Name: Meniscus Repair Using the FiberStitch™ Implant
Uploaded: 2020-06-25T00:00:00Z
Channel: Arthrex
Description: J. Lee Pace, MD (Farmington, CT), presents a clinical case during which he repaired a torn meniscus using the all-suture, all-inside FiberStitch™ implant. This was also an opportunity for a second look at an earlier, successful all-inside QuadLink™ ACL reconstruction.

<p>J. Lee Pace, MD (Farmington, CT), presents a clinical case during which he repaired a torn meniscus using the all-suture, all-inside FiberStitch™ implant. This was also an opportunity for a second look at an earlier, successful all-inside QuadLink™ ACL reconstruction.</p>

Not Hidden

English  - en

video

VID1-001187-en-US | A | Meniscus Repair Using the FiberStitch™ Implant

J. Lee Pace

Human

Surgeons presenting one or more clinical cases

Chirurg:innen präsentieren einen oder mehrere klinische Fälle

Videos von Fallpräsentationen

Case Presentation Videos

Cirurgiões que apresentam um ou mais casos clínicos.

Vídeos apresentações de casos

Cirujanos que presentan uno o más casos clínicos.

Video presentaciones de casos

Meniscus Repair Using the FiberStitch™ Implant

Hello. My name is doctor Lee pace, and I'm here to present a meniscus repair case using the FiberStitch device. This is a 21 year old female who is about 18 months status post and All-inside QuadLink ACL reconstruction, who sustained a new injury to her left knee while playing soccer. She presented with a medial joint line tenderness and swelling and associated mechanical symptoms. We obtained an MRI which showed this far peripheral undersurface. Posterior horn. Medial meniscus. Tear. Now, given her young age and her desire to get back to sports and the tear pattern seen on this MRI, we felt that surgical intervention would be best warranted to give her the best possible chance at preserving her meniscus and getting back to the activities that she wants to get back to. I felt this was a fantastic indication for the FiberStitch device. The FiberStitch deploys all suture based anchors with two Coreless FiberWire with a Pre-tied sliding knot. It's single handed and has active implant deployment. It's very easy to use. It has a wheel on the top of it that you simply roll all the way back to a firm stop to deploy the anchor, and then you roll all the way forward to clear the cannula and prepare the next anchor. You do that once, and then you do that again to simply deploy the anchors on the posterior aspect of the meniscus. The other innovative aspect of the FiberStitch device is that it has two vertical mattress stitches. The first stitch is tensioned outside of the joint. This feature allows the surgeon to really customize his or her tension to reduce the meniscus properly, without over constraint. After the first suture is tensioned, then simply pulling on the remaining free end of the suture will tension the second vertical mattress suture to achieve a more broad compression of the meniscus repair. So here we go with this case. Upon initial probing, this was an unstable Under surface tear, with rather poor visualization due to her tight medial compartment. So I performed an MCL fenestration in a percutaneous fashion so that I could really see and understand the character of the specific, sometimes hard to access and repair meniscus tear. So here I am using the FiberStitch device. I take my two passes as one. Would I deploy the anchors on the posterior capsule and as you can see, I was able to get my first pass on the undersurface of the meniscus so that I could get that anatomic reduction of the meniscus. Once I have the anchors placed, then outside the joint, I'll tension the first vertical mattress stitch, get the compression that I want, and then I will tension the second vertical mattress stitch. Once I've achieved the desired compression across the meniscus repair, I then simply take the suture cutter into the joint and cut the suture at the level of the meniscus to complete the repair. I was then able to pass two more FiberStitch anchors in similar fashion to achieve an excellent and stable anatomic reduction and compression of this specific, sometimes hard to fix meniscus tear. In addition to the repair, I provided biologic stimulation by performing a marrow venting procedure of the medial condyle. Post-operative rehab was rather straightforward. More of the limitations came to protecting the MCL fenestration than this specific meniscus repair. The patient was made 50% partial weight bearing for two weeks and then allowed to weight bear after that. She was also in a hinge knee brace for four weeks to protect the MCL fenestration, and the only sort of early restriction put in place specific for the meniscus repair was a range of motion restriction from 0 to 90 degrees for six weeks. When I saw her back at her three month follow up, she had complete pain relief. She had no swelling and full and painless range of motion with no flexion pain at end range flexion. She had no joint line tenderness, and at that point we had cleared her for return to impact activities.