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Arthroscopic all-inside ramp lesion repair using the posterolateral transseptal portal view

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

Abstract

Purpose

The purpose of this study was to evaluate and describe the clinical results and outcomes of a novel method for all-inside suture repair of medial meniscus ramp lesions through posteromedial and posterolateral transseptal portals during anterior cruciate ligament (ACL) reconstruction. Further, this investigation compared the posterolateral view to the notch view for diagnosis and repair.

Methods

Between 2011 and 2014, 166 patients had ramp lesions concomitantly with ACL injury; 128 patients (107 men and 21 women) were enrolled in the study after qualification. All patients underwent repair of the posterior horn ramp lesion of the medial meniscus, using a suture hook device with PDS No. 1 through a posteromedial portal while viewing from the posterolateral transseptal portal during ACL reconstruction, with a minimum of a 2-year follow-up.

Results

Patients were followed up for a minimum of 2 years (range 24–47 months). Their average Lysholm score increased from 61.7 ± 3.2 preoperatively to 87.8 ± 3.9 at last follow-up (p < 0.001). Moreover, their average IKDC scores also improved from 53.6 ± 2.1 (pre-op) to 82.1 ± 3.5 (at last follow-up) (p < 0.001). The peroneal nerve and the popliteal neurovascular bundle were not damaged in any of the patients.

Conclusion

This study provides evidence that the posterolateral transseptal technique protects neurovascular structures. This technique may be used safely and easily for repair of the posterior horn ramp lesion of the medial meniscus during ACL reconstruction.

Level of evidence

IV.

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Abbreviations

ACL:

Anterior cruciate ligament

MFC:

Medial femoral condyle

PHMM:

Posterior horn of medial meniscus

PCL:

Posterior cruciate ligament

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Acknowledgements

The authors gratefully appreciate Dr. Jin Hwan Ahn and Professor René Verdonk for their help and guidance.

Authors’ contributions

SK developed the original idea and the protocol and defined the intellectual content. MA developed the protocol. RV and JHA supervised the study. MS prepared and drafted the manuscript.

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Authors and Affiliations

  1. Orthopedic Department Chair, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Sohrab Keyhani

  2. Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

    Jin Hwan Ahn

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

    René Verdonk

  4. Guilan University of Medical Sciences, Rasht, Iran

    Mehran Soleymanha

  5. Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mohammadreza Abbasian

Authors
  1. Sohrab Keyhani
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  2. Jin Hwan Ahn
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  3. René Verdonk
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  4. Mehran Soleymanha
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  5. Mohammadreza Abbasian
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Corresponding author

Correspondence to Mehran Soleymanha.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

No funding was received for this study.

Ethical approval

This study was approved by the ethics committee of Akhtar orthopedic training and research hospital (ID 9745).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Keyhani, S., Ahn, J.H., Verdonk, R. et al. Arthroscopic all-inside ramp lesion repair using the posterolateral transseptal portal view. Knee Surg Sports Traumatol Arthrosc 25, 454–458 (2017). https://doi.org/10.1007/s00167-016-4410-9

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  • DOI: https://doi.org/10.1007/s00167-016-4410-9

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