A novel surgical technique for arthroscopic repair of type II posterior lateral meniscal root tear

• Published in: The knee Vol. 27; no. 5; pp. 1560 - 1566
• Main Authors: Zhang, Zheng-Zheng, Zhou, Yun-Feng, Luo, Huan, Zhang, Hao-Zhi, Chen, Zhong, Jiang, Chuan, Hou, Jing-Yi, Yang, Rui, Song, Bin, Li, Wei-Ping
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2020; Elsevier Limited
• Subjects: Adult; Anterior cruciate ligament; Anterior Cruciate Ligament Reconstruction - methods; Arthroscopy; Arthroscopy - methods; Endoscopy; FasT-Fix system; Female; Humans; Joint and ligament injuries; Knee; Knee Joint - diagnostic imaging; Knee Joint - surgery; Lateral meniscal extrusion; Magnetic Resonance Imaging; Male; Meniscal repair; Meniscal root tear; Menisci, Tibial - diagnostic imaging; Menisci, Tibial - surgery; Meniscus; Patient satisfaction; Patients; Second-Look Surgery; Sports injuries; Surgery; Surgical techniques; Suture Techniques; Sutures; Tibial Meniscus Injuries - diagnosis; Tibial Meniscus Injuries - surgery; Treatment Outcome; Values; Young Adult; United States > US; FasT-Fix system; Meniscal repair; Arthroscopy; Meniscal root tear; Lateral meniscal extrusion
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2020.07.100

Several suture repair techniques have been reported for radial tear close to the posterior lateral meniscal root (type II PLMRT). However, no study has evaluated the clinical results after repair using the FasT-Fix system. This paper describes a novel H-plasty surgical repair technique and reports its clinical results. From January 2015 to January 2017, 47 patients underwent repair of type II PLMRT with concomitant anterior cruciate ligament reconstruction and were included in this study. Assessments performed preoperatively and at final follow-up included the Lysholm score, subjective International Knee Documentation Committee (IKDC) score, and knee stability assessments (pivot-shift test, Lachman test, KNEELAX arthrometer side-to-side difference). Magnetic resonance imaging was used to compare the lateral meniscal extrusion pre- versus postoperatively. Second-look arthroscopy was performed to evaluate the meniscal healing in 38 cases. Forty-seven patients were followed up for an average of 30.7 months (range 18–46 months). No patients experienced meniscal mechanical symptoms. At final follow-up, there were significant improvements in the Lysholm score, IKDC score, knee stability assessments, and lateral meniscal extrusion compared with the preoperative values. In the 38 of 47 patients that underwent second-look arthroscopy after an average of 17.5 months (range 14–19 months), all repairs (100%) were completely healed. The novel H-plasty repair using the FasT-Fix system was an effective surgical treatment for type II PLMRT. Considering the satisfactory clinical results and the convenience of the surgery, H-plasty repair is recommended to be used preferentially.