Surgical techniques and outcomes of repairing meniscal. Surgical treatment of meniscus tears of the knee greg i. He coinvented the arthrex meniscal cinch used by surgeons around the world for repairing a torn meniscus and developed several surgical videos used for educating surgeons in advanced techniques in knee and shoulder arthroscopy. Surgical technique surgical indications when a repairable tear is identi. Numerous techniques and multiple devices have been introduced and present the clinician with a vast array of surgical options. The patient is positioned supine on the operating table, the foot of the bed is lowered, and the contralateral leg is abducted. The lowprofile peek implants are loaded with a pretied 20 fiberwire suture that. The purpose of this prospective study was to evaluate and compare the results of arthroscopic meniscal repair using three different techniques. Jul 21, 2006 the purpose of this prospective study was to evaluate and compare the results of arthroscopic meniscal repair using three different techniques. Jul 19, 2017 meniscal repair provides improved longterm outcomes, better clinical outcome scores, and less severe degenerative changes seen radiographically compared with partial meniscectomy. Like its predecessor, the fastfix 360 system has biomechanical properties that best reproduce the vertical mattress suture technique.
Meniscal repair is supported by wellfounded biomechanic principles. Video 1 insideout meniscal repair technique and corresponding posterolateral and posteromedial surgical approaches. Factors affecting success include tear age, location and pattern, age of the patient, as well as any associated injuries. Meniscal repair should take into account the strength of suture and compression at the surgical site. Simplified arthroscopic lateral meniscal root repair. The ideal method for holding the meniscal cinch is also shown. The new meniscal tissue is anchored into the shinbone to stabilize the transplant. Sequential meniscal running stitch surgical technique. Deploy the implant by squeezing the trocar and handle together. Set needle depth penetration from 10 mm to 18 mm with the simple push of a button.
This treatise offers wisdom aimed at assessing true surgical candidates, exploring the intricacies of meniscal composition and function, an. If the tear is amenable to repair this will be attempted. Surgical technique the meniscal cinch is packaged with 2 small peek implants polyetheretherketone loaded onto small needles. You can count on a strong, reproducible and reliable meniscal repair. Target small, medium, or large meniscal repairs with ease, using as few as two or as many as six continuous stitches. New arthrex ar4500 meniscal cinch surgical supplies for sale. Meniscal injuries management and surgical techniques. A suture technique for easier reduction and repair of. The lowprofile peek implants are loaded with a pretied 20. This article presents an arthroscopic lateral meniscal root repair technique involving the use of 2 simple cinch loop configuration sutures and tibial suture anchor fixation. Meniscal repair by allinside technique with fastfix device.
Surgical technique figure 1 overview maxfire meniscal repair system the maxfire meniscal repair system is an allinside, allsuture anchor meniscal repair system. Watch as craig undergoes surgery to correct a lateral meniscus tear in his knee. Arthroscopic meniscal repair with an absorbable screw. The outsidein technique was used in 17 patients group a, the insideout in 20 patients group b, while the rest of the 20. The menisci directly influence the transmission of forces, distribution of load, amount of contact force, and pressure distribution patterns. May 24, 2019 arthroscopy association of north america.
Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. As with all arthroscopic procedures, good visualization of the meniscal tear and adequate arthroscopic distention are essential. Arthroscopic meniscal repair using the meniscal cinch. The meniscal cinch ii brings allinside meniscal repair to a new level of.
We described a new technique for meniscal repair called butterfly technique using viper device and hypothesized that high primary. Designs offered include the banana knife, hook knife, and push knife. The technique uses a cannula system to safely and precisely control the placement of meniscal sutures. Our aim in the employment of this new technique for the repair of buckethandle meniscal tears was to provide a simpler and safer surgical treatment for such challenging tears and a more convenient environment for suturing of these tears, especially for surgeons with limited experience. One of the important factors effecting meniscal healing is the strength of primary fixation obtained by repairing technique. This is beyond a gathering of orthopaedic surgeons.
Typically, a 2 to 4inch incision is made in the knee with a few other small poke holes. Meniscal repair provides improved longterm outcomes, better clinical outcome scores, and less severe degenerative changes seen radiographically compared with partial meniscectomy. The meniscal cinch ii technique offers a linear deployment mechanism to provide ergonomic handling and simplicity. Allinside arthroscopic meniscal repair with meniscal cinch ncbi. Aana advanced arthroscopic surgical techniques 1st edition by nicholas a sgaglione copublished with the arthroscopy association of north america, the knee. I would recommend this book to surgical trainees and it has certainly met the authors aims. A suture technique for easier reduction and repair of bucket. Meniscal cinch with metal cannula showing black markings in 2mm increments white arrow, depth stop with white markings in 2mm increments black arrow, and delivery needles 1 and 2 stars.
The lowprofile cannula allows flexibility in tight locations in the knee and the crimped cannula supports active implant deployment. Anterior horn meniscal repair using an outsidein suture. Hold the meniscal cinch by placing the index finger above the cannula, the middle finger below the cannula and the first trocar pinched between the base of the thumb and index fingers. Nakamoto, md facp section of orthopedics and sports medicine virginia mason medical center. The outsidein technique was used in 17 patients group a, the insideout in 20 patients group b, while the rest of the 20 patients group c were managed by the allinside technique using the mitek rapidloc soft tissue anchor mitek surgical products, westwood, ma, usa. The ultra fastfix meniscal repair system also gives the surgeon the versatility of placing horizontal or vertical mattress suture fixation, without risk to neurovascular structures. A novel threedimensional method of measuring labral and capsule volume to predict recurrent. If you are using adblocking software, please disable it and reload the page. Thoroughly discussing the varied elements of meniscal damage and repair, meniscal injuries. Mark adickes explains how a meniscal cinch surgery is performed to relieve chronic knee pain. Allinside arthroscopic meniscal repair with meniscal cinch. This video is unavailable because we were unable to load a message from our sponsors.
Meniscal repair cdrom see all formats and editions hide other formats and editions. More recently, case reports documenting morbidities associated with the use of newer generation meniscal repair fixators. Subjects will be followed for 2 years to evaluate the effectiveness of the repair, by assessing the reoperation rate, and by assessing improvements in knee pain and knee function. From this perspective, it is important to choose the technique ensuring a higher primary fixation strength for meniscal repairs. The time from index surgery to onset of symptoms, the nature. Horizontal meniscus tears meeting specified criteria will be repaired by any commonly used suture technique. This article presents an arthroscopic lateral meniscal root repair technique involving the use of 2 simple cinchloop configuration sutures and tibial suture anchor fixation. Given the potential longterm sequelae of meniscal pathology, patients with symptomatic meniscal tears warrant a thorough assessment with surgical consultation to. Then, the posteromedial approach is shown on a cadaver. Surgical techniques meniscus repair we have previously described in detail our insideout surgical technique for meniscus repair,52,80,81 which is similar to that originally described by henning. Thus the menisci serve many vital functions to the knee joint, and thus the preservation. The meniscal cinch is packaged with 2 small peek implants polyetheretherketone loaded onto small. The meniscal knives are great tools for dealing with meniscal tears or softtissue resection.
All inside arthroscopic meniscal repair with meniscal cinch. New arthrex ar4500 meniscal cinch surgical supplies for. Arthrex arthrex meniscal cinch ii outpatient surgery magazine. Management and surgical techniques includes the insights and expertise of over 20 leading surgeons and researchers on topics ranging from meniscal anatomy, physical examination, innovative resection and repair techniques, gene therapy, and tissue regeneration. The meniscal repair technique, total number of sutures, and suture material were analyzed. A meniscal repair is a surgical procedure to repair a torn meniscus via keyhole surgery. Price new from used from multimedia cd please retry. The speedcinch brings meniscal repair to a new level of effectiveness, safety and speed.
Suturebased arthroscopic repair promotes healing and. Surgical technique of meniscal replacement sciencedirect. The needle tip is designed to be as atraumatic to the meniscus as possible, delivering reduced tissue tearing during. Apr 24, 2009 a comparison of the surgical techniques used for meniscal repairs, which is the best for the patient and is surgery always the answer. Between january 2002 and march 2004, 57 patients who met the inclusion criteria underwent an arthroscopic meniscal repair. The meniscal cinch implant allows surgeons to consistently repair meniscus tears with an allinside arthroscopic technique, eliminating the need for accessory incisions required for traditional insideout techniques that often result in additional morbidity. The meniscal cinch and ultra fastfix devices may be more desirable implants for use during allinside meniscal repair as they have superior biomechanical properties when compared with the maxfire. If the meniscal injury is unrepairable or there is a high likelihood that a repair may. Aana advanced arthroscopic surgical techniques is a comprehensive techniquebased book that presents the latest diagnostic and reconstructive techniques in arthroscopic surgery for the knee. A meniscal repair involves carefully stitching the torn edge of the meniscus via further specialised tools on the end of the endoscopes. Surgical decision making meniscal tears and osteoarthritis frequently coexist, but to.
Meniscal repair surgical techniques linkedin slideshare. A comparison of the surgical techniques used for meniscal repairs, which is the best for the patient and is surgery always the answer. This way, meniscal repair techniques have significantly developed in recent years. Us8961538b2 method and system for meniscal repair using. More stitches are placed into the meniscal transplant to sew it into place. The 70 arthroscope is used to examine posteromedial meniscal regions. The meniscal cinch is packaged with 2 small peek implants polyetheretherketone loaded onto small needles. The butterfly suture technique for meniscal repair. Thus the menisci serve many vital functions to the knee joint, and thus the preservation of meniscal tissue through repair is desirable. Whatever technique you use, obtaining compression before you leave the operating room is.
How to make a difficult knee surgery seem like a simple shoulder case. The outsidein technique was used in 17 patients group a, the insideout in 20 patients group b, while the rest of. Lateral meniscal root tears are most commonly associated with anterior cruciate ligament acl tears. Cannulas are available in straight, sidetoside curved and upwardcurved. Indications for an outsidein technique are similar to those established for traditional insideout techniques. Allinside arthroscopic meniscal repair with the arthrex meniscal. The surgical technique consisted firstly of stimulating the borders of the meniscal injury by abrading them with a shaver or specific rasps, and subsequently drilling the most external portion of the meniscus using a jelco no.
The meniscal cinch device allows surgeons to consistently repair meniscus tears with an allinside arthroscopic technique, eliminating the need for accessory incisions required for traditional insideout techniques that often result in additional morbidity. David caborn sequential meniscal running stitch using sequent conmed duration. Watch more videos from this episode watch as craig undergoes surgery to correct a lateral meniscus tear. Gill is unique in its presentation in that it is meant to be used as a howto technique guide that includes intraoperative photos taken with the arthroscope, detailing and illustrating each step in arthroscopic surgery of. The meniscal cinch ii device brings a new level of simplicity and safety to. Event description it was reported that the first implant was inserted correctly but upon insertion of the second trocar, the knot did not slide all the way down to the meniscus. Sequent offers three different size configurations, allowing. The meniscal cinch allows surgeons to consistently repair meniscus tears with an allinside arthroscopic technique, eliminating. Feb 15, 2016 video 1 insideout meniscal repair technique and corresponding posterolateral and posteromedial surgical approaches. There have been advances in both surgical techniques e.
The meniscal cinch assembly 100 of the present invention allows surgeons to repair meniscus tears with an allinside arthroscopic technique eliminating the need for accessory incisions required for traditional insideout techniques that often result in additional morbidity. Study of suture repair of torn meniscus in the knee full. Meniscal tears are the most common indication for knee surgery. Twotunnel meniscal root repair surgical video feat. The suture comes pretied with a sliding, locking knot. The meniscal cinch implant allows surgeons to consistently repair meniscus tears with an allinside arthroscopic technique, eliminating the need for accessory. By nyu langone orthopedics featuring laith jazrawi, shane blackmore. It is a minimally invasive procedure often undergone as an outpatient. The risk of complications from meniscal transplant surgery is very slight. A reusable handle also provides better gripping in wet environments. Surgical techniques and outcomes of repairing meniscal radial. This article presents an arthroscopic lateral meniscal root repair technique involving the use of 2 simple cinch. Meniscal repair techniques orthopaedic product news. He coinvented the arthrex meniscal cinch used by surgeons around the.
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