Skip to main content

Advertisement

SpringerLink
Log in

Posterior knee arthroscopy facilitates the safe and effective all-inside repair of locked bucket-handle medial meniscal tear using a suture hook technique

  • KNEE
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study reported the outcomes of locked bucket-handle medial meniscal tear (BHMMT) repairs using an arthroscopic posterior approach during anterior cruciate ligament (ACL) reconstruction.

Methods

Between 2011 and 2014, 48 patients with BHMMTs and ACL tears who met the eligibility criteria were enrolled in the present study. BHMMTs were assessed using a posterolateral transseptal portal and repaired using a posteromedial portal. Transportal ACL reconstruction was performed using hamstrings autograft. Patients were assessed based on their IKDC and Lysholm scores and Tegner activity level. Meniscal healing was clinically evaluated based on the absence of swelling, joint line tenderness, locking, and catching; McMurray test results; and the need for meniscectomy.

Results

According to follow-up assessments, the average IKDC and Lysholm scores improved significantly after 3–5 years (P < 0.001)

Conclusion

 Excellent clinical outcomes were obtained when locked BHMMTs were repaired using an all-inside suture technique that employed posteromedial and posterolateral transseptal portals.

Level of evidence

IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ahn J-H, Ha CW (2000) Posterior trans-septal portal for arthroscopic surgery of the knee joint. Arthroscopy 16:774–779

    Article  CAS  PubMed  Google Scholar 

  2. Ahn JH, Kim K-I, Wang JH, Kyung BS, Seo MC, Lee SH (2015) Arthroscopic repair of bucket-handle tears of the lateral meniscus. Knee Surg Sports Traumatol Arthrosc 23:205–210

    Article  PubMed  Google Scholar 

  3. Ahn JH, Kim S-H, Yoo JC, Wang JH (2004) All-inside suture technique using two posteromedial portals in a medial meniscus posterior horn tear. Arthroscopy 20:101–108

    Article  PubMed  Google Scholar 

  4. Alabi IA, Bancha C, Artha A, Kanokvaleewong C, Pena RJ (2020) Arthroscopic procedure for revision of failed isolated bucket-handle meniscal tear repair. J Orthop 21:350–369

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Billières J, Pujol N (2019) Meniscal repair associated with a partial meniscectomy for treating complex horizontal cleavage tears in young patients may lead to excellent long-term outcomes. Knee Surg Sports Traumatol Arthrosc 27:343–348

    Article  PubMed  Google Scholar 

  6. Blanchard ER, Hadley CJ, Wicks ED, Emper W, Cohen SB (2020) Return to play after isolated meniscal repairs in athletes: a systematic review. Orthop J Sports Med 8:2325967120962093

    Article  PubMed  PubMed Central  Google Scholar 

  7. Buyukdogan K, Laidlaw MS, Miller MD (2017) Meniscal ramp lesion repair by a trans-septal portal technique. Arthrosc Tech 6:e1379–e1386

    Article  PubMed  PubMed Central  Google Scholar 

  8. Claret G, Montañana J, Rios J, Ruiz-Ibán M-Á, Popescu D, Núñez M et al (2016) The effect of percutaneous release of the medial collateral ligament in arthroscopic medial meniscectomy on functional outcome. Knee 23:251–255

    Article  PubMed  Google Scholar 

  9. Gaudiani MA, Knapik DM, Kaufman MW, Salata MJ, Voos JE, Karns MR (2020) Percutaneous superficial medial collateral ligament release outcomes during medial meniscal arthroscopy: a systematic review. Arthrosc Sports Med Rehabil 2:e153–e159

    Article  PubMed  PubMed Central  Google Scholar 

  10. Han X, Wang P, Yu J, Wang X, Tan H (2020) Arthroscopic pie-crusting release of the posteromedial complex of the knee for surgical treatment of medial meniscus injury. BMC Musculoskelet Disord 21:1–9

    Article  Google Scholar 

  11. Keyhani S, Ahn JH, Verdonk R, Soleymanha M, Abbasian M (2017) Arthroscopic all-inside ramp lesion repair using the posterolateral transseptal portal view. Knee Surg Sports Traumatol Arthrosc 5:454–458

    Article  Google Scholar 

  12. Kim SH, Lee SH, Kim KI, Yang JW (2018) Diagnostic accuracy of sequential arthroscopic approach for ramp lesions of the posterior horn of the medial meniscus in anterior cruciate ligament-deficient knee. Arthroscopy 34:1582–1589

    Article  PubMed  Google Scholar 

  13. Kongmalai P, Chernchujit B (2016) Posterior horn of medial meniscal peripheral capsular lesion: the arthroscopic repair technique working in the posterior compartment. Arthrosc Tech 5:e763–e767

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lee WQ, Gan JZ, Lie DTT (2019) Save the meniscus: clinical outcomes of meniscectomy versus meniscal repair. J Orthop Surg (Hong Kong) 27:2309499019849813

    Google Scholar 

  15. Lubowitz JH, Rossi MJ, Baker BS, Guttmann D (2004) Arthroscopic visualization of the posterior compartments of the knee. Arthroscopy 20:675–680

    Article  PubMed  Google Scholar 

  16. Malinowski K, Góralczyk A, Hermanowicz K, LaPrade RF (2019) Tips and pearls for all-inside medial meniscus repair. Arthrosc Tech 8:e131–e139

    Article  PubMed  PubMed Central  Google Scholar 

  17. Morgan CD (1991) The “all-inside” meniscus repair. Arthroscopy 7:120–125

    Article  CAS  PubMed  Google Scholar 

  18. Okazaki Y, Furumatsu T, Okazaki Y, Masuda S, Hiranaka T, Kodama Y et al (2020) Medial meniscus posterior root repair decreases posteromedial extrusion of the medial meniscus during knee flexion. Knee 27:132–139

    Article  PubMed  Google Scholar 

  19. Peltier A, Lording TD, Lustig S, Servien E, Maubisson L, Neyret P (2015) Posteromedial meniscal tears may be missed during anterior cruciate ligament reconstruction. Arthroscopy 31:691–698

    Article  PubMed  Google Scholar 

  20. Sonnery-Cottet B (2020) Editorial commentary: ramp lesion: the eye sees only what the mind is prepared to comprehend. Arthroscopy 36:2934–2937

    Article  PubMed  Google Scholar 

  21. Sonnery-Cottet B, Conteduca J, Thaunat M, Gunepin FX, Seil R (2014) Hidden lesions of the posterior horn of the medial meniscus: a systematic arthroscopic exploration of the concealed portion of the knee. Am J Sports Med 42:921–926

    Article  PubMed  Google Scholar 

  22. Tashiro Y, Mori T, Kawano T, Oniduka T, Arner JW, Fu FH et al (2020) Meniscal ramp lesions should be considered in anterior cruciate ligament-injured knees, especially with larger instability or longer delay before surgery. Knee Surg Sports Traumatol Arthrosc 28:3569–3575

    Article  PubMed  Google Scholar 

  23. Thaunat M, Fayard JM, Guimaraes TM, Jan N, Murphy CG, Sonnery-Cottet B (2016) Classification and surgical repair of ramp lesions of the medial meniscus. Arthrosc Tech 5:e871–e875

    Article  PubMed  PubMed Central  Google Scholar 

  24. Thaunat M, Fournier G, O’Loughlin P, Kouevidjin BT, Clowez G, Borella M et al (2020) Clinical outcome and failure analysis of medial meniscus bucket-handle tear repair: a series of 96 patients with a minimum 2 year follow-up. Arch Orthop Trauma Surg 140:1649–1654

    Article  PubMed  Google Scholar 

Download references

Funding

There is no funding source.

Author information

Authors and Affiliations

  1. Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran

    Sohrab Keyhani, Farzad Amouzadeh, Mohammad Movahedinia & Seyyed Morteza Kazemi

  2. Guilan University of Medical Sciences, Rasht, Iran

    Mehran Soleymanha

  3. Department of Orthopedics and Traumatology, Gent University, Ghent, Belgium

    Rene Verdonk

Authors
  1. Sohrab Keyhani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mehran Soleymanha
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rene Verdonk
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Farzad Amouzadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mohammad Movahedinia
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Seyyed Morteza Kazemi
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SK designed the study and was the main surgeon of the patients. He carried out the post-operative visits and drafted the manuscript and has given final approval of the version to be published. MS conveinced of the study and parcipitated in its drafting and design. RV helped to draft the manuscript and revisied the study design. FA hepled Keyhani during surgery and post-opeative visits and participated in data gathering. MM carried out data acquisition and analysis and interpretation of data. He revised the manuscript critically for important intellectual content. MK conveinced of the study and parcipitated in its design. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sohrab Keyhani.

Ethics declarations

Conflict of interest

All authors declared no conflict of interest.

Ethical approval

The study protocol was reviewed and approved by the local Ethics Committee.

Informed consent

Written informed consent was obtained from all patients before initiation of the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Keyhani, S., Soleymanha, M., Verdonk, R. et al. Posterior knee arthroscopy facilitates the safe and effective all-inside repair of locked bucket-handle medial meniscal tear using a suture hook technique. Knee Surg Sports Traumatol Arthrosc 30, 1311–1315 (2022). https://doi.org/10.1007/s00167-021-06576-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-021-06576-x

Keywords

Search

Navigation