My technique on one of the first isolated meniscal extrusion repairs in Washington State.

This video, titled "My technique on one of the first isolated meniscal extrusion repairs in Washington State," features a highly unique surgical approach for a young patient who failed conservative treatments for an isolated medial meniscal extrusion. Notably, the patient's cartilage and meniscus were completely intact with no tearing at all, even at the root.

The procedural steps shown in the video include:

• Evaluation and Preparation: The surgeon evaluates the knee, using probing and joint motion to confirm the extrusion. A ball rasp is used to carefully abrade and prepare the tibio-capsular junction, clearing the tissue surfaces to encourage a solid healing response.
• Anchor Placement & Suture Passing: Utilizing small 1.8 FiberTak anchors, the surgeon inserts a suture lasso through an anteromedial portal. The suture lasso is passed through both the meniscus and the joint capsule. The surgeon highlights that performing this intra-articularly (inside the joint capsule) avoids over-constraining the knee or accidentally trapping the Medial Collateral Ligament (MCL).
• Horizontal Mattress Stitching: The sutures are arranged and passed in a horizontal mattress pattern. The first stitch is applied posteromedially, and a second anchor is placed anteromedially to repeat the process.
• Sequential Tensioning: The surgeon utilizes the built-in locking mechanisms of the anchors to slowly pull the slack out of the lines. This step sequentially cinches the tissue down, effectively pulling the extruded meniscus back into place over the tibial plateau.
• Final Fixation & Bio-Stimulation: After the final tightening, the surgeon probes the area, verifying that the procedure successfully reduced the extrusion by 3 to 4 millimeters. Finally, the surgeon microfractures the knee notch to release bone marrow cells into the joint space, promoting better overall tissue healing.