Short-term effects of all-inside suture for posterior root tear of the lateral meniscus combined with anterior cruciate ligament reconstruction

Qin Hailong; Zhang Keyuan

doi:10.3969/j.issn.1009-4237.2025.05.008

Abstract：Objective To study the short-term effect of arthroscopic side-to-side all-inside suture of La-prade type 2B and 2C posterior root injuries of the lateral meniscus combined with anterior cruciate ligament(ACL)reconstruction.Methods A retrospective analysis was conducted on 37 patients diagnosed with ACL rupture com-bined with radial tear of the posterior root of the lateral meniscus at the First Affiliated Hospital of Xinjiang Medical University from Aug.2019 to Mar.2021.Among the patients,32 were male and 5 were female,with the ages ran-ging from 17 to 45(mean 28.1)years.All patients underwent arthroscopic side-to-side all-inside suture of the pos-terior root of the lateral meniscus and ACL reconstruction.Patients were followed up for at least one year,with an average follow-up period of 17.5 months.The Lachman test results,positive rates of pivot shift tests before&during surgery and at the last follow-up,knee joint scores like Lysholm score and International Knee Documentation Com-mittee(IKDC)score,VAS,meniscus extrusion at the last follow-up,clinical healing,MRI healing and healing con-ditions during the second arthroscopic examination were recorded.Results At the last follow-up of the 37 patients,36 achieved clinical healing,with a clinical healing rate of 97.3%;34 patients showed healed meniscus on MRI im-ages,with a healing rate of 91.9%;21 patients underwent secondary arthroscopic exploration,of whom the arthro-scopic healing rate was 100.0%.The IKDC knee joint scores,Lysholm scores and pain assessed by VAS at the last follow-up were significantly improved compared with those before surgery(P＜0.05).The anterior drawer test and Lachman test were both positive before surgery,with a positive rate of 100.0%.The intraoperative anterior drawer test turned negative immediately after meniscus suture,and all the Lachman tests showed negative results at the last follow-up.The lateral meniscus extrusion on coronal MRI of the knee joint after the operation was minimally 0.2 mm and maximally 1.4 mm,0.82 mm on average.Among them,10 patients had an extrusion＞1 mm,accounting for 27.0%.The average extrusion was 0.2 mm.Conclusion Arthroscopic ACL reconstruction and side-to-side all-in-side suture of the posterior root for lateral meniscus Laprade types 2B and 2C fresh meniscus injuries can achieve full clinical healing,and restore the circular tension and biomechanical function of the meniscus,without causing obvious meniscus extrusion.