2017 ISAKOS Biennial Congress ePoster #1350

 

Repair Of Meniscal Ramp Lesions Through A Double Posteromedial Portal: A Cadaveric Study

Cecile Toanen, MD, La Roche-Sur-Yon FRANCE
Matthieu Sanchez, MD, Boulogne FRANCE
Philippe Boisrenoult, MD, Le Chesnay FRANCE
Jean Sebastien Beranger, MD, Le Chesnay FRANCE
Philippe Beaufils, MD, Versailles FRANCE
Nicolas Pujol, MD, Le Chesnay FRANCE

Versailles Hospital, LE CHESNAY, FRANCE

FDA Status Not Applicable

Summary

This study demonstrate the technical feasibility of a direct repair of meniscal ramp lesion through a new double posteromedial portal.

Abstract

Purpose

The aim of this study was to establish the feasibility of suture repair of medial meniscal ramp lesion by a new arthroscopic approach, using a double posteromedial portal.

Material And Methods

Eleven fresh cadaveric knees were used. Two posteromedial portals were created under direct arthroscopic visualization via a standard anterolateral portal: the standard instrumental portal and the additional optical portal (more proximal). A 2 cm vertical tear at the meniscocapsular junction of the posterior horn of the medial meniscus was created. An all-inside suture repair using a suture hook device was performed with one or two sliding knot PDS N°0. The stability and quality of the suture were tested with the probe. A dissection of the posteromedial corner was then performed to evaluate anatomic relationships with posteromedial portals: saphenous vessels, medial saphenous nerve, hamstrings and adductor tendons were dissected.

Results

Direct meniscal ramp lesion repair using a suture hook device through a double posteromedial portal has always been possible. The suture was always good quality and stable using probe. A single knot was achieved in 4 cases and two knots were needed in 7 cases. The average skin distance between the two posteromedial portals was 3.8 cm +/-0.2. No nerve, vascular, muscular or tendon damage have been identified.

Conclusions

A direct repair of medial meniscus ramp lesions is achievable through a double posteromedial arthroscopic portal. This new arthroscopic technique, which provides improved vision of this type of lesion, could allow a quality suture without specific complications.