2개의 후 내측도달법을 이용한 내측 반월상 연골판 후각부 All - Inside 봉합술

• Published in: Knee surgery & related research 1998-06, Vol.10 (1), p.67
• Main Authors: 안진환, 하권익, 하철원, Jin Hwan Ahn, Kwon Ick Ha, Chul Won Ha
• Format: Article
• Language: Korean
• Subjects: All - Inside Technique; Arthroscopic Meniscus Repair; Knee; Medial Meniscus; Posterior Horn Tear
• ISSN: 2234-0726

The authors report an improve technique of all-inside repair using 2 posteromedial portal for medial meniscus posterior horn peripheral tears, which greatly reduced technical difficulties of Morgan`s original technique of all-inside repair. The authors` all-inside technique using 2 posteromedial portal is as follows. The arthroscopy is advanced to the posteromedial compartment through the way between PCL and medial femoral condyle after routine arthroscopic examination of the knee joint. The first posteromedial portal is established under arthroscopic control, and thorough examination and probing of the medial meniscus posterior horn is done. The second posteromedial portal is established about 1cm above the 1st posteromedial portal. The Universal Cannula of 5.5mm diameter is inserted through this 2nd posteromedial portal. Then a suture hook is inserted through the 1st posteromedial portal and meniscal suture is performed. At this moment, a probe is inserted through the 2nd posteromedial portal, which stabilizes and posterioly draw the inner fragment to facilitate this suture passage, makes the sutures of the more inner portion feasible, and avoids damage to the arterial cartilage of the femoral condyle by the sharp tip of the suture hook. After inserting the suture material long enough through the lumen of the suture hook, a suture retriever is inserted through the 2nd posteromedial portal and universal cannula and the knot is advanced and tightened through the universal cannula using a knot pusher. After making 4-5knots, a cutter inserted thfough the 1st posteromedial portal makes the cut of the suture material. Usually 3-4 sutures are required for the posterior horn tears. The authors` technique has reduced the technical difficulties of Morgan`s technique of all-inside meniscus repair. This technique has the advantage of greatly increasing the working area of suture hook, making the passage of suture hook much easier, and making it feasible to repair the tears located much inner from the meniscocapsular junction, in addition to all the advantages of Morgan`s technique.