Arthroscopic Meniscal Hoop-Plasty Using a 1-mm Polyethylene Tape for Treating and Preventing Lateral Meniscus Extrusion.

Abstract

Lateral meniscus (LM) extrusion is a clinically significant condition associated with loss of hoop stress function and progressive joint degeneration. Preventing or correcting LM extrusion is critical for preserving knee joint function. Although several centralization and hoop augmentation techniques have been reported, many are nonanatomic and mechanically insufficient for restoring hoop tension. We describe an arthroscopic technique, not previously reported in this form, for reconstructing meniscal hoop tension using a 1-mm polyethylene tape, which has an ultimate strength of 596 N. The tape is arthroscopically passed circumferentially through the red-red zone of the LM-from the posterior root to the anterior root-using a combination of suture-relay techniques with a specific type of suture passer and an upward suture passer. Bone tunnels are created at the root attachments via an anteromedial tibial incision, and the tape is tensioned and fixed with an anchor staple. Hoop-plasty is indicated for patients in whom the LM shows extrusion, and it can be performed in conjunction with partial meniscectomy, meniscal repair, or distal femoral osteotomy. Although postoperative outcomes may vary, this technique may offer an effective and anatomic approach for restoring LM hoop function and managing or preventing extrusion. Early magnetic resonance imaging follow-up shows extrusion reduction.