Clinical case of continuous lasso-loop overlocking repair of horizontal medial meniscal tear in right knee. The procedure is performed with the patient in the supine position on the operating table with a tight tourniquet; the knee is flexed to 90°. After tear debridement, we insert a spinal needle with a No. 0 FiberWire suture through the skin from the posteromedial aspect of the knee in the safe zone, as described for the classic outside-in technique. The needle tip initially penetrates the superior part of the tear. We grasp the suture and pass it through the anteromedial portal. Subsequently, we pull the needle back to the level of the red zone of the meniscus and then penetrate the inferior part of the tear. This maneuver creates a loop, through which we pass the free end of the suture with a probe or a suture grasper. Next, we pull the free end of the stitch, which has been passed through the spinal needle’s eye. Finally, we tighten the stitch. We repeat this maneuver several times until we create a stable W-shaped configuration of overlocking stitches. In the final stage, all stitches are checked with the probe and tightened if needed. At the end of the procedure, both ends of the sutures are aligned to the anteromedial portal with a suture manipulator, creating a classic nonsliding knot. The knot is placed under the inferior surface of the meniscus to prevent abrasion and irritation of the cartilage. Finally, a stable construction is confirmed with the probe. In case of vertical tears, the same technique can be successfully used to attain a solid repair.
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
- Changes in contact area in meniscus horizontal cleavage tears subjected to repair and resection.Arthroscopy. 2017; 33: 617-624
- Lateral meniscus replacement using peroneus longus tendon autograft.Arthrosc Tech. 2020; 9: e1163-e1169
- Management of traumatic meniscus tears: The 2019 ESSKA meniscus consensus.Knee Surg Sports Traumatol Arthrosc. 2020; 28: 1177-1194
- All-inside meniscus repair method for injury of the margin of the anterior segment of the meniscus.Arthrosc Tech. 2018; 7: e215-e218
- Repair of peripheral vertical meniscus lesions in porcine menisci: In vitro biomechanical testing of 3 different meniscus repair devices.Am J Sports Med. 2013; 41: 1074-1081
- Outside-in single-lasso loop technique for meniscal repair: Fast, economic, and reproducible.Arthrosc Tech. 2018; 7: e1191-e1196
- A new technique to improve tissue grip: “The lasso-loop stitch.”.Arthroscopy. 2006; 22: 1246.e1-1246.e3
- Margin convergence in rotator cuff repair: The shoelace technique.Arthrosc Tech. 2018; 7: e823-e827
- Ultrasound-assisted arthroscopic all-inside repair technique for posterior lateral meniscus tear.Arthrosc Tech. 2022; 11: e929-e935
- Implant associated meniscus micro-tears: Imaging human cadaveric menisci.Arthroscopy. 2021; 37: e5
- Inside-out bucket-handle meniscus repair with a single-handed self-advancing zone-specific meniscus repair device.Arthrosc Tech. 2020; 9: e117-e121
The author reports the following potential conflicts of interest or sources of funding: O.M. receives personal fees from Arthrex (paid workshop at 2021 Kazan Artromaster Congress, paid lecture at 2022 Sochi Artroclub Congress, and 2020 Moscow Arthrex Conference) and DePuy Synthes (paid workshop at 2021 St Petersburg Vreden Readings Congress), outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
User LicenseCreative Commons Attribution – NonCommercial – NoDerivs (CC BY-NC-ND 4.0) |
For non-commercial purposes:
- Read, print & download
- Redistribute or republish the final article
- Text & data mine
- Translate the article (private use only, not for distribution)
- Reuse portions or extracts from the article in other works
- Sell or re-use for commercial purposes
- Distribute translations or adaptations of the article
Elsevier's open access license policy