Deep flexion helps to avoid popliteal artery injury during all-inside lateral meniscal repair: A cadaveric study |
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| Affiliation: | 1. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya City, Japan;2. Department of Orthopedic Surgery, Asahi University Hospital, Gifu City, Japan;3. Department of Orthopedic Surgery, Toyota Memorial Hospital, Toyota City, Japan;1. Anatomy Laboratory, Faculty of Medicine, University of Thessaly, Larissa, Greece;2. Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessalia, Larissa, Greece;3. Laboratory of Mechanics and Strength of Materials, Department of Mechanical Engineering, University of Thessaly Volos, Volos, Greece;4. Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA;1. Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan;2. Department of Orthopedic Surgery, Aichi Medical University, Yazakokarimata, Nagakute, Aichi 480-1195, Japan;1. Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan;2. Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya, Saitama 343-8555, Japan;1. Department of Orthopaedics, Ohio State University Wexner Medical Center, Columbus, OH, United States;2. Department of Orthopaedics, Sports Medicine, Ohio State University, Wexner Medical Center, United States;3. The Ohio State University College of Medicine, Ohio State University, Wexner Medical Center, United States;4. Sports Medicine, Cleveland Clinic Foundation, United States;5. Department of Psychology, Ohio State University, Columbus, OH, United States;6. Division of Physical Therapy, School of Health and Rehabilitation Sciences, Ohio State University and Jameson Crane Sports Medicine Research Institute, Ohio State University, United States;7. Cartilage Restoration Program, Ohio State University, Wexner Medical Center, United States;1. Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan;2. Department of Orthopaedic Surgery, University of Michigan, MI, USA;3. Deparment of Orthopaedic Surgery, Saiseikai Niigata Hospital, Niigata, Japan;4. Center for Fostering Innovative Leadership, Institute for Research Collaboration and Promotion, Niigata University, Niigata, Japan;1. Department of Sports Medicine, Rizhao People’s Hospital, Rizhao City, Shandong Province, China;2. Department of Neonatology, Rizhao People’s Hospital, Rizhao City, Shandong Province, China;3. Department of Orthopaedics,Pinccess Royal Hospital, West Sussex, UK |
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| Abstract: | BackgroundArthroscopic meniscus repair rarely leads to major complications such as popliteal artery injury. The distance between the suturing device and the popliteal artery, and the risk of popliteal artery injury at different knee flexion angles during all-inside lateral meniscal repair remain unclear.MethodsAll-inside devices were inserted into 10 human cadaveric knees at the posterior horn of the lateral meniscus through the anterolateral portal at 60°, 90°, and 120° knee flexion; posterior segment of the lateral meniscus through the anterolateral portal at 60°, 90°, and 120°; and anteromedial portal at 90°. Distance and positional relationship between the device and popliteal artery were measured radiographically.ResultsIn posterior horn repair through the anterolateral portal, the median distance increased from 5.7 mm at 60° to 9.1 mm at 90° (P = 0.63) and 18.0 mm at 120° (P = 0.02). The device pushed the wire at 60° in three cases, 90° in one case, and 120° in 0 cases. In posterior segment repair through the anterolateral portal, the median distance was 12.6 mm at 60°, 10.4 mm at 90°, and 18.3 mm at 120° (P = 0.08). The median distance at 90° was 18.1 mm through the anteromedial portal, the same as that at 120° through the anterolateral portal (P = 0.43), but greater than that at 90° through the anterolateral portal (P = 0.04). The wire was not pushed in any case.ConclusionAlthough all-inside repair of the posterior part of the lateral meniscus through the anterolateral portal is risky, deeper knee flexion reduces the risk of popliteal artery injury. |
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| Keywords: | Arthroscopy Cadaver Knee flexion Knee Meniscus Popliteal artery injury Anatomy |
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