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. 2024 Jan 17:35:81-84.
doi: 10.1016/j.asmart.2023.11.009. eCollection 2024 Jan.

Minimizing the risk of injury to the popliteal artery during pullout repair of medial meniscus posterior root tears: A cadaveric study

Yuta Mori  1 , Tomoaki Kamiya  1 , Shinichiro Okimura  1 , Kousuke Shiwaku  1 , Yohei Okada  1 , Atsushi Teramoto  1 , Toshihiko Yamashita  1
Affiliations

Minimizing the risk of injury to the popliteal artery during pullout repair of medial meniscus posterior root tears: A cadaveric study

Yuta Mori et al. Asia Pac J Sports Med Arthrosc Rehabil Technol. .

Abstract

Background: The purpose of this study was to investigate the positional effect of guide pins used in the transtibial pullout repair of medial meniscus posterior root tears on the popliteal artery.

Methods: We used eight cadaveric knees. Two 2.4-mm guide pins were inserted into the posterior root of the medial meniscus at 50° to the articular surface from the medial edge of the tibial tuberosity (anteromedial group) and the anterior edge of the medial collateral ligament (posteromedial group) using an aiming guide placed at the posterior root attachment of the medial meniscus from the anteromedial portal. The posterior capsule was dissected, and the popliteal artery was identified. The positional effect of the guide pins on the popliteal artery was photographed arthroscopically at 0°, 30°, 60°, and 90° knee flexion angles. The popliteal artery diameter and the minimum distance between the popliteal artery center and the guide pin tip were measured.

Results: At 90° knee flexion, most of the guide pins in the anteromedial (6 knees; 75 %) and posteromedial groups (7 knees; 87.5 %) collided with the femoral intercondylar wall. The rate of collision was significantly higher at the 90° knee flexion position than that at other angles (p = 0.02). The average shortest distance between the popliteal artery center and the guide pin tip at 0° knee flexion in the posteromedial group (5.4 mm ± 3.4 mm) was significantly greater than that at other knee flexion angles, although the mean distance in the posteromedial group was so negligible that the guide pin could penetrate the popliteal artery.

Conclusions: Knee flexion at 90° causes less damage to the popliteal artery during the transtibial pullout repair of medial meniscus posterior root tears.

Keywords: Medial meniscus posterior root tears; Popliteal artery; Transtibial pullout repair.

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Conflict of interest statement

The authors report that they have no conflicts of interest in the authorship and publication of this article.

Figures

Fig. 1
Fig. 1
Direction of guide pins insertion. In the anteromedial (AM) group, the guide pins were inserted from the medial edge of the tibial tuberosity; in the posteromedial (PM) group, they were inserted from the anterior edge of the medial collateral ligament.
Fig. 2
Fig. 2
Minimal distance between the center of the popliteal artery (PA) and the tip of the guide pin (double arrow).
Fig. 3
Fig. 3
Arthroscopic view of the left knee with 90° flexion. The guide pin struck the femoral intercondylar wall. PA, popliteal artery.
Fig. 4
Fig. 4
Number of guide pins that struck the femoral intercondylar wall. In both groups, the rate of collision of the guide pins with the intercondylar wall is significantly higher at the 90° knee flexion position compared with that at other angles (*p < 0.01). AM, anteromedial; PM, posteromedial.
Fig. 5
Fig. 5
Arthroscopic view of the left knee with 0° flexion. The guide pin came in contact with the popliteal artery (PA).
See this image and copyright information in PMC

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