Modified Suture-Gripping Technique for Arthroscopic Meniscal Suturing

Meniscal preservation is essential for the maintenance of knee function. The suture-gripping technique, using a suture shuttle, enables accurate needle insertion from inside the joint and flexible withdrawal of the suture from outside the capsule, thereby facilitating meniscal repair of the anterior segment. Using a continuous suturing technique with this method is possible, and we described a modified approach. We recently recognized that ARTHRO-PIERCE, a device originally designed for hip arthroscopy, can be used to perform the same suture-gripping technique principles for meniscal repair. The ARTHRO-PIERCE has a sharper tip-when compared with a suture shuttle holding a suture at its tip-that improves penetration, a more rigid shaft that improves reach and trajectory toward the anterior horn and anterior body, and robust suture grasping without relying on a loop mechanism than a conventional suture shuttle. Here, we describe the step-by-step surgical technique. This technique expands the versatility of the suture-gripping technique for anterior meniscal suturing with improved device handling and secure suture control.