Clinical observation of arthroscopic all-inside combined with outside-in “suture loop” repair for meniscus bucket-handle tear_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

Maimaitikelimu·tusongjiang , JIA Yong ,  XU Gang , HE Chunqing , ZHANG Fei , LIU Jian , WANG Pengbo , Wumuerbieke

Department of Orthopaedics, Urumqi General Hospital of Military, Urumqi Xinjiang, 830000, P.R.China;

Corresponding author：

XU Gang, Email: jxugang@sina.com

Keywords：

Menisics; bucket-handle tear; outside-in “suture loop” repair; arthroscope

DOI：

10.7507/1002-1892.202003132

Video：

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Objective To investigate the effectiveness of arthroscopic all-inside combined with outside-in “suture loop” repair for meniscus bucket-handle tear (BHT).Methods Between August 2016 and May 2019, 44 case of meniscus BHT were treated with arthroscopic all-inside combined outside-in “suture loop”. There were 29 males and 15 females with an average age of 26.6 years (range, 18-42 years). The causes of injury included sports injury in 31 cases, falling injury in 7 cases, and sprain in 6 cases. There were 32 cases of medial meniscus posterior horn tears and 12 cases of lateral meniscus posterior horn tears. The disease duration ranged from 6 weeks to 3 months. Thirty-three cases were complicated with anterior cruciate ligament rupture. All patients had normal lower limb alignment. The preoperative Lysholm score was 42.1±9.1. According to the evaluation criteria of MRI and Barrett et al., the healing of meniscus was evaluated, and the effectiveness was evaluated by Lysholm score.Results All the 44 patients were followed up 8-36 months with an average of 16.8 months. At last follow-up, according to the evaluation criteria of Barrett et al., 39 cases were clinically healed, 5 cases were not healed, the clinical healing rate was 88.6%; according to MRI evaluation, 32 cases were completely healed, 7 cases were partially healed, and 5 cases were not healed, the total healing rate was 88.6%, and the complete healing rate was 72.7%. Lysholm score was 87.8±4.8, which was significantly different from that before operation (t=31.060, P=0.000).Conclusion Arthroscopic all-inside combined with outside-in “suture loop” repair is a reliable and effective method for the meniscus BHT, which can obtain good joint function.

Citation： Maimaitikelimu·tusongjiang, JIA Yong, XU Gang, HE Chunqing, ZHANG Fei, LIU Jian, WANG Pengbo, Wumuerbieke. Clinical observation of arthroscopic all-inside combined with outside-in “suture loop” repair for meniscus bucket-handle tear. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(10): 1238-1242. doi: 10.7507/1002-1892.202003132 Copy

1.	Dorsay TA, Helms CA. Bucket-handle meniscal tears of the knee: Sensitivity and specificity of MRI signs. Skeletal Radiol, 2003, 32(5): 266-272.
2.	Black AK. Editorial commentary: Don’t float away-medial collateral ligament and medial meniscus will protect your anterior cruciate ligament reconstruction if you respect them. Arthroscopy, 2019, 35(3): 938-939.
3.	Shoemaker SC, Markolf KL. The role of the meniscus in the anterior-posterior stability of the loaded anterior cruciate-deficient knee. J Bone Joint Surg (Am), 1986, 68(1): 71-79.
4.	Matteo BD, Tarabella V, Filardo G, et al. Thomas Annandale: the first meniscus repair. Knee Surg Sports Traumatol Arthrosc, 2013, 21(9): 1963-1966.
5.	Roldán E, Reeves ND, Cooper G, et al. In vivo mechanical behaviour of the anterior cruciate ligament: A study of six daily and high impact activities. Gait Posture, 2017, 58: 201-207.
6.	Musahl V, Rahnemai-Azar AA, Costello J, et al. The influence of meniscal and anterolateral capsular injury on knee laxity in patients with anterior cruciate ligament injuries. Am J Sports Med, 2016, 44(12): 3126-3131.
7.	Uchida R, Mae T, Hiramatsu K, et al. Effects of suture site or penetration depth on anchor location in all-inside meniscal repair. Knee, 2016, 23(6): 1024-1028.
8.	Soejima T, Tabuchi K, Noguchi K, et al. An all-inside repair for full radial posterior lateral meniscus tears. Arthrosc Tech, 2016, 5(1): e133-138.
9.	黄东红, 卢启贵, 王平, 等. 关节镜下双面立体缝合修复半月板桶柄状撕裂的中期疗效. 中国修复重建外科杂志, 2015, 29(2): 163-166.
10.	Barrett GR, Treacy SH, Ruff CH. Preliminary results of the T-fix endoscopic meniscus technique in an anterior cruciate ligament reconstruction population. Arthroscopy, 1997, 13(2): 218-223.
11.	李飞龙, 罗小辑, 梁熙, 等. 前交叉韧带解剖研究进展及其对韧带重建技术的影响. 中国修复重建外科杂志, 2018, 32(3): 377-381.
12.	骆俊. MRI 对膝关节半月板桶柄样撕裂的诊断价值. 影像研究与医学应用, 2017, 1(3): 44-45.
13.	Moatshe G, Cinque ME, Godin JA, et al. Comparable outcomes after bucket-handle meniscal repair and vertical meniscal repair can be achieved at a minimum 2 years’ follow-up. Am J Sports Med, 2017, 45(13): 3104-3110.
14.	Tachibana Y, Sakaguchi K, Goto T, et al. Repair integrity evaluated by second-look arthroscopy after arthroscopic meniscal repair with the Fast-Fix during anterior cruciate ligament reconstruction. Am J Sports Med, 2010, 38(5): 965-971.
15.	Barber FA, Coons DA, Ruiz-Suarez M. Meniscal repair with the RapidLoc meniscal repair device. Arthroscopy, 2006, 22(9): 962-966.
16.	Haas AL, Schepsis AA, Hornstein J, et al. Meniscal repair using the Fast-Fix all-inside meniscal repair device. Arthroscopy, 2005, 21(2): 167-175.
17.	Koh IJ, Kwak DS, Kim TK, et al. How effective is multiple needle puncturing for medial soft tissue balancing during total knee arthroplasty? A cadaveric study. J Arthroplasty, 2014, 29(12): 2478-2483.
18.	Funchal LFZ, Astur DC, Ortiz R, et al. The presence of the arthroscopic “floating meniscus” sign as an indicator for surgical intervention in patients with combined anterior cruciate ligament and grade Ⅱ medial collateral ligament injury. Arthroscopy, 2019, 35(3): 930-937.
19.	丁云鹏, 章亚东, 贾海港, 等. 关节镜下前交叉韧带重建联合同种异体半月板移植的中期疗效分析. 中国修复重建外科杂志, 2019, 33(9): 1071-1076.

1. Dorsay TA, Helms CA. Bucket-handle meniscal tears of the knee: Sensitivity and specificity of MRI signs. Skeletal Radiol, 2003, 32(5): 266-272.
2. Black AK. Editorial commentary: Don’t float away-medial collateral ligament and medial meniscus will protect your anterior cruciate ligament reconstruction if you respect them. Arthroscopy, 2019, 35(3): 938-939.
3. Shoemaker SC, Markolf KL. The role of the meniscus in the anterior-posterior stability of the loaded anterior cruciate-deficient knee. J Bone Joint Surg (Am), 1986, 68(1): 71-79.
4. Matteo BD, Tarabella V, Filardo G, et al. Thomas Annandale: the first meniscus repair. Knee Surg Sports Traumatol Arthrosc, 2013, 21(9): 1963-1966.
5. Roldán E, Reeves ND, Cooper G, et al. In vivo mechanical behaviour of the anterior cruciate ligament: A study of six daily and high impact activities. Gait Posture, 2017, 58: 201-207.
6. Musahl V, Rahnemai-Azar AA, Costello J, et al. The influence of meniscal and anterolateral capsular injury on knee laxity in patients with anterior cruciate ligament injuries. Am J Sports Med, 2016, 44(12): 3126-3131.
7. Uchida R, Mae T, Hiramatsu K, et al. Effects of suture site or penetration depth on anchor location in all-inside meniscal repair. Knee, 2016, 23(6): 1024-1028.
8. Soejima T, Tabuchi K, Noguchi K, et al. An all-inside repair for full radial posterior lateral meniscus tears. Arthrosc Tech, 2016, 5(1): e133-138.
9. 黄东红, 卢启贵, 王平, 等. 关节镜下双面立体缝合修复半月板桶柄状撕裂的中期疗效. 中国修复重建外科杂志, 2015, 29(2): 163-166.
10. Barrett GR, Treacy SH, Ruff CH. Preliminary results of the T-fix endoscopic meniscus technique in an anterior cruciate ligament reconstruction population. Arthroscopy, 1997, 13(2): 218-223.
11. 李飞龙, 罗小辑, 梁熙, 等. 前交叉韧带解剖研究进展及其对韧带重建技术的影响. 中国修复重建外科杂志, 2018, 32(3): 377-381.
12. 骆俊. MRI 对膝关节半月板桶柄样撕裂的诊断价值. 影像研究与医学应用, 2017, 1(3): 44-45.
13. Moatshe G, Cinque ME, Godin JA, et al. Comparable outcomes after bucket-handle meniscal repair and vertical meniscal repair can be achieved at a minimum 2 years’ follow-up. Am J Sports Med, 2017, 45(13): 3104-3110.
14. Tachibana Y, Sakaguchi K, Goto T, et al. Repair integrity evaluated by second-look arthroscopy after arthroscopic meniscal repair with the Fast-Fix during anterior cruciate ligament reconstruction. Am J Sports Med, 2010, 38(5): 965-971.
15. Barber FA, Coons DA, Ruiz-Suarez M. Meniscal repair with the RapidLoc meniscal repair device. Arthroscopy, 2006, 22(9): 962-966.
16. Haas AL, Schepsis AA, Hornstein J, et al. Meniscal repair using the Fast-Fix all-inside meniscal repair device. Arthroscopy, 2005, 21(2): 167-175.
17. Koh IJ, Kwak DS, Kim TK, et al. How effective is multiple needle puncturing for medial soft tissue balancing during total knee arthroplasty? A cadaveric study. J Arthroplasty, 2014, 29(12): 2478-2483.
18. Funchal LFZ, Astur DC, Ortiz R, et al. The presence of the arthroscopic “floating meniscus” sign as an indicator for surgical intervention in patients with combined anterior cruciate ligament and grade Ⅱ medial collateral ligament injury. Arthroscopy, 2019, 35(3): 930-937.
19. 丁云鹏, 章亚东, 贾海港, 等. 关节镜下前交叉韧带重建联合同种异体半月板移植的中期疗效分析. 中国修复重建外科杂志, 2019, 33(9): 1071-1076.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical observation of arthroscopic all-inside combined with outside-in “suture loop” repair for meniscus bucket-handle tear

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