ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
No risk of iatrogenic peroneal nerve injury in all-inside lateral meniscal repair with either 14- or 18-mm needles through the popliteus tendon in the standard arthroscopic knee conditions.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 4 citations in OpenAlex.
- Identifying Risk Zones for Neurovascular Injury in Pediatric All-Inside Arthroscopic Lateral Meniscal Repair.Orthopaedic journal of sports medicine · 2025Article
- Lateral Meniscal Tears Can be Safely Repaired "All-Inside" Without Peroneal Nerve Injury: Case Series and Literature Review.Journal of orthopaedic case reports · 2024Article
- Impact of lower limb alignment abnormality (physiologic knee valgus) on the functional recovery outcome of athletes with meniscal injuries.American journal of translational research · 2024Article
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Authors and funding
5 authors at 1 institution in 1 country.
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Abstract
purposeThe objectives of this prospective study were to evaluate the risk of peroneal nerve (PN) injury in simulated all-inside lateral meniscal repair with sutures placed through the popliteus tendon (PT) and to determine the optimal needle length.
methodsTwenty-nine axial magnetic resonance images (MRI) of postoperative knees with infused intra-articular fluid and in a figure-of-four position were used. The cross-sectional length of the PT was divided into four equal parts with measurements performed at the 25%, 50% and 75% points according to their anteroposterior arrangement. Simulated repairs were performed with 14-mm and 18-mm straight needles via the anteromedial (AM) and anterolateral (AL) portals. Distances from the needle tip following full insertion through the PT to the PN and from the anterior PT border to the posterior knee capsule were measured to determine PN injury risk and ideal needle insertion depths at the different landmarks.
resultsSimulated repairs on the 29 knee MRI images resulted in no incidences of PN injury. The average distances from the needle tip to the PN of the 14-mm needle were significantly greater than the 18-mm needle in all the simulated repairs (P < 0.02), except at the 25% point in the AM approach. When using the 14-mm needle, capsule underpenetration was found in three knees (10.3%) at the 25% point during the AM approach, in one knee (3.4%) at the 50% and 75% points in the AM approach, and in all repairs from the AL portal. The average distances from the anterior PT border to the capsule at the 25%, 50%, and 75% division points on the PT in the AM approach were 7.7 ± 2.7 mm, 7.9 ± 2.5 mm and 7.6 ± 2.8 mm, respectively, whilst in the AL approach were 8.4 ± 2.9 mm, 8.1 ± 2.8 mm and 7.6 ± 2.7 mm.
conclusionSimulated all-inside lateral meniscal repair with suture placement through the PT with 14-mm and 18-mm needles was safe. The measurements in this study can be used to determine potential PN injury risk in relation to the PT and the appropriate needle length for safe lateral meniscal repairs.
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