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. 2012 Oct 22;1(2):e209-12.
doi: 10.1016/j.eats.2012.08.001. Print 2012 Dec.

Arthroscopic centralization of an extruded lateral meniscus

Hideyuki Koga  1 , Takeshi Muneta, Kazuyoshi Yagishita, Toshifumi Watanabe, Tomoyuki Mochizuki, Masafumi Horie, Tomomasa Nakamura, Atsushi Okawa, Ichiro Sekiya
Affiliations

Arthroscopic centralization of an extruded lateral meniscus

Hideyuki Koga et al. Arthrosc Tech. .

Abstract

Extrusion of the lateral meniscus has been reported after posterior root tear or radial tear, partial meniscectomy, and meniscoplasty of discoid meniscus. It has also been shown to be associated with the development of osteoarthritis. This technical note describes a new arthroscopic technique to centralize and stabilize the mid body of the lateral meniscus to restore and maintain the lateral meniscus function by repairing/preventing extrusion of the meniscus. A JuggerKnot Soft Anchor (Biomet, Warsaw, IN), loaded with a MaxBraid suture (Biomet), was placed on the lateral edge of the lateral tibial plateau, just anterior to the popliteal hiatus, through a midlateral portal. A Micro Suture Lasso Small Curve with Nitinol Wire Loop (Arthrex, Naples, FL) was used to pass 2 limbs of the MaxBraid suture through the meniscus at the margin between the meniscus and the capsule. Another anchor was inserted on the lateral edge of the lateral tibial plateau, 1 cm anterior to the first anchor, and the same procedure was repeated. The sutures were then tied by use of a self-locking sliding knot, achieving centralization and secure stabilization of the lateral meniscus.

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Figures

Figure 1
Figure 1
Preoperative magnetic resonance imaging (left knee, coronal view) showed that the mid body of the lateral meniscus (arrow) was extruded after anterior cruciate ligament reconstruction and partial meniscectomy of the lateral meniscus at another hospital. In this case, the reconstructed anterior cruciate ligament was lax, and revision anterior cruciate ligament reconstruction was also planned.
Figure 2
Figure 2
Arthroscopic findings. (A) Arthroscopic view of the lateral meniscus in a left knee from the anterolateral portal in the figure-of-4 position. Displacement of the lateral meniscus (arrow) was confirmed by pushing the mid body of the meniscus out of the rim of the lateral tibial plateau with a probe. (B) A JuggerKnot Soft Anchor was inserted on the lateral edge of the lateral tibial plateau. (C) A Micro Suture Lasso Small Curve (arrowhead) with Nitinol Wire Loop was inserted and penetrated the meniscus from superior to inferior at the margin between the meniscus and the capsule. (D) The displaced meniscus was centralized after stabilization of the mid body of the lateral meniscus (arrow) by 2 anchors (arrowheads).
Figure 3
Figure 3
Magnetic resonance image at 3 months postoperatively showed that the mid body of the lateral meniscus (arrow) was well positioned without extrusion.
See this image and copyright information in PMC

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