Surgical Discussion

Patient positioning:  Supine position with the affected leg placed in a leg holder to allow for arthroscopic access and fluoroscopic guidance.

Anatomical surgical approach:  A standard anterolateral portal was established for knee arthroscopy. The complete radial tear of the posterior meniscus overlying the fracture margin was identified. Five all-inside sutures were used to reduce and fix the tear, restoring ring tension. Following meniscal repair, a minimally invasive latteral approach was utilized under fluoroscopic guidance to tamp the articular surface and fill the defect. A 4.0mm cannulated subchondral raft and 'jail-screw' were then placed to support the articular surface.

The complete radial tear of the posterior meniscus was successfully adapted and fixed with five all-inside arthrex sutures, restoring ring tension and function. Fluoroscopic guidance facilitated accurate reduction of the articular surface and defect filling with Vitoss. The subchondral raft and jail-screw provided stable foundation of the articular surface. Final arthroscopic inspection confirmed both the stability of the meniscal repair, togeter with the anatomic restoration of the surface - including posterior meniscal support.

Postoperative protocol:   Postoperatively, the patient will be managed in a range of motion (ROM) brace limited to 30 degrees for 4 weeks, increasing to 60 degrees at 6 weeks, and 90 degrees at 8 weeks postop. Touch weight bearing will be maintained until 8 weeks, followed by progression to full weight bearing by 10 weeks.

Follow up:   Not specified

Orthopaedic implants used:   - Arthrex Fiberstitch all-inside meniscal sutures - 4.0mm cannulated screws - Vitoss bone graft substitute