Arthroscopic meniscal repair with an all-Inside suture system

Objective: Application of an arthroscopic suture system to restore the form and function of the meniscus by adaptation of a longitudinal tear close to the base. Indications: Unstable longitudinal tears near the base of the meniscus, mainly in the posterior horn of the medial or lateral of the meniscus. Dislocated bucket-handle tears of the medial and lateral meniscus close to the base. Contraindications: Poor tissue quality with fibrillated meniscal tissue. Meniscal tears in the avascular zone (zone I). Insufficient blood supply from the joint capsule and the base of the meniscus. Degenerative meniscal lesions. Anterior or posterior knee joint instability. Allergic reactions to nonresorbable suture material. Surgical Technique: Standard anterior arthroscopic portals. Arthroscopic assessment of the meniscal tear using the probe. Revitalization of the tear margins and perforation of the meniscal base to induce bleeding. Adaptation of the tear margins and fixation with a suture-anchor system using an ipsilateral standard portal for tears in the posterior horn or by way of a contralateral standard portal for tears in the lateral horn. Postoperative Management: Full weight bearing with the knee in extension in a knee immobilizer, relative to the pain threshold in the 1st postoperative week. Range of motion exercises without weight bearing from full extension to 90° knee flexion (0/0/90). © Urban & Vogel München 2006.