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REPAIR OF MENISCAL RAMP LESIONS THROUGH A POSTEROMEDIAL PORTAL DURING ACL RECONSTRUCTION…
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Complications related to the
posteromedial portal
Two patients sustained a hematoma which
required an arthroscopy lavage during the first
week after the index surgery. It was not possible
to conclude that this complication was related
to the puncture of the saphenous vein during
the posteromedial approach. No patient had a
neuroma located at the level of the
posteromedial approach. It was difficult to
precise the incidence of saphenous nerve
lesions due to the posteromedial approach
because the hamstring removal can cause
sensibility change in different territories of the
saphenous nerve (infrapatellar or sartorius
branches).
DISCUSSION
The most important finding of this study is that
vertical posterior sutures through an additional
posteromedial approach during ACL re
construction to repair peripheral tears of the
posterior segment of the medial meniscus
provided a high rate of meniscus healing and
appeared to be safe and effective in this group
Fig. 5:
Newly formed injury after the medial meniscal repair of the right knee. (
a
) A meniscal flap with an
anterior pedicle located in the red/white zone is detached. (
b
) This newly formed injury is identified by a
residual nonabsorbable suture material on the meniscus. (
c
) Aspect of the medial meniscus after
economical subsequent meniscectomy of the unstable flap, the vertical suture from the primary repair are
left alone. (
d
) View of the posterior segment with the scope placed deep in the notch: the original tear site
is healed completely.
a
c
b
d