Transcription for Repair of Radial Meniscus Tear Video
There are many different kinds of meniscus tears. One of the most challenging is the radial tear. It’s most commonly in the mid one-third body of the lateral meniscus, and you can see that in this structure right here.
Why is it challenging? Because most of the tear is through an avascular area, so it won’t heal. Traditionally, we removed the tear by cutting around the tear and leaving just these parts. The problem with that is, besides that you’re missing up to about a third of the meniscus, which is important to be there, it actually can destabilize the front, and the back as well, because it’s losing the hoop stresses that are necessary for your meniscus to share the load. So it’s very important to try to maintain that.
So one of the things that I developed is a new kind of stitching pattern to try to hold those pieces together, and one of the interesting things about this stitch is that as you pull the two parts apart, it actually pushes them together to try to keep the meniscus whole. So, again, you can see the tear is perpendicular to the meniscus. When we look at the repair from the top, you’ll see that it looks like an equals sign as it’s going across this way. And, traditionally, when people are trying to repair this, they put simple stitches through it. The problem is, is it doesn’t really compress the area we’re trying to hold together.
When we look at it from the opposite side, you’ll see that it looks like a multiplication sign, and the reason that this really works is, in 3-dimensional, as we try to pull this apart, it doesn’t come apart because the construct is actually pushing it together. The more it pulls apart, the more it’s pushing together, so that way it stabilizes the meniscus. The hope is that this will actually somehow scar together. And maybe we need to put some biologics in there, like stem cells and those kind of things that we’re working on these days that actually can try to get the body to heal across, but as long as these stitches stay intact, it should help it not fall apart.
Now, I’m pulling pretty hard here.
Learn more about meniscus surgery from New York City’s leading orthopedic surgeon Dr. Ron Noy.