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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-09-2015 | Knee

Repair of a complete radial tear in the midbody of the medial meniscus using a novel crisscross suture transtibial tunnel surgical technique: a case report

Authors: Evan W. James, Christopher M. LaPrade, John A. Feagin, Robert F. LaPrade

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 9/2015

Abstract

Complete radial meniscus tears have been reported to result in deleterious effects in the knee joint if left unrepaired. An emphasis on meniscal preservation is important in order to restore native meniscal function. In this case report, a complete radial tear of the medial meniscus midbody was repaired using a novel crisscross suture transtibial technique. This technique secured the anterior and posterior meniscal horns, which were released from their extruded and scarred position along the capsule, using crisscrossing sutures passed through two transtibial tunnels and secured over a bone bridge on the anterolateral tibia. In addition, the repair was supplemented with the injection of platelet-rich plasma and bone marrow aspirate concentrate to promote the healing of the meniscal tissue. Complete healing on second-look arthroscopy is presented, including in the previously unreported white–white meniscal zone.

Level of evidence

Case Report, Level IV.

Allaire R, Muriuki M, Gilbertson L, Harner CD (2008) Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am 90:1922–1931CrossRefPubMed

Arnoczky SP, Warren RF (1983) The microvasculature of the meniscus and its response to injury. An experimental study in the dog. Am J Sports Med 11:131–141CrossRefPubMed

Badlani JT, Borrero C, Golla S, Harner CD, Irrgang JJ (2013) The effects of meniscus injury on the development of knee osteoarthritis: data from the osteoarthritis initiative. Am J Sports Med 41:1238–1244CrossRefPubMed

Barber-Westin SD, Noyes FR (2014) Clinical healing rates of meniscus repairs of tears in the central-third (red–white) zone. Arthroscopy 30:134–146CrossRefPubMed

Beaufils P, Hulet C, Dhénain M, Nizard R, Nourissat G, Pujol N (2009) Clinical practice guidelines for the management of meniscal lesions and isolated lesions of the anterior cruciate ligament of the knee in adults. Orthop Traumatol Surg Res 17:437–442CrossRef

Campbell KJ, Boykin RE, Wijdicks CA, Erik Giphart J, LaPrade RF, Philippon MJ (2013) Treatment of a hip capsular injury in a professional soccer player with platelet-rich plasma and bone marrow aspirate concentrate therapy. Knee Surg Sports Traumatol Arthrosc 21:1684–1687CrossRefPubMed

Choi NH, Kim TH, Son KM, Victoroff BN (2010) Meniscal repair for radial tears of the midbody of the lateral meniscus. Am J Sports Med 38:2472–2476CrossRefPubMed

de Girolamo L, Galliera E, Volpi P, Denti M, Dogliotti G, Quaglia A, Cabitza P, Corsi Romanelli MM, Randelli P (2013) Why menisci show higher healing rate when repaired during ACL reconstruction? Growth factors release can be the explanation. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-013-2712-8 PubMed

Driscoll MD, Robin BN, Horie M, Hubert ZT, Sampson HW, Jupiter DC, Tharakan B, Reeve RE (2013) Marrow stimulation improves meniscal healing at early endpoints in a rabbit meniscal model. Arthroscopy 29:113–121CrossRefPubMed

10.

Feucht MJ, Grande E, Brunhuber J, Rosenstiel N, Burgkart R, Imhoff AB, Braun S (2014) Biomechanical comparison between suture anchor and transtibial pull-out repair for posterior medial meniscus root tears. Am J Sports Med 42:187–193CrossRefPubMed

11.

Foad A (2012) Self-limited healing of a radial tear of the lateral meniscus. Knee Surg Sports Traumatol Arthrosc 20:933–936CrossRefPubMed

12.

Freedman KB, Nho SJ, Cole BJ (2003) Marrow stimulating technique to augment meniscus repair. Arthroscopy 19:794–798CrossRefPubMed

13.

Goedecke A, Wobus M, Krech M, Munch N, Richter K, Holig K, Bornhauser M (2011) Differential effect of platelet-rich plasma and fetal calf serum on bone marrow-derived human mesenchymal stromal cells expanded in vitro. J Tissue Eng Regen Med 5:648–654CrossRefPubMed

14.

Harner CD, Mauro CS, Lesniak BP, Romanowski JR (2009) Biomechanical consequences of a tear of the posterior root of the medial meniscus. J Bone Joint Surg Am 91(Suppl 2):257–270PubMed

15.

Johannsen AM, Civitarese DM, Padalecki JR, Goldsmith MT, Wijdicks CA, LaPrade RF (2012) Qualitative and quantitative anatomic analysis of the posterior root attachments of the medial and lateral menisci. Am J Sports Med 40:2342–2347CrossRefPubMed

16.

Krüger JP, Hondke S, Endres M, Pruss A, Siclari A, Kaps C (2012) Human platelet-rich plasma stimulates migration and chondrogenic differentiation of human subchondral progenitor cells. J Orthop Res 30:845–852CrossRefPubMed

17.

LaPrade CM, Jansson KS, Dornan G, Smith SD, Wijdicks CA, LaPrade RF (2014) Altered tibiofemoral contact mechanics due to lateral meniscus posterior horn root avulsions and radial tears can be restored with in situ pull-out suture repairs. J Bone Joint Surg Am 96:471–479CrossRefPubMed

18.

Magee T, Shapiro M, Williams D (2002) MR accuracy and arthroscopic incidence of meniscal radial tears. Skeletal Radiol 31:686–689CrossRefPubMed

19.

Matsubara H, Okazaki K, Izawa T, Tashiro Y, Matsuda S, Nishimura T, Nakanishi Y, Kawamura H, Iwamoto Y (2012) New suture method for radial tears of the meniscus: biomechanical analysis of cross-suture and double horizontal suture techniques using cyclic load testing. Am J Sports Med 40:414–418CrossRefPubMed

20.

McDermott I (2011) Meniscal tears, repairs and replacement: their relevance to osteoarthritis of the knee. Br J Sports Med 45:292–297CrossRefPubMed

21.

Melton JT, Murray JR, Karim A, Pandit H, Wandless F, Thomas NP (2011) Meniscal repair in anterior cruciate ligament reconstruction: a long-term outcome study. Knee Surg Sports Traumatol Arthrosc 19:1729–1734CrossRefPubMed

22.

Mishra A, Tummala P, King A, Lee B, Kraus M, Tse V, Jacobs CR (2009) Buffered platelet-rich plasma enhances mesenchymal stem cell proliferation and chondrogenic differentiation. Tissue Eng Part C Methods 15:431–435PubMedCentralCrossRefPubMed

23.

Muriuki MG, Tuason DA, Tucker BG, Harner CD (2011) Changes in tibiofemoral contact mechanics following radial split and vertical tears of the medial meniscus an in vitro investigation of the efficacy of arthroscopic repair. J Bone Joint Surg Am 93:1089–1095CrossRefPubMed

24.

Padalecki JR, Jansson KS, Smith SD, Dornan GJ, Pierce CM, Wijdicks CA, LaPrade RF (2014) Biomechanical consequences of a complete radial tear adjacent to the medial meniscus posterior root attachment site: in situ pull-out repair restores derangement of joint mechanics. Am J Sports Med 42:699–707CrossRefPubMed

25.

Ra HJ, Ha JK, Jang SH, Lee DW, Kim JG (2013) Arthroscopic inside-out repair of complete radial tears of the meniscus with a fibrin clot. Knee Surg Sports Traumatol Arthrosc 21:2126–2130CrossRefPubMed

26.

Stärke C, Kopf S, Grobel KH, Becker R (2010) The effect of a nonanatomic repair of the meniscal horn attachment on meniscal tension: a biomechanical study. Arthroscopy 26:358–365CrossRefPubMed

27.

Stein T, Mehling AP, Welsch F, von Eisenhart-Rothe R, Jäger A (2010) Long-term outcome after arthroscopic meniscal repair versus arthroscopic partial meniscectomy for traumatic meniscal repairs. Am J Sports Med 38:1542–1548CrossRefPubMed

28.

Thompson WO, Thaete FL, Fu FH, Dye SF (1991) Tibial meniscal dynamics using three dimensional reconstruction of magnetic resonance images. Am J Sports Med 19:210–216CrossRefPubMed

29.

Vangsness CT Jr, Farr J II, Boyd J, Dellaero DT, Mills CR, Leroux-Williams M (2014) Adult human mesenchymal stem cells delivered via intra-articular injection to the knee following partial medial meniscectomy: a randomized, double-blind, controlled study. J Bone Joint Surg Am 96:90–98CrossRefPubMed

30.

Wei LC, Gao SG, Xu M, Jiang W, Tian J, Lei GH (2012) A novel hypothesis: the application of platelet-rich plasma can promote the clinical healing of white–white meniscal tears. Med Sci Monit 18:HY47–HY50PubMedCentralPubMed

Title: Repair of a complete radial tear in the midbody of the medial meniscus using a novel crisscross suture transtibial tunnel surgical technique: a case report
Authors: Evan W. James
Christopher M. LaPrade
John A. Feagin
Robert F. LaPrade
Publication date: 01-09-2015
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 9/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-014-3089-z

At a glance: The STEP trials

Springer Medicine

Repair of a complete radial tear in the midbody of the medial meniscus using a novel crisscross suture transtibial tunnel surgical technique: a case report

Abstract

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Level of evidence

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