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Meniscal repair.

Yoon KH, Park KH - Knee Surg Relat Res (2014)

Bottom Line: The meniscus has several important roles, such as transmission of the load, absorption of the shock in the knee joint, acting as a secondary anteroposterior stabilizer of the knee joint, and contributing to proprioception of the knee joint.Degenerative changes of the knee joint develop in the long-term follow-up even after partial meniscectomy.In this review article, we will discuss operative techniques and clinical outcomes of arthroscopic repair of the meniscus and the meniscal root and postoperative rehabilitation and complications as well.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Seoul, Korea.

ABSTRACT
The meniscus has several important roles, such as transmission of the load, absorption of the shock in the knee joint, acting as a secondary anteroposterior stabilizer of the knee joint, and contributing to proprioception of the knee joint. Degenerative changes of the knee joint develop in the long-term follow-up even after partial meniscectomy. Thus, there has been growing interest in meniscal repair. In addition, with increased understanding of the important roles of the meniscal root and advancement of diagnostic methods, efforts have been made to ensure preservation of the meniscal roots. In this review article, we will discuss operative techniques and clinical outcomes of arthroscopic repair of the meniscus and the meniscal root and postoperative rehabilitation and complications as well.

No MeSH data available.


Related in: MedlinePlus

Inside-out repair technique. (A) A longitudinal tear is identified. (B) Long needles with sutures attached are passed through appropriate cannulas superior and inferior to the tear site. (C) Vertical sutures are tied over the joint capsule.
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Figure 1: Inside-out repair technique. (A) A longitudinal tear is identified. (B) Long needles with sutures attached are passed through appropriate cannulas superior and inferior to the tear site. (C) Vertical sutures are tied over the joint capsule.

Mentions: The inside-out technique can be performed using double-armed needles with an absorbable or non-absorbable suture passing through single-lumen zone-specific repair cannulas. Before meniscal repair, tear debridement and perisynovial tissue abrasion with a meniscal rasp or motorized shaver should be performed to stimulate a proliferative fibroblastic healing response16). First, a 4 to 5 cm skin incision and dissection are made along the posterior border of the collateral ligaments. For medial meniscal repair, the fascia is opened and the hamstrings and medial gastrocnemius are retracted posteriorly. A popliteal retractor can be placed in the interval between the medial head of the gastrocnemius and the posterior capsule of the joint to protect the popliteal vessels and to aid in passing the needles16). For lateral meniscal repair, the knee joint should be brought to 90° of flexion so that the peroneal nerve drops more inferiorly and is protected, and the iliotibial tract is retracted upwards and the biceps tendon downwards. Then, careful dissection should be performed to reflect the lateral gastrocnemius head off the posterior capsule. After this dissection, suturing is performed by passing a long needle with a suture attached through the cannula and then through the meniscus to exit laterally. After the first needle is passed, the cannula is repositioned at the inferior or superior articular surface of the meniscus and then a second needle is passed and retrieved (Fig. 1). After passing the needles, the sutures for the medial meniscus are tied over the joint capsule with the knee in 20° of flexion34), the sutures for the lateral meniscus are tied over the joint capsule with the knee in 90° of flexion16,35).


Meniscal repair.

Yoon KH, Park KH - Knee Surg Relat Res (2014)

Inside-out repair technique. (A) A longitudinal tear is identified. (B) Long needles with sutures attached are passed through appropriate cannulas superior and inferior to the tear site. (C) Vertical sutures are tied over the joint capsule.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061409&req=5

Figure 1: Inside-out repair technique. (A) A longitudinal tear is identified. (B) Long needles with sutures attached are passed through appropriate cannulas superior and inferior to the tear site. (C) Vertical sutures are tied over the joint capsule.
Mentions: The inside-out technique can be performed using double-armed needles with an absorbable or non-absorbable suture passing through single-lumen zone-specific repair cannulas. Before meniscal repair, tear debridement and perisynovial tissue abrasion with a meniscal rasp or motorized shaver should be performed to stimulate a proliferative fibroblastic healing response16). First, a 4 to 5 cm skin incision and dissection are made along the posterior border of the collateral ligaments. For medial meniscal repair, the fascia is opened and the hamstrings and medial gastrocnemius are retracted posteriorly. A popliteal retractor can be placed in the interval between the medial head of the gastrocnemius and the posterior capsule of the joint to protect the popliteal vessels and to aid in passing the needles16). For lateral meniscal repair, the knee joint should be brought to 90° of flexion so that the peroneal nerve drops more inferiorly and is protected, and the iliotibial tract is retracted upwards and the biceps tendon downwards. Then, careful dissection should be performed to reflect the lateral gastrocnemius head off the posterior capsule. After this dissection, suturing is performed by passing a long needle with a suture attached through the cannula and then through the meniscus to exit laterally. After the first needle is passed, the cannula is repositioned at the inferior or superior articular surface of the meniscus and then a second needle is passed and retrieved (Fig. 1). After passing the needles, the sutures for the medial meniscus are tied over the joint capsule with the knee in 20° of flexion34), the sutures for the lateral meniscus are tied over the joint capsule with the knee in 90° of flexion16,35).

Bottom Line: The meniscus has several important roles, such as transmission of the load, absorption of the shock in the knee joint, acting as a secondary anteroposterior stabilizer of the knee joint, and contributing to proprioception of the knee joint.Degenerative changes of the knee joint develop in the long-term follow-up even after partial meniscectomy.In this review article, we will discuss operative techniques and clinical outcomes of arthroscopic repair of the meniscus and the meniscal root and postoperative rehabilitation and complications as well.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Seoul, Korea.

ABSTRACT
The meniscus has several important roles, such as transmission of the load, absorption of the shock in the knee joint, acting as a secondary anteroposterior stabilizer of the knee joint, and contributing to proprioception of the knee joint. Degenerative changes of the knee joint develop in the long-term follow-up even after partial meniscectomy. Thus, there has been growing interest in meniscal repair. In addition, with increased understanding of the important roles of the meniscal root and advancement of diagnostic methods, efforts have been made to ensure preservation of the meniscal roots. In this review article, we will discuss operative techniques and clinical outcomes of arthroscopic repair of the meniscus and the meniscal root and postoperative rehabilitation and complications as well.

No MeSH data available.


Related in: MedlinePlus