Complications in medial meniscus suture: a cadaveric study |
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Authors: | Alejandro Espejo-Baena Pau Golano Stephan Meschian Jose Maria Garcia-Herrera J M Serrano Jiménez |
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Institution: | (1) Hospital Clinico Universitario Virgen de la Victoria, Paseo Reding, 9 – 1°C, 29016 Malaga, Spain;(2) Departamento de Anatomia y Embriologia Humana (Unidad Bellvitge), Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain |
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Abstract: | The aim of this study was to examine the possibility of complications in medial meniscus repair using an inside-out suturing
device. Anatomical cadaveric study. Six fresh frozen cadaveric lower limbs were used. The posterior horn of the medial meniscus
was sutured using three vertical stitches. An anatomical dissection was subsequently performed to check for any possible effects
upon the structures of the medial aspect of the knee. In addition, an incision was made in a safety zone in order to ascertain
whether it was possible to carry out the suture without affecting the aforementioned structures. No vascular or nervous structures
were pierced by the needle. On knotting, it was found that a number of different structures had become trapped: the sartorial
tendon was affected in each of the specimens used. In four cases, the saphenous vein was trapped by some of the knots. The
saphenous nerve was trapped in four instances. Once this had been established, a small accessory incision was made to provide
access to a safety zone, where suture can be performed without affecting any neurovascular or tendinous structures. Inside-out
suture of the posterior meniscal horn carries a high incidence of entrapment of the neurovascular structures of the medial
aspect of the knee. The sartorial tendon is constantly affected. Such complications can easily be avoided by entering the
safety zone via a small auxiliary incision. This study provides evidence that complications affecting the peripheral structures
of the medial aspect of the knee may arise during inside-out suture of the posterior horn of the medial meniscus and proposes
a simple method of averting them. |
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Keywords: | Arthroscopy Surgery Meniscus Knee Suture |
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