Avoiding injury to the popliteal neurovascular bundle in all-inside suturing of the posterior horn of the lateral meniscus: An MRI assessment of portal selection and safety
Arthroscopy Jan 08, 2020
Gilat R, et al. - Researchers simulated all-inside suturing of the posterior horn of the lateral meniscus (PHLM) utilizing magnetic resonance imaging of 60 knees in order to evaluate the risk of injury to the popliteal neurovascular bundle (PNVB) while suturing the PHLM. Lines were formed from the medial and the lateral edges of the patellar tendon to the PHLM at progressing distances from the posterior cruciate ligament (PCL) to simulate the suturing device trajectory. Of 1,200 measurements done, the simulated suturing trajectory transected the PNVB 343 times. Finding suggests that all-inside suturing of the PHLM at 0 mm from the PCL was more secured with a more lateral portal. More then 3 mm from the PCL, a more medial portal bears a lower risk to the PNVB. Young and women's individuals had a smaller distance between the PHLM and the PNVB, implying a higher risk for injury to the PNVB. Moreover, precautionary preoperative magnetic resonance imaging assessment might aid in more secured portal selection when designing repair of the PHLM.
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