Abstract
Various techniques for meniscal suturing have been described: inside-out, outside-in, and all-inside. In some, the knots are intra-articular, while in others they are outside the joints. Suture materials include barbed absorbable pins, meniscal staples, absorbable and non-absorbable monofilament sutures and non-absorbable multifilament sutures. The gold standard, however, is mattress sutures with non-absorbable multifilament sutures and extra-articular knots.
Because some of the newer fixation devices are quite expensive, give inferior fixation and cause complications through breakage and synovitis following absorption of the material, a simple and inexpensive outside-in technique was developed.
With this technique, it is possible to suture the meniscus from the anterior horn to the anterior third of the posterior horn. The only requirements are two no-20 hypodermic needles, 1/0 monofilament nylon and 2/0 multifilament non-absorbable suture. Mattress-type sutures can be placed either superiorly or inferiorly in the meniscus, with the knot extra-articular. For tears in the posterior two thirds of the meniscus, which is inaccessible with this technique, one of the commercially-available all-inside techniques is used.
The abstracts were prepared by Professor M.B.E. Sweet. Correspondence should be addressed to him at PO Box 47363, Parklands, Johannesburg 2121, South Africa.
