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Published in: Journal of Orthopaedic Surgery and Research 1/2018

Open Access 01-12-2018 | Technical note

A technique combining “U” shape suture and shared tunneling to treat the posterior cruciate ligament rupture and posterior root tears of the medial meniscus

Authors: Xing-He Xue, Jian Lin, Wei-Hui Qi, Xiao-Yun Pan

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2018

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Abstract

Background

The standard treatment of the posterior cruciate ligament (PCL) rupture accompanied with the posterior root of medial meniscus (PRMM) tears is controversial. Our research describes a minimally invasive technique for the PCL rupture accompanied with the PRMM tears.

Methods

We described a “U” shape suture and shared tunneling technique to treat the PCL rupture accompanied with PRMM tears. Three patients (ages 28, 42, and 59 years old) who underwent this surgery have been followed up for more than 1 year at most. The MRI was done, and the hospital for special surgery (HSS) score was adopted to evaluate the clinical effect. Firstly, we built both femoral and tibial bone tunnels for the PCL reconstruction. Secondly, we used the suture hook to pass the suture line through the PRMM. Thirdly, we passed the prepared tendon through the bone tunnel and fixed the prepared tendon by an endobutton plate and an interference screw (Smith & Nephew) respectively on the side of the femur and tibia. At last, we used an endobutton plate (Smith & Nephew) outside the tibial bone tunnel to fix the PRMM.

Results

These three patients did not show any complications. At 1 year after the operation, we found good knee stability, negative posterior drawer test, and normal range of motion compared with the contralateral knee joint. The MRI also showed a good union of the PRMM and PCL. The hospital for special surgery (HSS) score was 90 points.

Conclusions

With an ideal therapeutic effect, this technique is worthy to be promoted for patients with the PCL rupture and PRMM tears.
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Literature
1.
go back to reference Fanelli GC, Beck JD, Edson CJ. Current concepts review: the posterior cruciate ligament. J Knee Surg. 2010;23(2):61–72.CrossRef Fanelli GC, Beck JD, Edson CJ. Current concepts review: the posterior cruciate ligament. J Knee Surg. 2010;23(2):61–72.CrossRef
2.
go back to reference Rosenthal MD, Rainey CE, Tognoni A, Worms R. Evaluation and management of posterior cruciate ligament injuries. Phys Ther Sport. 2012;13(4):196–208.CrossRef Rosenthal MD, Rainey CE, Tognoni A, Worms R. Evaluation and management of posterior cruciate ligament injuries. Phys Ther Sport. 2012;13(4):196–208.CrossRef
3.
go back to reference Voos JE, Mauro CS, Wente T, Warren RF, Wickiewicz TL. Posterior cruciate ligament: anatomy, biomechanics, and outcomes. Am J Sports Med. 2012;40(1):222–31.CrossRef Voos JE, Mauro CS, Wente T, Warren RF, Wickiewicz TL. Posterior cruciate ligament: anatomy, biomechanics, and outcomes. Am J Sports Med. 2012;40(1):222–31.CrossRef
4.
go back to reference Gao SG, Zhang C, Zhao RB, Liao Z, Li YS, Yu F, et al. Effect of partial and complete posterior cruciate ligament transection on medial meniscus: a biomechanical evaluation in a cadaveric model. Indian J Orthop. 2013;47(5):493–9.CrossRef Gao SG, Zhang C, Zhao RB, Liao Z, Li YS, Yu F, et al. Effect of partial and complete posterior cruciate ligament transection on medial meniscus: a biomechanical evaluation in a cadaveric model. Indian J Orthop. 2013;47(5):493–9.CrossRef
5.
go back to reference Ren AH, Zheng ZZ, Shang Y, Tian CY. An anatomical study of normal meniscal roots with isotropic 3D MRI at 3T. Eur J Radiol. 2012;81(7):e783–8.CrossRef Ren AH, Zheng ZZ, Shang Y, Tian CY. An anatomical study of normal meniscal roots with isotropic 3D MRI at 3T. Eur J Radiol. 2012;81(7):e783–8.CrossRef
6.
go back to reference Ahn JH, Wang JH, Yoo JC, Noh HK, Park JH. A pull out suture for transection of the posterior horn of the medial meniscus: using a posterior trans-septal portal. Knee Surg Sports Traumatol Arthrosc. 2007;15(12):1510–3.CrossRef Ahn JH, Wang JH, Yoo JC, Noh HK, Park JH. A pull out suture for transection of the posterior horn of the medial meniscus: using a posterior trans-septal portal. Knee Surg Sports Traumatol Arthrosc. 2007;15(12):1510–3.CrossRef
7.
go back to reference Kim JH, Shin DE, Dan JM, Nam KS, Ahn TK, Lee DH. Arthroscopic suture anchor repair of posterior root attachment injury in medial meniscus: technical note. Arch Orthop Trauma Surg. 2009;129(8):1085–8.CrossRef Kim JH, Shin DE, Dan JM, Nam KS, Ahn TK, Lee DH. Arthroscopic suture anchor repair of posterior root attachment injury in medial meniscus: technical note. Arch Orthop Trauma Surg. 2009;129(8):1085–8.CrossRef
8.
go back to reference Woodmass JM, Mohan R, Stuart MJ, Krych AJ. Medial meniscus posterior root repair using a transtibial technique. Arthrosc Tech. 2017;6(3):e511–6.CrossRef Woodmass JM, Mohan R, Stuart MJ, Krych AJ. Medial meniscus posterior root repair using a transtibial technique. Arthrosc Tech. 2017;6(3):e511–6.CrossRef
9.
go back to reference Zhang C, Deng Z, Luo W, Xiao W, Hu Y, Liao Z, et al. Rupture of posterior cruciate ligament leads to radial displacement of the medial meniscus. BMC Musculoskelet Disord. 2017;18(1):297.CrossRef Zhang C, Deng Z, Luo W, Xiao W, Hu Y, Liao Z, et al. Rupture of posterior cruciate ligament leads to radial displacement of the medial meniscus. BMC Musculoskelet Disord. 2017;18(1):297.CrossRef
10.
go back to reference Chung KS, Ha JK, Yeom CH, Ra HJ, Jang HS, Choi SH, et al. Comparison of clinical and radiologic results between partial meniscectomy and refixation of medial meniscus posterior root tears: a minimum 5-year follow-up. Arthroscopy. 2015;31(10):1941–50.CrossRef Chung KS, Ha JK, Yeom CH, Ra HJ, Jang HS, Choi SH, et al. Comparison of clinical and radiologic results between partial meniscectomy and refixation of medial meniscus posterior root tears: a minimum 5-year follow-up. Arthroscopy. 2015;31(10):1941–50.CrossRef
11.
go back to reference Jung YH, Choi NH, Oh JS, Victoroff BN. All-inside repair for a root tear of the medial meniscus using a suture anchor. Am J Sports Med. 2012;40(6):1406–11.CrossRef Jung YH, Choi NH, Oh JS, Victoroff BN. All-inside repair for a root tear of the medial meniscus using a suture anchor. Am J Sports Med. 2012;40(6):1406–11.CrossRef
12.
go back to reference Kim SB, Ha JK, Lee SW, Kim DW, Shim JC, Kim JG, et al. Medial meniscus root tear refixation: comparison of clinical, radiologic, and arthroscopic findings with medial meniscectomy. Arthroscopy. 2011;27(3):346–54.CrossRef Kim SB, Ha JK, Lee SW, Kim DW, Shim JC, Kim JG, et al. Medial meniscus root tear refixation: comparison of clinical, radiologic, and arthroscopic findings with medial meniscectomy. Arthroscopy. 2011;27(3):346–54.CrossRef
13.
go back to reference Krych AJ, Reardon PJ, Johnson NR, Mohan R, Peter L, Levy BA, et al. Non-operative management of medial meniscus posterior horn root tears is associated with worsening arthritis and poor clinical outcome at 5-year follow-up. Knee Surg Sports Traumatol Arthrosc. 2017;25(2):383–9.CrossRef Krych AJ, Reardon PJ, Johnson NR, Mohan R, Peter L, Levy BA, et al. Non-operative management of medial meniscus posterior horn root tears is associated with worsening arthritis and poor clinical outcome at 5-year follow-up. Knee Surg Sports Traumatol Arthrosc. 2017;25(2):383–9.CrossRef
14.
go back to reference Allaire R, Muriuki M, Gilbertson L, Harner CD. Biomechanical consequences of a tear of the posterior root of the medial meniscus: similar to total meniscectomy. J Bone Joint Surg Am. 2008;90(9):1922–31.CrossRef Allaire R, Muriuki M, Gilbertson L, Harner CD. Biomechanical consequences of a tear of the posterior root of the medial meniscus: similar to total meniscectomy. J Bone Joint Surg Am. 2008;90(9):1922–31.CrossRef
Metadata
Title
A technique combining “U” shape suture and shared tunneling to treat the posterior cruciate ligament rupture and posterior root tears of the medial meniscus
Authors
Xing-He Xue
Jian Lin
Wei-Hui Qi
Xiao-Yun Pan
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2018
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-018-0973-0

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