MRI outcomes after modified arthroscopic all-inside repair for lateral meniscal tears anterior to the popliteal hiatus.MethodsPatients who underwent modified arthroscopic all-inside repair for lateral meniscal tears anterior to the popliteal hiatus at our institution were identified. The clinical assessment consisted of the symptoms of meniscal tears, McMurray test, and patient-reported outcomes (Lysholm score, Tegner score, and International Knee Documentation Committee (IKDC) score). The status of meniscal healing was assessed using postoperative MRI scan.ResultsTwenty-five patients met the inclusion criteria. The mean age was 27.60 ± 8.37 years (range, 16 to 43 years). The mean follow-up period was 26.04 ± 2.88 months (range, 24 to 36 months). At final follow-up, the symptoms of meniscal tears disappeared in 23 patients with a negative McMurray test. The patient-reported outcomes of Lysholm, Tegner, and IKDC score improved significantly compared to the preoperative values (P = 0.001). No significant differences were observed in postoperative clinical outcomes between patients with or without concomitant ACL tears (P > 0.05). Postoperative MRI scan showed that the repaired lateral meniscus anterior to the popliteal hiatus obtained healing in 23 (92.0%) patients and no healing in 2 patients.ConclusionThis modified arthroscopic all-inside repair technique was safe and effective to treat lateral meniscal tears anterior to the popliteal hiatus, resulting in significantly improved clinical outcomes with a high healing rate and low risk of adjacent structures injury.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Modified Arthroscopic All-inside Repair for Lateral Meniscal Tears Anterior to the Popliteal Hiatus: A Retrospective Case Series with Minimum 2-Year Follow-Up

Zhuo¹,

Zhu²,

Pan³

et al. 2020

Preprint

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“…This procedure is associated with a very low failure rate with no specific complications. 18 The aim is to obtain a final vertical stich, perpendicular to the collagen fibers. Thus, the curvature of the device helps to place the suture perfectly.…”

Section: Surgical Technique (With Video Illustration)mentioning

confidence: 99%

All-Inside Double-Sided Suture Repair for Longitudinal Meniscal Tears

Foissey¹,

Thaunat²,

Fayard³

2021

Arthroscopy Techniques

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The current consensus in the literature is that the meniscus must be saved. Even though inside-out sutures are still considered as the gold standard, the need to alternate between intra-and extra-articular structures for every stitch makes it laborious. New generations of all-inside systems are now routinely used in operating rooms and enable easier, quicker, and safer techniques. However traditional all-inside repair with limited upper fixation does not provide uniform compression from top to down, essential precondition for satisfactory meniscal healing. This Technical Note describes a simple and accessible alternative technique that provides stable fixation and overall compression of vertical meniscal tears from top to down with standard all-inside instrumentation.

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“…These two techniques have been found to be comparable, both in terms of clinical failure rates and subjective functional outcomes 41 . It is advised to place sutures adjacent to the popliteus tendon, although placing sutures or all-inside devices through the tendon has not been found to result in adverse outcomes 40,42 . For inside-out repairs, the needles must be inserted from the anteromedial portal only and never from the anterolateral portal because the needle trajectory in such a case will endanger the popliteus neurovascular structures.…”

Section: General Principles For Lateral Meniscus Surgerymentioning

confidence: 99%

Lateral Meniscus Tears in Acl Injured Knee

Tapasvi¹

2021

Hip Knee J.

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Anterior cruciate ligament (ACL) tears can be associated with injuries to the lateral meniscus (LM) in about 20-30% cases. The lateral meniscus is more mobile than the medial and besides contributing to load transmission, it also stabilizes the knee in pivot-shift testing. The LM tears more often in the acute setting and its incidence does not rise in cases of chronic ACL instability. Lateral meniscus tears can be minor or major depending how severely the knee function gets impaired. Major tears are the complete radial tears, longitudinal bucket handle tears and posterior root tears. Male gender, high body mass index and contact injury mechanism are all risk factors for an LM tear. Anatomic factors which can contribute to LM tears include a high posterior tibial slope, varus malalignment and greater asymmetry between medial and lateral slopes. The lateral meniscus must be saved and repaired whenever possible to prevent residual knee instability and progressive lateral compartment arthritis, which can set in soon after a meniscectomy. The development of techniques and technology have rendered most tears amenable to repair. Longitudinal tears can be repaired by the all-inside or inside-out technique and the needles and devices must be inserted through a high anteromedial or transpatellar portal to prevent injury to the popliteal neurovascular structures. A lateral safety incision must always be used for inside-out repairs. Radial tears can be repaired by two horizontal sutures, a cross stich, a cross-tag or a hash-tag suture configuration. Lateral meniscus posterior root repairs are repaired by transtibial technique, either by drilling an independent anatomic tunnel or the sutures pulled out via the ACL tibial tunnel. The lateral meniscus has high healing rates and repairs yield improvement in functional outcome, beside delaying radiographic arthritis.

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The popliteus tendon provides a safe and reliable location for all-inside meniscal repair device placement

Abstract: Level IV.

Cited by 19 publications

References 49 publications

A Modified Arthroscopic All-inside Repair for Lateral Meniscal Tears Anterior to the Popliteal Hiatus: A Retrospective Case Series with Minimum 2-Year Follow-Up

A Modified Arthroscopic All-inside Repair for Lateral Meniscal Tears Anterior to the Popliteal Hiatus: A Retrospective Case Series with Minimum 2-Year Follow-Up

All-Inside Double-Sided Suture Repair for Longitudinal Meniscal Tears

Lateral Meniscus Tears in Acl Injured Knee

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