2025 ISAKOS Biennial Congress ePoster
Description Of A Novel Surgical Technique For Repairing Complete Radial Tears Of The Lateral Meniscus And Results Of Our Series
Juan Pablo Zicaro, MD, Olivos, Buenos Aires ARGENTINA
Mariano Manuel Zapata, MD, CABA, Buenos Aires ARGENTINA
Mariano Agustin Revah, MD, CABA, buenos aires ARGENTINA
Matias Costa-Paz, MD, PhD, Buenos Aires, Buenos Aires ARGENTINA
Carlos H. Yacuzzi, MD, Buenos Aires, BA ARGENTINA
Oscar Alejandro Zicaro, MD, tigre, Buenos Aires ARGENTINA
Hospital Italiano de Buenos Aires, Buenos Aires, Buenos Aires, ARGENTINA
FDA Status Not Applicable
Summary
This novel surgical technique for lateral meniscus complete radial tears provides great stability. After almost 2 years of follow-up, return to sports rate is almost 100% and the failure rate 7.7%
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Abstract
Introduction
The management of radial tears of the lateral meniscus (LM) is very complex, as the absence of the LM alters the knee biomechanics, increasing the probability of developing osteoarthritis of the lateral compartment in the short to medium term. Failure rates described after repair of these lesions range from 11% to 23%. Multiple techniques have been described that address different strategies to achieve a more stable repair and decrease the failure rate.
Objective
The primary objective of this study is to describe a novel surgical technique to repair a complete radial tear of the lateral meniscus. We also present the results of our series.
Methods
We evaluated patients operated on between 2019 and 2023. We describe the surgical technique and evaluate the surgical data, return to sports, clinical outcomes and failure rate.
Results
Surgical Technique:
We use 3 portals: medial and lateral parapatellar and the Patel portal. With a suture passer or a "pigtail" clamp two stitches are made on the posterior flap of the meniscus. These stitches can be exchanged for a tape-type suture to achieve a larger contact surface and less shear. Using an outside-in needle, the suture must pass from the anterior capsule to the cephalic edge of the anterior horn of the meniscus and recover the cephalic stitch of the proximal end. The same is repeated at the caudal edge of the meniscus. In this way, two parallel stitches will be formed side by side of the radial lesion, exiting through the anterior capsule. By pulling and adjusting the stitch, the meniscus will be reduced, compressed and then repaired to the anterior capsule. Then, two vertical menisco-meniscus stitches in a "hashtag" format will be performed. Finally, vertical inside-out menisco-capsular stitches are performed as much as required. Through a lateral approach, the stitches are recovered under the iliotibial band then sutured. For isolated repairs, microfractures to the notch and Platelet-Rich Plasma rich in White Blood Cells infiltration are performed for biological augmentation.
Our series:
Thirteen patients were included, 11 males with an average follow-up of 23.6 months (95% CI 8.2 months) and an average age of 25 years (95% CI 5.2 years). In 3 cases, it was performed alongside with an ACL reconstruction. In 1 case (7.7%) the repair failed and a partial meniscectomy was performed, one (7.7%) developed a DVT treated with clinical management. All patients returned to their sports activity, 70% (n=9) to the same level and 30% (n=4) to a lower level. The average Lysholm scale pre and postoperatively was 11.5 (SD 5.2) and 75.6 (SD 11.3) and the IKDC scale 24.31 (SD 6.3) and 60.26 (SD 9.2) respectively.
Conclusion
This novel surgical technique for lateral meniscus complete radial tears provides great stability to the peripheral fibers of the meniscus. After almost 2 years of follow-up, return to sports rate is almost 100% and the failure rate 7.7%.