The Popliteal Artery is Safe in Medial Meniscal Repair Using All Inside Devices in Adults: An MRI-Based Simulation...

Area of Science:

• Orthopedic Surgery
• Radiology
• Anatomy

Background:

• All-inside meniscal repair is a common orthopedic procedure.
• Understanding the proximity of critical neurovascular structures is crucial for surgical safety.
• The popliteal artery (PA) and common peroneal nerve (CPN) are at risk during knee surgery.

Purpose of the Study:

• To assess the risk of injury to the popliteal artery (PA) and common peroneal nerve (CPN) during all-inside meniscal repairs.
• To simulate these risks using magnetic resonance imaging (MRI) data of the knee.

Main Methods:

• MRI scans of 200 adult knees in extension were used for simulation.
• Simulated repairs of the posterior horn of medial and lateral menisci (PHMM, PHLM) via anteromedial (AM) and anterolateral (AL) portals.
• Measurements of distances from repair devices to PA and CPN using straight and curved devices.

Main Results:

• The PA is safe in PHMM repairs with both straight and curved devices.
• The PA is at risk during PHLM repairs with both device types.
• The CPN is safe in lateral meniscus (LM) repairs using all-inside devices.

Conclusions:

• Medial meniscus repairs pose minimal PA risk.
• Lateral meniscus repairs carry a risk to the PA; minimizing insertion depth is recommended.
• CPN safety is maintained during lateral meniscus repairs.