Limited Capsular Bridge Meniscus Repair.

Abstract

Meniscus preservation is the preferred approach for managing meniscal tears, with various techniques described in the literature. While the all-inside, inside-out, and outside-in techniques offer distinct advantages, each is limited by factors, such as soft tissue entrapment, insufficient repair strength, increased neurovascular risk, and high cost. This article describes a limited capsular bridge method designed to enhance biomechanical strength, particularly for complex tears, while minimizing soft tissue entrapment, reducing risk of neurovascular injury, and lowering cost. The technique involves a stepwise approach: a suture passer is used to place a vertical suture across the meniscus, and a spinal needle preloaded with a polydioxanone loop is used to pass both limbs of the suture extracapsular to create a limited capsular bridge. The suture ends are tied through a small skin incision with minimal extracapsular disruption. This provides a vertical repair configuration that offers improved biomechanical stability, lower soft tissue entrapment, neurovascular risks, and cost-effectiveness. While promising, it presents a steeper learning curve and is more time-consuming than traditional methods.