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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 26, Issue 12, pp 3611–3619 | Cite as

The popliteus tendon provides a safe and reliable location for all-inside meniscal repair device placement

  • Hervé Ouanezar
  • William G. Blakeney
  • Charles Latrobe
  • Adnan Saithna
  • Levi Reina Fernandes
  • Jean Romain Delaloye
  • Mathieu Thaunat
  • Bertrand Sonnery-CottetEmail author
Knee
  • 343 Downloads

Abstract

Purpose

Repairs of the posterior horn of the lateral meniscus can be technically challenging. In contrast to medial meniscus repairs, the capsule around the posterior segment attachment of the lateral meniscus is quite thin. This study evaluates the clinical results of an arthroscopic all-inside repair technique for unstable, vertical, lateral meniscus tears, using a suture repair placed directly into the popliteus tendon.

Methods

A retrospective analysis of prospectively collected data from the SANTI database was performed. All patients who had undergone combined ACL reconstruction with lateral meniscus all-inside repair, using sutures placed in the popliteus tendon, between 2011 and 2015, were included. Patients were reviewed clinically at 1 and 2 years’ follow-up. At final follow-up, all patients were contacted to identify if they underwent further surgery or had knee pain, locking or effusion. Symptomatic patients were recalled for clinical evaluation by a physician and Magnetic Resonance Imaging of the knee. Operative notes for those undergoing further surgery were reviewed and rates and type of re-operation, including for failed lateral meniscal repair were recorded.

Results

Two hundred patients (mean age 28.6 ± 10.2 years) with a mean follow-up of 45.5 ± 12.8 months (range 24.7–75.2) were included. The mean Subjective International Knee Documentation Committee (IKDC) at final follow-up was 85.0 ± 11.3. The post-operative mean side-to-side laxity measured at 1 year was 0.6 ± 1.0 mm. Twenty-six patients underwent re-operation (13%) at a mean follow-up of 14.8 ± 7.8 months. The ACL graft rupture rate was 5.0%. Other causes for re-operation included medial meniscus tear (2.5%), cyclops lesion (1.5%) and septic arthritis (0.5%). The lateral meniscus repair failure rate was 3.5%. No specific complications relating to placement of sutures in the popliteus tendon were identified.

Conclusion

Arthroscopic all-inside repair of unstable, vertical, lateral meniscus tears using a suture placed in the popliteus tendon is a safe technique. It is associated with a very low failure rate with no specific complications.

Level of evidence

Level IV.

Keywords

ACL rupture Lateral meniscus tears All-inside repair Meniscal repair Popliteus tendon 

Notes

Funding

No funding was received for this study.

Compliance with ethical standards

Conflict of interest

B.S.-C. is a paid consultant, receives royalties and research support, and has made presentations for Arthrex. M.T. is a paid consultant, receives research support, and has made presentations for Arthrex. A.S. is a paid consultant for Arthrex.

Ethical approval

This study received institutional review board (IRB) approval from Ramsay Générale de Santé. IRB’s number which was assigned is: COS-RGDS-2018-02-001-Avis IRB-SONNERY COTTET-B. This study was performed in accordance with the Declaration of Helsinki ethical standards.

Informed consent

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

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  • Hervé Ouanezar
    • 1
  • William G. Blakeney
    • 1
  • Charles Latrobe
    • 1
  • Adnan Saithna
    • 2
  • Levi Reina Fernandes
    • 1
  • Jean Romain Delaloye
    • 1
  • Mathieu Thaunat
    • 1
  • Bertrand Sonnery-Cottet
    • 1
    Email author
  1. 1.Centre Orthopédique Santy, FIFA Medical Center of Excellence, Ramsay-Générale de SantéHôpital Privé Jean MermozLyonFrance
  2. 2.Department of Orthopaedic SurgerySouthport and Ormskirk HospitalSouthportUK

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