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Pediatric Meniscal Tear

   

Henning Technique (Scott GA,J Bone Joint Surg 1986;68A:847-861)

  • Medial meniscal tears should be sutured with the knee flexed approximately 15 to 20 degrees.
  • Abraid rim to improve healing (Henning, Arthroscopy 1987;3:13-18)
  • First suture placed through the inferior surface of the meniscus at the posterior origin of the tear.
  • Use long needles with 2-0 non-absorbable suture swedged on. 
  • Bend needles 15 degrees 4 mm from the tip, and again 15 degrees 1.5 cm from the tip.
  • Place popliteal retractor in behind the posterior horn of the medial meniscus. Flexion of the knee to approximately 60 degrees may facilitate location of the needle.
  • Grasp needle needle holder and withdrawn through the postero-medial incision.
  • A vertical suture is made by passing the second needle under the meniscus, bypassing the tear site.
  • Place second suture through the superior surface of the meniscus, approximately 3 mm anterior to the first suture.
  • Place additional sutures are alternated between the superior and inferior surfaces every 3 mm.

Zone Specific Cannula Technique: Long needles with wedged on 2-0 Ethibond or 2-0 PDS sutures are passed through zone-specific cannulas placed against the superior or inferior surface of the torn meniscal fragment. (Rosenberg T, Contemp Orthop 1985;10:43-50)

Double Barrel Curved Cannula Technique(Clancy WG Jr, Orthopedics 1983;6:1125-1128

All-inside techinique.  (Morgan Arthroscopy 1991;7:120-125)

If meniscal repair is attempted in an ACL deficient knee without reconstructing the ACL, failure rates of 13% to 30% have been reported. OKU-5

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