X-Shaped Cross-Stitch Suture Technique for the Repair of Horizontal Tears of the Lateral Meniscus

Horizontal tears of the lateral meniscus often extend into the avascular zone, making healing difficult. Whereas partial meniscectomy was once standard, growing recognition of meniscal function has promoted repair techniques, especially all-inside suture methods. We describe an all-inside suture meniscal repair technique using an X-shaped cross-stitch configuration to enhance compression across horizontal cleavage tears. After standard arthroscopic examination and tear-site preparation, sutures are sequentially passed through the peripheral meniscal tissue at 2 points approximately 10 mm apart using a Knee Scorpion device (Arthrex, Naples, FL). An X-shaped suture configuration is created by retrieving and tightening the sutures, providing stable compression. Postoperative rehabilitation involves progressive weight-bearing and range of motion without the use of braces. This technique enables stable reduction of horizontal meniscal tears without trans-capsular fixation. It minimizes capsular injury, maintains meniscal mobility, and provides uniform compression, potentially improving healing outcomes. Standard arthroscopic equipment is sufficient, eliminating the need for specialized implants. The X-shaped cross-stitch suture offers a reproducible, cost-effective method for repairing horizontal lateral meniscal tears using an all-inside suture meniscal repair technique. Further biomechanical and clinical studies are warranted to validate its long-term effectiveness.