Short-term effectiveness of edge-to-edge #-shaped suture for complete radial tear of lateral meniscus body_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHONG Hehe , CHEN Jing , SUN Pengpeng , CAI Dongfeng , YANG Lidan , XIONG Huazhang ,  WU Shuhong

Department of Orthopedics, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563000, P. R. China;

Corresponding author：

WU Shuhong, Email: 15329112966@163.com

Keywords：

Lateral meniscus; radial tear; arthroscopy; edge-to-edge suture

DOI：

10.7507/1002-1892.202504026

Video：

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Objective To investigate the surgical method and short-term effectiveness of arthroscopy edge-to-edge #-shaped suture in the treatment of the complete radial tear of the lateral meniscus body. Methods The clinical data of 13 patients with complete radial tear of lateral meniscus body between May 2020 and August 2023 were retrospectively analyzed. There were 10 males and 3 females, aged 15-38 years (mean, 24.2 years). There were 11 cases of acute injury, with time from injury to admission ranging from 2 days to 5 months, and 2 cases of chronic injury, with the time from injury to admission being 3 months and 5 months respectively. All patients had tenderness in the lateral joint space, and 2 patients with chronic injury had positive McMurray’s sign. All patients were treated with arthroscopic edge-to-edge #-shaped suture technique. The knee joint activity, tenderness in the lateral joint space or McMurray’s sign were detected, and the healing of the incision and the occurrence of complications were observed. X-ray films and MRI of the knee joint were performed to evaluate joint degeneration and meniscus healing. Lysholm score, International Knee Documentation Committee (IKDC) subjective function score, Tegner score, and visual analogue scale (VAS) score were used to evaluate the functional recovery before and after operation. Results The operation time ranged from 46 to 100 minutes (mean, 80.8 minutes). All the incisions healed by first intention, and no complications such as intraoperative vascular and nerve injury or postoperative infection occurred. All 13 patients were followed up 20-59 months (mean, 29.3 months). All patients had no tenderness, swelling, and locking in the lateral space. One patient with chronic injury continued to have tenderness in the lateral space of the knee joint, while the remaining patients had no tenderness, swelling, and locking in the lateral space. Immediate postoperative MRI of knee joint showed continuous recovery of the lateral meniscus. At last follow-up, no degenerative changes were observed in X-ray films of knee joint. MRI revealed the changes of lateral meniscus body after repair. Lysholm score, IKDC subjective function score, Tegner score, and VAS score were all significantly improved when compared with those before operation (P<0.05). Conclusion The edge-to-edge #-shaped suture technique can effectively repair the complete radial tear of the lateral meniscus body, and the short-term effectiveness is satisfactory, which can be used as an effective means to repair the meniscus injury.

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2.	Robles E, Michelin RM, Schlechter JA. Use of an accessory anteromedial portal to facilitate repair of mid-body radial tears of the lateral meniscus in children and adolescents. Arthrosc Tech, 2021, 10(12): e2675-e2681.
3.	Rocha de Faria JL, Pavão DM, Pires E Albuquerque RS, et al. Continuous meniscal suture in radial meniscal tear: The hourglass technique. Arthrosc Tech, 2021, 10(7): e1763-e1772.
4.	Alomar AZ, Al Jedia KM, Shadid AM, et al. Concurrent research around meniscus: A bibliometric analysis and review of the top fifty cited papers. Indian J Orthop, 2022, 56(5): 785-796.
5.	Chen KH, Ma HH, Fu A, et al. Arthroscopic all-inside wrapping repair of lateral meniscus bucket-handle tears: clinical and imaging outcomes. J Orthop Surg Res, 2025, 20(1): 115. doi: 10.1186/s13018-025-05489-6.
6.	Li Q, Qiu M, Nie S, et al. Arthroscopic repair technique of lateral meniscus tear at the popliteal hiatus area. Arthrosc Tech, 2024, 14(2): 102926. doi: 10.1016/j.eats.2024.102926.
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.	Jeon YS, Alsomali K, Yang SW, et al. Posterior horn lateral meniscal oblique radial tear in acute anterior cruciate ligament reconstruction incidence and outcomes after all-inside repair: Clinical and second-look arthroscopic evaluation. Am J Sports Med, 2022, 50(14): 3796-3804.
9.	Burke JF, Klosterman EL, Tagliero AJ, et al. Lateral meniscal oblique radial tears were observed concomitantly with anterior cruciate ligament tears in 6% of pediatric patients undergoing anterior cruciate ligament reconstruction. Arthrosc Sports Med Rehabil, 2024, 7(1): 101012. doi: 10.1016/j.asmr.2024.101012.
10.	Homan MD, Kennedy NI, LaPrade CM, et al. Combined rip-stop and transtibial pull-out technique for lateral meniscus radial repairs. Arthrosc Tech, 2023, 12(9): e1623-e1629.
11.	Zhang ZZ, Luo H, Zhang HZ, et al. H-plasty repair technique improved tibiofemoral contact mechanics after repair for adjacent radial tears of posterior lateral meniscus root: A biomechanical study. Arthroscopy, 2021, 37(7): 2204-2216.
12.	Wang Z, Xiong Y, Tang X, et al. An arthroscopic repair technique for meniscal tear using a needle and suture: outside-in transfer all-inside repair. BMC Musculoskelet Disord, 2019, 20(1): 614. doi: 10.1186/s12891-019-2984-3.
13.	Everhart JS, Magnussen RA, Abouljoud MM, et al. Meniscus tears accelerate joint space loss and lateral meniscal extrusion increases risk of knee arthroplasty in middle-aged adults. J Orthop Res, 2020, 38(11): 2495-2504.
14.	Kato T, Kaneda K, Harato K, et al. Bilateral medial and lateral discoid menisci: A case report. J Orthop Case Rep, 2023, 13(3): 54-58.
15.	Hansen CF, Madsen MØ, Warming S, et al. Pedi-IKDC exhibits questionable measurement properties in a cohort of pediatric patients with ACL rupture. Scand J Med Sci Sports, 2023, 33(9): 1831-1840.
16.	Lin JS, Akers A, Miller TL. Updates and advances in the management of lateral meniscal radial tears: A critical analysis review. JBJS Rev, 2020, 8(11): e2000056. doi: 10.2106/JBJS.RVW.20.00056.
17.	Ode GE, Van Thiel GS, McArthur SA, et al. Effects of serial sectioning and repair of radial tears in the lateral meniscus. Am J Sports Med, 2012, 40(8): 1863-1870.
18.	田鑫铎, 缪炜, 刘欣, 等. 关节镜下All-inside单针垂直缝合技术治疗膝关节半月板完全放射状撕裂. 中国修复重建外科杂志, 2025, 39(5): 550-555.
19.	Feltz K, Brown A, Hanish S, et al. An arthroscopic-assisted radial meniscal tear repair using reinforced suture tape rebars and suture tapes. Arthrosc Tech, 2021, 10(5): e1395-e1401.
20.	Itthipanichpong T, Moonwong S, Thamrongskulsiri N, et al. Validity and reliability of the thai versions of the lysholm knee scoring scale and tegner activity scale. Orthop J Sports Med, 2023, 11(2): 23259671221149785. doi: 10.1177/23259671221149785.

1. Markes AR, Hodax JD, Ma CB. Meniscus form and function. Clin Sports Med, 2020, 39(1): 1-12.
2. Robles E, Michelin RM, Schlechter JA. Use of an accessory anteromedial portal to facilitate repair of mid-body radial tears of the lateral meniscus in children and adolescents. Arthrosc Tech, 2021, 10(12): e2675-e2681.
3. Rocha de Faria JL, Pavão DM, Pires E Albuquerque RS, et al. Continuous meniscal suture in radial meniscal tear: The hourglass technique. Arthrosc Tech, 2021, 10(7): e1763-e1772.
4. Alomar AZ, Al Jedia KM, Shadid AM, et al. Concurrent research around meniscus: A bibliometric analysis and review of the top fifty cited papers. Indian J Orthop, 2022, 56(5): 785-796.
5. Chen KH, Ma HH, Fu A, et al. Arthroscopic all-inside wrapping repair of lateral meniscus bucket-handle tears: clinical and imaging outcomes. J Orthop Surg Res, 2025, 20(1): 115. doi: 10.1186/s13018-025-05489-6.
6. Li Q, Qiu M, Nie S, et al. Arthroscopic repair technique of lateral meniscus tear at the popliteal hiatus area. Arthrosc Tech, 2024, 14(2): 102926. doi: 10.1016/j.eats.2024.102926.
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. Jeon YS, Alsomali K, Yang SW, et al. Posterior horn lateral meniscal oblique radial tear in acute anterior cruciate ligament reconstruction incidence and outcomes after all-inside repair: Clinical and second-look arthroscopic evaluation. Am J Sports Med, 2022, 50(14): 3796-3804.
9. Burke JF, Klosterman EL, Tagliero AJ, et al. Lateral meniscal oblique radial tears were observed concomitantly with anterior cruciate ligament tears in 6% of pediatric patients undergoing anterior cruciate ligament reconstruction. Arthrosc Sports Med Rehabil, 2024, 7(1): 101012. doi: 10.1016/j.asmr.2024.101012.
10. Homan MD, Kennedy NI, LaPrade CM, et al. Combined rip-stop and transtibial pull-out technique for lateral meniscus radial repairs. Arthrosc Tech, 2023, 12(9): e1623-e1629.
11. Zhang ZZ, Luo H, Zhang HZ, et al. H-plasty repair technique improved tibiofemoral contact mechanics after repair for adjacent radial tears of posterior lateral meniscus root: A biomechanical study. Arthroscopy, 2021, 37(7): 2204-2216.
12. Wang Z, Xiong Y, Tang X, et al. An arthroscopic repair technique for meniscal tear using a needle and suture: outside-in transfer all-inside repair. BMC Musculoskelet Disord, 2019, 20(1): 614. doi: 10.1186/s12891-019-2984-3.
13. Everhart JS, Magnussen RA, Abouljoud MM, et al. Meniscus tears accelerate joint space loss and lateral meniscal extrusion increases risk of knee arthroplasty in middle-aged adults. J Orthop Res, 2020, 38(11): 2495-2504.
14. Kato T, Kaneda K, Harato K, et al. Bilateral medial and lateral discoid menisci: A case report. J Orthop Case Rep, 2023, 13(3): 54-58.
15. Hansen CF, Madsen MØ, Warming S, et al. Pedi-IKDC exhibits questionable measurement properties in a cohort of pediatric patients with ACL rupture. Scand J Med Sci Sports, 2023, 33(9): 1831-1840.
16. Lin JS, Akers A, Miller TL. Updates and advances in the management of lateral meniscal radial tears: A critical analysis review. JBJS Rev, 2020, 8(11): e2000056. doi: 10.2106/JBJS.RVW.20.00056.
17. Ode GE, Van Thiel GS, McArthur SA, et al. Effects of serial sectioning and repair of radial tears in the lateral meniscus. Am J Sports Med, 2012, 40(8): 1863-1870.
18. 田鑫铎, 缪炜, 刘欣, 等. 关节镜下All-inside单针垂直缝合技术治疗膝关节半月板完全放射状撕裂. 中国修复重建外科杂志, 2025, 39(5): 550-555.
19. Feltz K, Brown A, Hanish S, et al. An arthroscopic-assisted radial meniscal tear repair using reinforced suture tape rebars and suture tapes. Arthrosc Tech, 2021, 10(5): e1395-e1401.
20. Itthipanichpong T, Moonwong S, Thamrongskulsiri N, et al. Validity and reliability of the thai versions of the lysholm knee scoring scale and tegner activity scale. Orthop J Sports Med, 2023, 11(2): 23259671221149785. doi: 10.1177/23259671221149785.

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