Technical note
All-inside suture technique using two posteromedial portals in a medial meniscus posterior horn tear

https://doi.org/10.1016/j.arthro.2003.11.008Get rights and content

Abstract

Up to two thirds of patients with anterior cruciate ligament rupture have a combined medial meniscus posterior horn tear. Researchers have proven the importance of repairing this tear to enhance stability after anterior cruciate ligament reconstruction. However, repairing the meniscal tear can be sometimes cumbersome and difficult or even impossible in certain circumstances, especially in places such as the posterior horn of the medial meniscus. We devised a simple and easy method of all-inside suturing of medial meniscus posterior horn tears using a 2-posteromedial portal system. Furthermore, with a modification of our technique, a clinician can not only suture single but also double longitudinal medial meniscus posterior horn tears.

Section snippets

Patient positioning

Allowing adequate room for placement of the posterior portals and space for maneuvering the intra-articular instruments is imperative when positioning the patient. The opposite healthy limb is elevated in a lithotomy position for further space security. The injured knee should be flexed 90°, which makes the posterior compartments roomy and enlarged. Also, this position permits manipulation of intra-articular instruments with relative ease and simultaneously protects the saphenous nerve by

Discussion

Meniscal fixators, despite some early promising clinical results,16, 17, 18 have been often reported as having several complications. The implant is too rigid and the knot is made in the articular surface of meniscus and is easy to break. Other complications include an inflammatory reaction combined with synovitis, possible cyst formation, possible migration, chondral injury, and insufficient tissue approximation.12, 16, 18, 19, 20, 21, 22, 23, 24, 25, 26 Most importantly, they are relatively

Acknowledgements

The authors deeply thank Chan Hwa Park and Myung Ju Shin for their assistance with the drawings in this article.

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