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Updated: Jul 18, 2026
A Novel Arthroscopic Medial Knot-Tying Suture-Bridge Repair with Rip-Stop Technique for Rotator Cuff Tears
Published on: January 13, 2026
[Arthroscopic meniscal suture]
1Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Waldeyerstrasse 1, D-48149 Münster, Germany. wolf.petersen@ukmuenster.de
Objective:
Restoration of the function of the meniscus by suturing a tear to prevent long-term degeneration.
Indications:
Unstable longitudinal meniscal tear in the red and red-white zones with an intact central fragment. Dislocated bucket-handle tear near the base in the presence of good-quality tissue.
Contraindications:
Lesion of the central meniscal fragment. Meniscal tears in the white, avascular zone. Degenerative meniscal lesions. Complex meniscal lesions. Untreated knee ligament instability. Uncooperative patient.
Surgical Technique:
Standard anterior arthroscopy approach. Revitalization of the tear margins and the perimeniscal synovial membrane, trephination of the base of the meniscus to promote healing. Fixation of the tear with a resorbable or nonresorbable suture size 2-0 to 0 USP by means of different suture techniques. "Outside-in technique": the suture is introduced from outside the joint through the base of the meniscus using a cannulated needle and is then pulled back out using a suture loop inserted with another cannulated needle. The U-suture is knotted over the joint capsule through a stab incision. "Inside-out technique": the suture is introduced using a needle through a guide cannula from outside the joint through the meniscus and joint capsule and then brought out of the joint. The U-suture is knotted over the capsule through a short skin incision. "All-inside technique": the suture loop is passed through the meniscal tear and knotted within the joint using a posterior arthroscopy approach.
Postoperative Management:
Full weight bearing without a brace for short tears with one suture. For tears with two sutures, partial weight bearing for 4 weeks without a brace. For large tears with three to four sutures, partial weight bearing up to 20 kp for 6 weeks and restricted knee motion in a brace up to 0/0/60 degrees .
Results:
The healing rate for knee joints with stable ligaments and an isolated meniscal tear is between 50% and 75%. In cases with simultaneous ACL (anterior cruciate ligament) plasty, the healing rate is > 75%; for unstable knee joints it is < 50%.