Repair techniques

Parallel Stitch (See Fig. ​Fig.1a):1a): Two 2.0 FiberWire meniscus needle sets were used. The first needle set was passed 5 mm from the inside of the meniscus and 5 mm from radial tear on either side of the tear through the outer surface of the meniscus. The next needle set was passed 5 mm from the first stitch towards the capsular side, maintaining 5 mm from the radial tear. The needles were then cut off and all suture pairs tied.

a Standard Repair with 2 parallel sutures across the radial tear. b. Cross Stitch Repair with 2 perpendicular sutures in a “X” configuration. c. Rebar Repair with 4 sutures, 2 longitudinal reinforcing sutures on each side of the tear with 2 horizontal stitches across the reinforcing sutures and the tear. d, e, f are cadaver views of the parallel suture repair, cross stitch repair and Rebar Repair respectively

Cross Stitch (See Fig. ​Fig.1b):1b): Two 2.0 FiberWire meniscus needles sets were used with the same template and the technique described by Matsubara (Matsubara et al. 2012). For the first set, one meniscus needle was inserted 5 mm from the inner meniscus and 5 mm from the radial tear then exited the meniscus laterally then the other needle was placed obliquely 10 mm from the inner meniscus edge and 5 mm from the radial repair on the opposite side from the first pass. The next set of needles was inserted in a similar fashion in the opposite direction to create an “X configuration”. The needles were then cut off and all suture pairs tied.

Rebar Repair (See Fig. ​Fig.1c):1c): Four needle sets were used. First, a vertical mattress type repair or reinforcing stitch was performed by placing the first needle 2 mm from the inner meniscus (central) and 5 mm posterior to the tear, then the second needle 8 mm from the inner meniscus and 5 mm posterior to the tear. On the other side of the tear, 5 mm anterior from the tear, another vertical mattress suture was passed with the next needle set in a similar fashion. The parallel horizontal sutures were then passed while making sure that each needle passed on the side of the reinforcing stitch away from the tear (see Fig. 2). Two 2.0 FiberWire meniscus needle sets were used. The first needle set was passed 7 mm from the inner meniscus and 5 mm from radial tear on each side of the tear through the more peripheral surface of the meniscus. The next needle set was passed 3 mm from the inner meniscus (central) and 5 mm anterior and posterior from the radial tear on each side of the tear. Each parallel suture was directly juxtaposition to a vertical suture. The needles were then cut off and all suture pairs tied.

Rebar Repair illustration. The 2 horizontal sutures are placed exactly juxtaposed to the vertical sutures. The horizontal sutures are running perpendicular to the radial meniscus tear