A Modified Suture Hook Technique for Lateral Meniscus Tears: Chinese Union Suture Procedure (CUSP)

Tears in the lateral meniscus, especially the body and posterior horn, are a common sports medicine injury, and severe cases require arthroscopic treatment. However, the narrow space in the posterolateral compartment of the knee joint makes the surgeon's operation inconvenient. Here we have proposed a suture technique suitable for lateral meniscus posterior horn/body injuries known as the Chinese Union Suture Procedure. The introduction of the posteromedial-transseptal portal allows for a suitable angle of operation for suture hooks in case of injuries to the posterior horn of the lateral meniscus or the popliteal hiatus area of the lateral meniscus. The use of the continuous sewing machine-like suture technique allows surgeons to more quickly and flexibly address meniscus tears. We have also introduced a retractor as an auxiliary tool for portal establishment. In conclusion, our improved technique enables vertical mattress suturing for meniscus tears, and it allows for tying knots on the tibial surface of the meniscus, which is challenging to achieve with traditional all-inside suture hook techniques. Our technique combines flexibility, speed, and cost-effectiveness, making it valuable for clinical applications.