Cutting Edge Orthopedics - Issue 3

Arthroscopic Meniscus Repair for Recurrent Subluxation of the Lateral Meniscus • 47  of the lateral meniscus, a modified outside-in technique was used with a straight-necked suture hook (Linvatec, Largo, FL, USA) and a spinal needle preloaded with No. 0 nylon to pull out the PDS [4]. This technique was performed using a small posterolateral incision to retrieve and tie the sutures and protect the peroneal nerve. Rehabilitation was performed as previously described [2]. Evaluation All preoperative evaluations were performed the day before surgery for each parameter, and post- operative evaluations were performed at the final follow-up by two of the authors. Careful histo- ries were taken documenting the nature of the pain and a physical examination was performed in each case. The median duration of symptoms before surgery was 6.0 months (range 3–60 months). Four patients (four knees) underwent arthroscopic exploration at other hospitals before visiting our hospital due to symptoms of recurrent subluxation of the lateral meniscus, but their symp- toms remained the same after surgery and the patients did not receive satisfactory explanations about their symptoms. The causes of injury were sports in nine, abrupt standing up from sitting in two, and unknown in 13 knees. Preoperative radiographic evaluations including anteroposterior, lateral, tunnel andMerchant views were taken for each patient, as well as MRI evaluations. Radiographic findings were unre- markable for 22 knees, whereas one knee revealed minimal patellofemoral joint osteophytes and one knee revealed mild lateral joint space narrowing. All MRI studies were retrospectively reviewed as film hard copies by a musculoskeletal radiologist and an orthopedic surgeon blinded to the arthroscopic findings, clinical histories, and initial MRI interpretations. MRI findings were unremarkable for 17 knees, whereas 7 knees revealed suspicious peripheral tears at the poste- rior horn of the lateral meniscus. Clinical results were evaluated using Tegner activity level as well as Lysholm Knee and Hospital for Special Surgery (HSS) scores, preoperatively and at final follow-up. The study was reviewed and approved by the Institutional Review Board of Kyung- Hee University Hospital at Gangdong, Seoul, Korea (No. 2013-01-047), and all patients signed informed consent forms. Statistical Analysis The Wilcoxon signed-rank test was used to identify significant differences between preoperative and last follow-up clinical evaluations. All statistical analyses were performed with SPSS (SPSS for Windows Release 11.0, SPSS Inc., Chicago, IL, USA), and 95% confidence intervals were used throughout. Results Upon arthroscopic examination, each patient’s lateral meniscus was normal in shape. Hypermobility of lateral meniscus with hiatus widening was observed in all knees through the anterolateral portal as well as the posterolateral portal. All tears were repaired with either the