Clinical study on treatment of complete radial tear of meniscus using arthroscopic All-inside single needle vertical suture technique_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

TIAN Xinduo ¹ ,  MIAO Yi ² , LIU Xin ³ , WANG Wei ⁴ , LIU Na ² , ZHANG Xuesong ²

1. The Second Department of Joint Surgery, the Second Hospital of Tangshan, Tangshan Hebei, 063000, P. R. China;
2. The First Department of Joint Surgery, the Second Hospital of Tangshan, Tangshan Hebei, 063000, P. R. China;
3. Departments of Scientific Research and Education, the Second Hospital of Tangshan, Tangshan Hebei, 063000, P. R. China;
4. The Fourth Department of Hand Surgery, the Second Hospital of Tangshan, Tangshan Hebei, 063000, P. R. China;

Corresponding author：

MIAO Yi, Email: 493583908@qq.com

Keywords：

Complete radial tear of meniscus; All-inside single needle vertical suture technique; arthroscopy

DOI：

10.7507/1002-1892.202502044

Video：

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Objective To exploring effectiveness of arthroscopic All-inside single needle vertical suture technique in treatment of complete radial tear of the meniscus. Methods Between January 2019 and January 2022, 18 patients (18 knees) with complete radial tear of the meniscus were treated by using arthroscopic All-inside single needle vertical suture technique. Among them, there were 12 males and 6 females with an average age of 37.1 years (range, 16-50 years). The causes of radial meniscus tears included the sports injuries in 11 cases, sprains/falls in 4 cases, and traffic accident injuries in 3 cases. The interval between injury and operation was 3-25 days (mean, 11.7 days). All patients had knee joint pain. Knee joint tenderness and McMurray sign were both positive. MRI showed the 15 cases of lateral meniscus tear and 3 cases of medial meniscus tear; 6 cases of simple meniscus tear, 11 cases of combined anterior cruciate ligament injury, 1 case of combined posterior cruciate ligament injury, and 15 cases of combined tibial plateau bone contusion. The operation time and incidence of postoperative complications were recorded. At last follow-up, the healing of the meniscus was evaluated according to Barrett's criteria and knee joint MRI, respectively. Lysholm score and International Knee Documentation Committee (IKDC) score were used to evaluate the functional recovery of the knee joint. Results The operation time was 19-28 minutes (mean, 23.3 minutes) in 6 patients with simple radial meniscus tear and 38-52 minutes (mean, 45.8 minutes) in 12 patients with concomitant cruciate ligament injuries. All incisions healed by first intention. After operation, 1 patient developed the deep vein thrombosis of lower limb, the other patients had no complications. All patients were followed up 12-18 months (mean, 15.2 months). At last follow-up, , 16 cases of meniscus reached clinical healing according to Barrett's criteria, with a healing rate of 88.9%. MRI re-examination of the knee joint showed that 5 cases had complete healing of the meniscus, 11 cases had partial healing, and 2 cases did not heal. The total healing rate (complete healing+partial healing) was 88.9%. After operation, the Lysholm score and IKDC score of 18 patients increased compared to preoperative scores, and further improved with time. The differences between different time points were significant (P<0.05). Six patients with simple radial tears of the meniscus had the same changes in the above scores, and the different time points were significant (P<0.05). Conclusion The arthroscopic All-inside single needle vertical suture technique can achieve good short-term effectiveness in the treatment of complete radial tears of the meniscus.

1.	王景致, 马辉, 赵晟, 等. 半月板损伤治疗的研究进展. 生物骨科材料与临床研究, 2024, 21(6): 85-90,93.
2.	Mameri ES, Dasari SP, Fortier LM, et al. Review of meniscus anatomy and biomechanics. Curr Rev Musculoskelet Med, 2022, 15(5): 323-335.
3.	严晨. 膝关节半月板放射状撕裂的MRI征象表现. 医疗装备, 2021, 34(8): 21-22.
4.	Chahla J, Knapik DM, Jawanda H, et al. Meniscal radial tears: A classification system based on tear morphology. Arthrosc Tech, 2024, 13(3): 102888. doi: 10.1016/j.eats.2023.11.016.
5.	Tachibana Y, Mae T, Fujie H, et al. Effect of radial meniscal tear on in situ forces of meniscus and tibiofemoral relationship. Knee Surg Sports Traumatol Arthrosc, 2017, 25(2): 355-361.
6.	Eijgenraam SM, Reijman M, Bierma-Zeinstra SMA, et al. Can we predict the clinical outcome of arthroscopic partial meniscectomy? A systematic review. Br J Sports Med, 2018, 52(8): 514-521.
7.	Mameri ES, Jackson GR, Gonzalez F, et al. Meniscus radial tears: Current concepts on management and repair techniques. Curr Rev Musculoskelet Med, 2023, 16(5): 182-191.
8.	Feroe AG, Clark SC, Hevesi M, et al. Management of meniscus pathology with concomitant anterior cruciate ligament injury. Curr Rev Musculoskelet Med, 2024, 17(8): 321-334.
9.	Barrett GR, Treacy SH, Ruff CG. Preliminary results of the T-fix endoscopic meniscus repair technique in an anterior cruciate ligament reconstruction population. Arthroscopy, 1997, 13(2): 218-223.
10.	Adams BG, Houston MN, Cameron KL. The epidemiology of meniscus injury. Sports Med Arthrosc Rev, 2021, 29(3): e24-e33.
11.	Abdelkafy A. The concept of three-dimensional hold of both circumferential and radial collagen fibres of the meniscus. Knee Surg Sports Traumatol Arthrosc, 2015, 23(1): 20-25.
12.	Lee DH, Lee BS, Kim JM, et al. Predictors of degenerative medial meniscus extrusion: radial component and knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc, 2011, 19(2): 222-229.
13.	Oosten J, Yoder R, DiBartola A, et al. Several Techniques exist with favorable biomechanical outcomes in radial meniscus tear repair-a systematic review. Arthroscopy, 2022, 38(8): 2557-2578.
14.	刘鹏鹏, 谢子康. 半月板损伤修复术的研究进展. 中国矫形外科杂志, 2024, 32(6): 535-540.
15.	Yeh SH, Hsu FW, Chen KH, et al. Repairing complete radial tears of the lateral meniscus: arthroscopic all-inside double vertical cross-suture technique is effective and safe with 2-year minimum follow-up. Arthroscopy, 2022, 38(6): 1919-1929.
16.	Uchida R, Horibe S, Tanaka Y, et al. Clinical outcomes after repair of an isolated radial tear in the middle segment of the lateral meniscus—All-inside suture repair vs trans-capsular suture repair. Asia Pac J Sports Med Arthrosc Rehabil Technol, 2023, 33: 25-31.
17.	Wei W, Zhang Y, Li R, et al. Efficacy of meniscus suture absorbability on meniscus healing success rate via second-look arthroscopy after meniscal repair: a systematic review and meta-analysis. BMC Musculoskelet Disord, 2023, 24(1): 717. doi: 10.1186/s12891-023-06602-8.
18.	孙官军, 李清山, 银毅, 等. 膝关节镜日间手术静脉血栓栓塞的发生率及危险因素分析. 安徽医药, 2025, 29(3): 524-529.
19.	胡智辉, 董俊军, 吴喜. 膝内侧副韧带拉花松解技术在内侧间室狭窄半月板损伤关节镜手术中的应用. 罕少疾病杂志, 2024, 31(11): 118-120.
20.	Sanada T, Iwaso H, Honda E, et al. All-inside repair for radial tear at the posterior horn of the lateral meniscus: a figure-8 suture technique. Arthrosc Tech, 2021, 10(8): e1973-e1977.
21.	Milliron EM, Moews L, Cavendish PA, et al. Anterolateral radial meniscus tear repair using traction suture and Super-Hashtag technique. Arthrosc Tech, 2023, 12(8): e1347-e1353.

1. 王景致, 马辉, 赵晟, 等. 半月板损伤治疗的研究进展. 生物骨科材料与临床研究, 2024, 21(6): 85-90,93.
2. Mameri ES, Dasari SP, Fortier LM, et al. Review of meniscus anatomy and biomechanics. Curr Rev Musculoskelet Med, 2022, 15(5): 323-335.
3. 严晨. 膝关节半月板放射状撕裂的MRI征象表现. 医疗装备, 2021, 34(8): 21-22.
4. Chahla J, Knapik DM, Jawanda H, et al. Meniscal radial tears: A classification system based on tear morphology. Arthrosc Tech, 2024, 13(3): 102888. doi: 10.1016/j.eats.2023.11.016.
5. Tachibana Y, Mae T, Fujie H, et al. Effect of radial meniscal tear on in situ forces of meniscus and tibiofemoral relationship. Knee Surg Sports Traumatol Arthrosc, 2017, 25(2): 355-361.
6. Eijgenraam SM, Reijman M, Bierma-Zeinstra SMA, et al. Can we predict the clinical outcome of arthroscopic partial meniscectomy? A systematic review. Br J Sports Med, 2018, 52(8): 514-521.
7. Mameri ES, Jackson GR, Gonzalez F, et al. Meniscus radial tears: Current concepts on management and repair techniques. Curr Rev Musculoskelet Med, 2023, 16(5): 182-191.
8. Feroe AG, Clark SC, Hevesi M, et al. Management of meniscus pathology with concomitant anterior cruciate ligament injury. Curr Rev Musculoskelet Med, 2024, 17(8): 321-334.
9. Barrett GR, Treacy SH, Ruff CG. Preliminary results of the T-fix endoscopic meniscus repair technique in an anterior cruciate ligament reconstruction population. Arthroscopy, 1997, 13(2): 218-223.
10. Adams BG, Houston MN, Cameron KL. The epidemiology of meniscus injury. Sports Med Arthrosc Rev, 2021, 29(3): e24-e33.
11. Abdelkafy A. The concept of three-dimensional hold of both circumferential and radial collagen fibres of the meniscus. Knee Surg Sports Traumatol Arthrosc, 2015, 23(1): 20-25.
12. Lee DH, Lee BS, Kim JM, et al. Predictors of degenerative medial meniscus extrusion: radial component and knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc, 2011, 19(2): 222-229.
13. Oosten J, Yoder R, DiBartola A, et al. Several Techniques exist with favorable biomechanical outcomes in radial meniscus tear repair-a systematic review. Arthroscopy, 2022, 38(8): 2557-2578.
14. 刘鹏鹏, 谢子康. 半月板损伤修复术的研究进展. 中国矫形外科杂志, 2024, 32(6): 535-540.
15. Yeh SH, Hsu FW, Chen KH, et al. Repairing complete radial tears of the lateral meniscus: arthroscopic all-inside double vertical cross-suture technique is effective and safe with 2-year minimum follow-up. Arthroscopy, 2022, 38(6): 1919-1929.
16. Uchida R, Horibe S, Tanaka Y, et al. Clinical outcomes after repair of an isolated radial tear in the middle segment of the lateral meniscus—All-inside suture repair vs trans-capsular suture repair. Asia Pac J Sports Med Arthrosc Rehabil Technol, 2023, 33: 25-31.
17. Wei W, Zhang Y, Li R, et al. Efficacy of meniscus suture absorbability on meniscus healing success rate via second-look arthroscopy after meniscal repair: a systematic review and meta-analysis. BMC Musculoskelet Disord, 2023, 24(1): 717. doi: 10.1186/s12891-023-06602-8.
18. 孙官军, 李清山, 银毅, 等. 膝关节镜日间手术静脉血栓栓塞的发生率及危险因素分析. 安徽医药, 2025, 29(3): 524-529.
19. 胡智辉, 董俊军, 吴喜. 膝内侧副韧带拉花松解技术在内侧间室狭窄半月板损伤关节镜手术中的应用. 罕少疾病杂志, 2024, 31(11): 118-120.
20. Sanada T, Iwaso H, Honda E, et al. All-inside repair for radial tear at the posterior horn of the lateral meniscus: a figure-8 suture technique. Arthrosc Tech, 2021, 10(8): e1973-e1977.
21. Milliron EM, Moews L, Cavendish PA, et al. Anterolateral radial meniscus tear repair using traction suture and Super-Hashtag technique. Arthrosc Tech, 2023, 12(8): e1347-e1353.

Chinese Journal of Reparative and Reconstructive Surgery

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