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Modified Pull-out Suture in Posterior Root Tear of the Medial Meniscus: Using a Posteromedial Portal
1Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
Abstract:
In cases with root tear of the medial meniscus posterior horn, the meniscus usually can be repaired by a pull out suture technique. However, there is difficulty in manipulating a suture hook via the anteromedial portal and looking through the arthroscopic camera via anterolateral portal in the narrow medial joint space at the same time. This article describes a modified simple pull out suture technique for root tear of the medial meniscus posterior horn using a posteromedial portal that provides a safe and easy handling of the suture hook. Our indications of this technique used in patients with Outerbridge 1-2 arthritic change and minimal varus axis change. Benefits of this technique are simple, less invasive, and reduced operation time by simultaneous suture with a hook via posteromedial portal and pulling of a string with grasper. It may reduce the possibility of an additional chondral or meniscal injury.
Insights
This study presents a modified pull-out suture technique for medial meniscus posterior horn root tears. The posteromedial portal approach simplifies suture hook manipulation, improving safety and efficiency for meniscus repair.
Area of Science:
- Orthopedic Surgery
- Knee Arthroscopy
- Meniscal Repair
Background:
- Root tears of the medial meniscus posterior horn often require surgical repair.
- Traditional pull-out suture techniques can be challenging due to limited space and instrument conflicts during arthroscopy.
- Difficulty arises from simultaneous manipulation of suture hooks and arthroscopic visualization in narrow joint spaces.
Purpose of the Study:
- To describe a modified simple pull-out suture technique for medial meniscus posterior horn root tears.
- To introduce the use of a posteromedial portal for improved suture hook handling.
- To offer a safer, easier, and more efficient surgical option for specific meniscus tears.
Main Methods:
- A modified pull-out suture technique utilizing a posteromedial portal is described.
- This technique facilitates safe and easy handling of the suture hook.
- Indications include Outerbridge grade 1-2 arthritic changes and minimal varus axis deviation.
Main Results:
- The modified technique offers a simple and less invasive approach.
- Reduced operation time is achieved through simultaneous suturing and grasping.
- Potential reduction in additional chondral or meniscal injury is a key benefit.
Conclusions:
- The modified pull-out suture technique using a posteromedial portal is effective for medial meniscus posterior horn root tears.
- This method enhances surgical safety and efficiency compared to traditional approaches.
- It is indicated for patients with early-stage osteoarthritis and mild knee alignment issues.