What Is the Optimal Minimum Penetration Depth for "All-Inside" Meniscal Repairs?

Area of Science:

• Orthopedic Surgery
• Arthroscopy
• Biomechanical Analysis

Background:

• Meniscal tears are common knee injuries requiring surgical repair.
• All-inside meniscal repair techniques utilize suture anchors for effective tissue approximation.
• Accurate placement of suture anchors is vital to prevent iatrogenic injury to posterior structures.

Purpose of the Study:

• To establish the minimum safe depth setting for all-inside meniscal suture anchors.
• To identify optimal penetration depth to ensure effective meniscal repair while minimizing risks.

Main Methods:

• Digitization of 3D surfaces of the meniscocapsular junction and posterior capsule in 16 cadaveric knees.
• Measurement of the distance from the meniscocapsular junction to the posterior capsule outer wall.
• Performance of all-inside meniscal repairs on 7 knees to assess actual capsular thickness and penetration depth.

Main Results:

• Mean capsular thickness (X1) ranged from 6.4-9.1 mm.
• Actual penetration depth (X2) exceeded predicted distances by 1.5-1.7 mm due to capsule deformation.
• A minimum penetration depth of 8-10 mm was determined to be necessary.

Conclusions:

• A minimum penetration depth of 8-10 mm is recommended for safe all-inside meniscal suture anchor placement.
• Surgeons should consider an additional distance (L) from the meniscocapsular junction for optimal anchor positioning.
• Optimal depth settings range from 8 mm to 16 mm for effective meniscal repair.