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Dr. Garcia demonstrates his technique for discoid meniscus repair in a young active patient.
Dr. Garcia specializes in complex knee, shoulder and elbow sports surgeries. He has prepared a number of surgical videos below to help patients better understand their procedures. He is frequently updating his surgical video database so check back soon for further updates.
In this video, Dr. Grant H. Garcia treats a young, active 13-year-old patient diagnosed with a symptomatic lateral discoid meniscus (an abnormally thick, crescent-shaped or complete disc variant) that has sustained an under-surface tear.
The complex surgical correction involves these essential procedures:
- Saucerization: Dr. Garcia begins by debulking and reshaping the oversized discoid meniscus using a sequential combination of arthroscopic biters and shavers. The goal is to reshape the tissue down to a near-normal anatomical peripheral width of roughly 7 to 9 millimeters.
- Identifying Instability: During saucerization, the surgeon identifies a high degree of joint instability and an uncontained under-surface tear. There is a complete lack of natural meniscus root attachment on the posterior horn (indicative of a Wrisberg-type variant), causing extreme mobility that would lead to premature structural failure if left unaddressed.
- Transtibial Root Repair: To secure the posterior horn, the surgeon preps the meniscus with a curved Firstpass device and specialized mini tape, executing a secure, high-strength locking suture. He sets up a transtibial drill guide to establish a bone tunnel through the shinbone and passes the anchor sutures through it to pull the root down tightly against its anatomical footprint.
- All-Inside and Inside-Out Repairs: Once the root is anchored, residual tissue mobility is evaluated. Dr. Garcia maps out a series of vertical mattress sutures using an all-inside repair device to secure the posterior horn body back to the joint capsule. For the anterior horn, he transitions to an inside-out approach utilizing spinal needles to route PDS sutures and suture tapes, eliminating all remaining shifting.
- Healing Enhancement: To finish the procedure, final probing confirms that the meniscus is rock-solid and anatomically restored. Dr. Garcia performs a microfracture technique inside the knee notch to stimulate blood flow and release bone marrow cells, which aids in overall tissue healing.
