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Arthroscopic Meniscectomy with Medial Collateral Ligament Trephination

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Knee Arthroscopy and Knee Preservation Surgery

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Abstract

Symptomatic irreparable meniscal tears that have failed nonoperative management can be managed surgically with arthroscopic partial meniscectomy. Tear patterns that are generally not amenable to repair include degenerative horizontal tears, complex tear patterns, oblique tears, and chronic bucket-handle tears. Arthroscopic meniscectomy can be performed with standard anterolateral and anteromedial portals. Portal placement is key for successful visualization and access of meniscal tears. Certain arthroscopic instruments should be made available including variably angled meniscal biters, shavers, standard 30-degree arthroscopes, and 70-degree arthroscopes for less readily accessible locations. Visualization of the posterior horn medial meniscus can be challenging in some knees. Percutaneous medial collateral ligament (MCL) trephination is a safe and effective measure that can significantly improve visualization and access to the medial posterior horn and posterior root so that the surgeon can identify the tear pattern and manage the lesion appropriately while minimizing the risk of iatrogenic chondral injury. Several case examples are presented in this chapter to illustrate surgical considerations with regards to arthroscopic meniscectomy.

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Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, University of California, San Francisco, San Francisco, CA, USA

    Rami George Alrabaa & Brian Feeley

Authors
  1. Rami George Alrabaa
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  2. Brian Feeley
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Corresponding author

Correspondence to Rami George Alrabaa .

Editor information

Editors and Affiliations

  1. Sports Medicine Clinic, Stanford University, Redwood City, CA, USA

    Seth L. Sherman

  2. Midwest Orthopedics, Rush University, Chicago, IL, USA

    Jorge Chahla

  3. Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA

    Scott A. Rodeo

  4. Complex Knee and Sports Medicine Surgeon, Twin Cities Spine Center, Edina, MN, USA

    Robert LaPrade

Section Editor information

  1. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA

    Aaron J. Krych

  2. Research Foundation, Centers for Advanced Orthopaedics (CAO), Washington, DC, USA

    Scott C. Faucett

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Alrabaa, R.G., Feeley, B. (2023). Arthroscopic Meniscectomy with Medial Collateral Ligament Trephination. In: Sherman, S.L., Chahla, J., Rodeo, S.A., LaPrade, R. (eds) Knee Arthroscopy and Knee Preservation Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-82869-1_21-1

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  • DOI: https://doi.org/10.1007/978-3-030-82869-1_21-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-82869-1

  • Online ISBN: 978-3-030-82869-1

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