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Meniscal Root Repair with the new Arthrex Sutureloc
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 surgical video, Dr. Grant H. Garcia demonstrates a medial meniscal root repair using the new Arthrex SutureLoc system, focusing on its strong fixation and intraoperative retensioning capabilities.
The procedure is executed through the following surgical steps:
- Joint Access & Footprint Preparation: To gain better visualization and working room inside the medial compartment, Dr. Garcia performs a small, controlled trephination. The patient is roughly a month and a half out from the initial injury, and the meniscal root is scarred down. The native bony footprint is carefully prepared, shaved, and irritated until a healthy, bleeding bone surface is exposed to aid biological healing.
- Tunnel Creation & SutureLoc Loading: A tibial drill guide is positioned over the footprint, and a 2.4 mm cannulated pin is driven through the bone. A core sleeve passes through the tunnel to cleanly evacuate the bone fragments. A passing wire then pulls the SutureLoc construct down into the tunnel. The end of the device is pulled just beneath the cortical bone surface where it expands securely. To maintain a clean workspace inside the working Passport cannula, three of the four attached sutures are temporarily pulled out of the way to prevent tangling.
- Suture Passing (The Rip-Stop Method): Using a knee Scorpion device, Dr. Garcia passes a horizontal mattress stitch through the meniscus to serve as a robust "rip-stop." He takes the passing stitch, locks it down on the tibial side, and establishes initial tension. He then passes a second, interrupted suture through the tissue to create an incredibly secure, multi-point fixation of the meniscal root.
- Dynamic Tensioning & Microfracture: The unique benefit of the SutureLoc device is that it can be dynamically adjusted. The knee is taken through a full range of motion up to 90 degrees of flexion and back to extension to check for any laxity. Dr. Garcia incrementally back-tensions the device until the meniscal root is compressed flat against the raw bone. To finish, microfracture holes are punched into the femoral notch to recruit healing stem cells to the joint.
