Inframeniscal portal for horizontal tears of the meniscus

Abstract

Purpose: The purpose of this study was to evaluate the results of arthroscopic partial meniscectomy with an inframeniscal portal in horizontal meniscal tears that involved the anterior portion of the meniscus and verify the efficiency of this technique.

Methods: Between January 2005 and December 2006, 40 patients with a horizontal tear in either the medial or lateral meniscus underwent arthroscopic partial meniscectomy by use of an inframeniscal portal. Four patients underwent revision meniscectomy with an inframeniscal portal and were included in this study. The mean age of the patients was 38.3 years (range, 19 to 55 years). The mean follow-up period was 25.3 months (range, 12 to 39 months). Thorough physical examination and the modified Lysholm scoring system were used to evaluate objective and subjective improvements.

Results: All patients recovered nearly full range of motion of the involved knee joint. The mean preoperative modified Lysholm score was 56.9 (range, 44 to 71), which increased to 91.4 (range, 81 to 100) at last follow-up (P < .001). Iatrogenic partial medial collateral ligament injury that was not higher than grade I occurred during creation of the medial inframeniscal portal in 2 cases. An impending synovial fistula occurred after creation of the lateral inframeniscal portal, which was resolved by debridement and closure with the patient under local anesthesia.

Conclusions: Use of the inframeniscal portal proved to be an effective method for accessing horizontal tears of the meniscus and resulted in symptomatic improvements in short-term follow-up and few minor complications.

Level of evidence: Level IV, therapeutic case series.