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A Modified Outside-in Suture Technique for Repair of the Middle Segment of the Meniscus Using a Spinal Needle

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Introduction: Several techniques have been used for arthroscopic repair of middle segment, posteromedial or posterolateral corner tears of the meniscus. One of the commonly used methods is the inside-out double arm needle technique.Surgical Technique: We have developed a vertical mattress absorbable suture technique. It is easy to perform with a small sized skin incision for knot tying. This technique just necessitates 1 or 2 spinal needles for repair.Materials and Methods: Between March 2010 and February 2012, 20 menisci were treated by this technique, a modified method of the outside-in vertical meniscal repair using a spinal needle and No. 2 PDS absorbable suture material. Evaluation of clinical results was done using the Lysholm score.Results: The mean preoperative Lysholm score was 63.9 and the mean postoperative score was 97.3. A second look arthroscopy was performed in 13 knees (65%) and the repair sites were well healed. Conclusions: We recommend this method as an alternative technique for repair of the middle segment, posteromedial or posterolateral corner of the meniscus.

Abstract

Introduction: Several techniques have been used for arthroscopic repair of middle segment, posteromedial or posterolateral corner tears of the meniscus. One of the commonly used methods is the inside-out double arm needle technique.Surgical Technique: We have developed a vertical mattress absorbable suture technique. It is easy to perform with a small sized skin incision for knot tying. This technique just necessitates 1 or 2 spinal needles for repair.Materials and Methods: Between March 2010 and February 2012, 20 menisci were treated by this technique, a modified method of the outside-in vertical meniscal repair using a spinal needle and No. 2 PDS absorbable suture material. Evaluation of clinical results was done using the Lysholm score.Results: The mean preoperative Lysholm score was 63.9 and the mean postoperative score was 97.3. A second look arthroscopy was performed in 13 knees (65%) and the repair sites were well healed. Conclusions: We recommend this method as an alternative technique for repair of the middle segment, posteromedial or posterolateral corner of the meniscus.

참고문헌 (11)

  1. Cho JH, "Arthroscopic all-inside repair of anterior horn tears of the lateral meniscus using a spinal needle", Knee Surg Sports Traumatol Arthrosc, 16, pp.683~686 (2008)
  2. Ahn JH, "Modified inside-out technique for meniscal repair", Arthroscopy, 20(2), pp.178~182 (2004)
  3. Abdelkafy A, "Two to nineteen years follow-up of arthroscopic meniscal repair using the outside-in technique : a retrospective study", Arch Orthop Trauma Surg, 127, pp.245~252 (2007)
  4. 이범식, "Review of Meniscal Allograft Transplantation Focusing on Long-term Results and Evaluation Methods", Knee Surgery and Related Research, 25(1), pp.1~6 (2013), 대한슬관절학회
  5. Rodeo SA, "Arthroscopic meniscal repair with use of the outside-in technique", Instr Course Lect, 49, pp.195~206 (2000)
  6. 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)
  7. Rimmer MG, "Failure strengths of different meniscal suturing techniques", Arthroscopy, 11, pp.146~150 (1995)
  8. Rubman MH, "Arthroscopic repair of meniscal tears that extend into the avascular zone : a review of 198 single and complex tears", Am J Sports Med, 26, pp.87~95 (1998)
  9. Seil R, "Chondral lesions after arthroscopic meniscus repair using meniscus arrows", Arthroscopy, 16, pp.E17~ (2000)
  10. Post WR, "Load to failure of common meniscal repair techniques : effects of suture technique and suture material", Arthroscopy, 13, pp.731~736 (1997)
  11. Ahn JH, "The modified outside-in suture : vertical repair of the anterior horn of the meniscus after decompression of a large meniscal cyst", Knee Surg Sports Traumatol Arthrosc, 14, pp.1288~1291 (2006)

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