Neural and vascular complications of arthroscopic meniscal surgery

Injuries to vessels and nerves are very rare complications of arthroscopic meniscal surgery. The clinical development and diagnosis of such complications are described and illustrated by cases described in the literature and by two of our own cases. Typical patterns of injury are simulated by dissection of cadaver knees. To avoid neural complications in suturing the menisci, on the medial side the joint capsule has to be prepared when using the inside-out or the outside-in technique. On the lateral side of the outside-in technique can be performed by small suture incisions in this area when the lateral knee structures can be palpated. When using the inside-out technique the peroneal nerve must be dissected free. When resecting the posterior horn of the medial meniscus forced external rotation of the knee should be avoided because in this position the popliteal artery and the medial inferior genicular artery lie close to the posterior horn.