MENISCAL SUTURE - sogacot.org · MENISCAL SUTURE Dr A. EspejoBaena Consultant in Orthopaedics Hospital ClínicoUniversitario Virgende la Victoria Málaga

MENISCAL SUTURE

Dr A. Espejo Baena

Consultant in Orthopaedics

Hospital Clínico Universitario

Virgen de la Victoria

Málaga

INDICATIONS

Young patient (<40 )

Stable Knee

Longitudinal tear

Red-Red Red-White

Meniscal Repair

Suturing is the best option:

•Better resistance to “pull out”

•Less incidence of complications

Anterior 2/3 of both

menisci

Medial MeniscusMeasurements

• Axial cut of medial

meniscus

• 3 Lines drawn

(COMPUTER

GENERATED NEEDLE)

• Meniscal suture

confluent point (most

posterior region)

Fernández de Rota Conde A, Mariscal Lara J, García Herrera JM, Alvarez I,

Amores F, Espejo Baena A.

Sutura de menisco interno: análisis del riesgo de lesión poplítea neurovascular

mediante resonancia magnética dinámica.

Cuadernos de Artroscopia. Vol.13. Supl.1. Núm.26. Febrero 2006.

Measurement

• Axial cut on medial

meniscus

• 3 Lines drawn

(COMPUTER

GENERATED NEEDLE)

• Meniscal suture


posterior region)






Medial Meniscus

Measurement


meniscus

• 3 Lines drawn

(COMPUTER

GENERATED NEEDLE)

• Meniscal suture


posterior region)






Medial Meniscus

Measurement


meniscus

• 3 Lines drawn

(COMPUTER

GENERATED NEEDLE)

• Meniscal suture


posterior region)






Medial Meniscus

1 2 3 4 5 6 7 8 9 10 AVERAG

E

DISTANCE 1

(Medial target

point)

2.12 2.22 2.05 1.86 2.35 1.98 2.94 1.93 2.41 1.86

2.17 cm

DISTANCE 2

(central

target point)

2.44 2.38 2.20 2.15 2.52 2.12 3.12 2.20 2.63 1.89

2.36 cm

DISTANCE 3

(Lateral

target point)

2.67 2.47 2.45 2.40 2.80 2.33 3.44 2.48 2.97 2.02

2.60 cm

Medial Meniscus

Distance to NV bundle

Distance to Comon Peroneal Nerve

Lateral Meniscus

1 2 3 4 5 6 AVERAG

E

DISTANCE 1

(Medial target

point)

1.60 1.00 0.90 1.60 1.50 1.00

1.27 cm

DISTANCIA 2

(Central

target point)

1.70 1.10 1.10 1.70 1.70 1.10

1.40 cm

DISTANCIA 3

(Lateral

target point)

1.80 1.90 1.30 1.90 1.80 1.20

1.65 cm

Distance to CPN

Lateral Meniscus

1 2 3 4 5 6 AVERAG

E

DISTANCE 1

(Lateral

Target Point)

1.20 1.30 1.60 1.40 0.90 1.90

1.37 cm

DISTANCIA 2

(Central

Target Point)

1.50 1.80 2.10 1.60 1.20 2.20

1.72 cm

DISTANCIA 3

(Medial

Target Point)

1.90 2.10 2.60 1.80 1.50 2.60

2.07 cm

Lateral Meniscus

Distance to the Plopliteus F. Structures

Posterior Horn of lateral meniscus:

“All inside” Technique

Medial Meniscus posterior Horn

CADAVERIC STUDY

O� MEDIAL ME�ISCUS REPAIR

6 fresh frozen lower limb cadavers

CADAVERIC STUDY

Inside-Out technique

3 vertical stiches

Simulation of posterior horn tear

RESULTS

�eedle puncture

�eurovascular Structures �one

Sartorius tendon in all specimens

RESULTS

Specimen Anterior Central Posterior

1 --- Sartorius Saph. Vein

Saph. Nerve

2 ---Sartorius

Deep Saph. VeinInfrapatellar Saph. N.

Branch

---

3 --- Sartorius

Saph. vein

Accesory Saph.

Vein

Saph. Nerve

4 --- Sartorius

Saph. Vein

SartoriusSaph. Nerve

Gracilis Tendon

5 --- --- Sartorius

6 --- Sartorius Sartorius

RESULTS

Structures Entrapment with knot

Saphenous �erve 4 specimens

Saphenous vein 4 specimens

Sartorius Tendon 6 specimens

Posterior Horn Medial Meniscus Repair

in ACL Reconstruction

Surgical Tecnique Objectives

Knotting in safety zone Avoiding entrapment

SummaryMeniscal repair:

� I-O Suturing is a good option(except post 1/3 of Lateral meniscus)

�Subcutaneous knotting in anterior 2/3

�In post 1/3 of Medial Meniscus knotting

on MCL

THANK YOU

Documents

MENISCAL SUTURE - sogacot.org · MENISCAL SUTURE Dr A. EspejoBaena Consultant in Orthopaedics Hospital ClínicoUniversitario Virgende la Victoria Málaga