Optimized Surgical Positioning Using an L-Shaped Support for Arthroscopic Repair of Lateral Meniscus Tears

Traumatic lateral meniscal injuries are associated with an increased risk of knee joint degeneration and osteoarthritis. Meniscal preservation through surgical repair is crucial for maintaining knee joint biomechanics. This is especially true for the lateral meniscus, given its unique anatomical and biomechanical properties. Visualization of the lateral compartment during arthroscopy is critical to access the lateral meniscus tear pattern and to determine its suitability for repair. Distraction of the lateral compartment during surgical repair of the lateral meniscus is also important to avoid iatrogenic injury to the articular cartilage. This Technical Note describes a simple surgical positioning technique to improve visualization and opening of the lateral compartment using an L-shaped support commonly used in total knee arthroplasties. The proposed method significantly improves exposure of the lateral femorotibial compartment, reducing the need for manual assistance and facilitating surgical repair, particularly in bucket-handle tears of the lateral meniscus. In addition, we discuss biomechanical considerations, surgical outcomes, and techniques to optimize lateral meniscus repair, emphasizing the benefits of inside-out and outside-in sutures. The described positioning technique and repair strategies potentially enhance surgical outcomes and long-term joint preservation.