[Avulsion injury to the posterior horn of the lateral meniscus. Technique for arthroscopic refixation].
An avulsion of the posterior tibial insertion of the meniscus (root tear) is a rare clinical diagnosis. Yet, due to the inconsistent clinical symptoms and the difficult arthroscopic assessment, an injury to the root of the meniscus can be easily missed. We present a possible technique for arthroscopic management of root tears using a tibial tunnel approach. A possible injury mechanism could be a rotational distortion of the knee. Another mechanism of injury is an overly posterior tunnel placement in ACL reconstruction. The clinical assessment of the lesion is based on thorough arthroscopic diagnosis of the lateral posterior horn in the figure of 4 position. A tibial ACL aimer can be used to locate a K-wire in the anatomical footprint of the posterior root of the meniscus. After overdrilling using a 4.5-mm drill, two sutures can be passed through the meniscal tissue and the sutures can be pulled out of the tibial tunnel. Extracortical fixation can be used by tying the sutures over a button.A root tear of the meniscus is a difficult clinical and arthroscopic diagnosis. A possibility for refixation of this lesion is to use a tibial tunnel technique. An associated injury to the ACL facilitates the tunnel placement and the suture management.
Petersen
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Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum, Waldeyer-Strasse 1, 48149 Münster, Deutschland. Wolf.Petersen@ukmuenster.de
Zantop
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T
D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D001864:Bone Wires; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000601:surgery*; D008592:Menisci, Tibial / Q000601:surgery; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D012086:Reoperation; D053441:Suture Anchors; D013537:Sutures; D000070600:Tibial Meniscus Injuries