Arthroscopic outside-in “two-needle suture” technique for anterior horn tears of the lateral meniscus

Background

The outside-in suture technique is regarded as a practical method for treating anterior horn tears of the lateral meniscus (LM). The conventional outside-in technique often requires a lumbar puncture needle or specialized instruments (Meniscus Mender II). In this study, we employed a relatively novel and practical outside-in “two-needle suture” technique for anterior horn of meniscus repair. This method is simple and does not require any specialized instruments.

Objective

The aim of this study is to report the use of the arthroscopic outside-in “two-needle suture” technique for repairing anterior horn tears of the LM and to evaluate its therapeutic effect to provide a foundation for the clinical management of anterior horn injuries of the LM.

Methods

From March 2019 to August 2023, 21 patients with anterior horn tears of the LM were treated at our orthopedic center using the “two-needle suture” technique. We recorded the operation times, tear classifications, Lysholm scores, IKDC scores, and Tegner scores preoperatively and postoperatively and analyzed the functional scores using paired t tests. Additionally, the Barrett criterion was employed to evaluate the healing status of the meniscus.

Results

In the “two-needle suture” method, only 20 mL hollow needles are used for suturing, with two needles advanced into the joint cavity from the superior and inferior surfaces of the meniscus. The first needle pulled the suture thread through the preset suture loop of the second needle, and then the suture thread was knotted outside the joint capsule. In our study, the follow-up period was 12.38 ± 1.83 months, and the operative time was 32.95 ± 11.89 min. Compared with the preoperative values, significant improvements in the Lysholm, IKDC, and Tegner scores were observed at the final follow-up (p < 0.05). According to the Barrett criterion, the clinical healing rate of the meniscus was 90.48 %. In addition, no complications or risks were observed.

Conclusion

The arthroscopic “two-needle suture” technique for anterior horn tears of the LM was simple, fast and safe, with a high rate of clinical healing. This technique is useful and a valuable reference for the clinical management of anterior horn injuries of the LM.