Lassiter Eric M, Farmer N Chase, Lee Anderson, Mustapha Rayanne, Yatsonsky David, Sohn David
Department of Orthopedic Surgery, University of Toledo Medical Center, Toledo, Ohio, USA.
Grossman School of Medicine, New York University, New York, USA.
J Orthop Case Rep. 2024 Dec;14(12):148-153. doi: 10.13107/jocr.2024.v14.i12.5054.
The menisci are a pair of fibrocartilaginous structures important for the normal biomechanical function of the knees. Tears are common, and multiple approaches have been used to repair meniscal tears. Of the approaches, the all-inside approach has historically been avoided for tears to the posterior aspect of the lateral meniscus (LM) due to the risk of popliteal and common peroneal neurovascular injury.
We reviewed the electronic medical records of all patients who underwent all-inside LM repair by our senior author from August 2022 through August 2023. Demographic, injury, and surgical data were collected to characterize surgical success and any complications attributed to the surgical approach. A literature review of MEDLINE was performed to investigate the current data regarding the all-inside approach and identify methods for improving safety and efficacy. Two cases were identified (one male and one female) who underwent all inside repair of the LM. No surgical complications were attributed to suture selection or placement, and no damage to the popliteal neurovascular structures was identified.
The all-inside approach is a safe arthroscopic approach for the repair of the LM. The current literature demonstrates multiple considerations and guidelines to mitigate the risk of neurovascular injury and supports the efficacy of the all-inside approach when compared to other surgical approaches.
半月板是一对纤维软骨结构，对膝关节的正常生物力学功能至关重要。半月板撕裂很常见，并且已经采用了多种方法来修复半月板撕裂。在这些方法中，由于存在腘窝和腓总神经血管损伤的风险，历史上一直避免采用全内入路来修复外侧半月板（LM）后缘的撕裂。
我们回顾了2022年8月至2023年8月期间由我们的资深作者进行全内入路LM修复的所有患者的电子病历。收集了人口统计学、损伤和手术数据，以描述手术成功率以及归因于手术方法的任何并发症。对MEDLINE进行了文献综述，以调查有关全内入路的当前数据，并确定提高安全性和有效性的方法。确定了2例（1例男性和1例女性）接受LM全内修复的患者。未发现手术并发症归因于缝线选择或放置，也未发现腘窝神经血管结构受损。
全内入路是一种用于修复LM的安全关节镜入路。当前文献展示了多种减轻神经血管损伤风险的考虑因素和指南，并支持全内入路与其他手术方法相比的有效性。
