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The FasT-Fix Repair Technique for Ramp Lesion of the Medial Meniscus

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Introduction: This technical note describes a new arthroscopic technique to repair the peripheral attachment lesion of the posterior horn of the medial meniscus. The operation was performed under arthroscopy using a standard anterior portal. Surgical Technique: A FasT-Fix needle was inserted obliquely close to the tibial plateau and the first implant was inserted into the joint capsule depending on its bending angle underneath the meniscus. The second implant was inserted through 1/3 periphery of the meniscus into the meniscocapsular area. The pre-tied self-sliding knot was tensioned to achieve secure fixation of the posterior meniscal peripheral attachment at the original attachment point. Materials and Methods: From August 2011 to February 2014, 23 knees were diagnosed as ramp lesion, underwent meniscal repair using FasT-Fix technique. Results: All patients were followed up for average 14 months. The Lysholm score improved from preoperative 64.4±4.52 to postoperative 91.2±4.60. Conclusions: We believe that the FasT-Fix technique via the standard anterior portal can be a more convenient and less traumatic alternative for repair of the peripheral attachment lesion of the posterior horn of the medial meniscus in the anterior cruciate ligament deficient knee.

Abstract

Introduction: This technical note describes a new arthroscopic technique to repair the peripheral attachment lesion of the posterior horn of the medial meniscus. The operation was performed under arthroscopy using a standard anterior portal. Surgical Technique: A FasT-Fix needle was inserted obliquely close to the tibial plateau and the first implant was inserted into the joint capsule depending on its bending angle underneath the meniscus. The second implant was inserted through 1/3 periphery of the meniscus into the meniscocapsular area. The pre-tied self-sliding knot was tensioned to achieve secure fixation of the posterior meniscal peripheral attachment at the original attachment point. Materials and Methods: From August 2011 to February 2014, 23 knees were diagnosed as ramp lesion, underwent meniscal repair using FasT-Fix technique. Results: All patients were followed up for average 14 months. The Lysholm score improved from preoperative 64.4±4.52 to postoperative 91.2±4.60. Conclusions: We believe that the FasT-Fix technique via the standard anterior portal can be a more convenient and less traumatic alternative for repair of the peripheral attachment lesion of the posterior horn of the medial meniscus in the anterior cruciate ligament deficient knee.

참고문헌 (12)

  1. Liu X, "Arthroscopic prevalence of ramp lesion in 868 patients with anterior cruciate ligament injury", Am J Sports Med, 39, pp.832~837 (2011)
  2. Bollen SR, "Posteromedial meniscocapsular injury associated with rupture of the anterior cruciate ligament : a previously unrecognised association", J Bone Joint Surg Br, 92, pp.222~223 (2010)
  3. Mariani PP, "Posterior horn instability of the medial meniscus a sign of posterior meniscotibial ligament insufficiency", Knee Surg Sports Traumatol Arthrosc, 19, pp.1148~1153 (2011)
  4. Ahn JH, "Longitudinal tear of the medial meniscus posterior horn in the anterior cruciate ligament-deficient knee significantly influences anterior stability", Am J Sports Med, 39, pp.2187~2193 (2011)
  5. Sonnery-Cottet B, "Hidden lesions of the posterior horn of the medial meniscus : a systematic arthroscopic exploration of the concealed portion of the knee", Am J Sports Med, 42, pp.921~926 (2014)
  6. Ahn JH, "Clinical and second-look arthroscopic evaluation of repaired medial meniscus in anterior cruciate ligament-reconstructed knees", Am J Sports Med, 38, pp.472~477 (2010)
  7. Ahn JH, "Arthroscopic all-inside suture repair of medial meniscus lesion in anterior cruciate ligament : deficient knees : results of second-look arthroscopies in 39 cases", Arthroscopy, 20, pp.936~945 (2004)
  8. Park IS, "New meniscus repair technique for periph eral tears near the posterior tibial attachment of the posterior horn of the medial meniscus", Arthroscopy, 22, pp.908~ (2006)
  9. Markolf KL, "Force measurements in the medial meniscus posterior horn attachment : effects of anterior cruciate ligament removal", Am J Sports Med, 40, pp.332~338 (2012)
  10. Tachibana Y, "Repair integrity evaluated by second-look arthroscopy after arthroscopic meniscal repair with the FasT-Fix during anterior cruciate ligament reconstruction", Am J Sports Med, 38, pp.965~971 (2010)
  11. Barber FA, "FasT-Fix meniscal repair : mid-term results", Arthroscopy, 24, pp.1342~1348 (2008)
  12. Kelly JD 4th, "Chondral injury and synovitis after arthroscopic meniscal repair using an outside-in mulberry knot suture technique", Arthroscopy, 20, pp.e49~e52 (2004)

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