Journal
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
Volume 23, Issue 1, Pages 20-25Publisher
SPRINGER
DOI: 10.1007/s00167-013-2421-3
Keywords
Arthroscopic mensical repair; Simplified cruciate suture; Ultimate tension load; Circumferential collagen fibres; Radial collagen fibres; Collagen fibres
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Collagen fibres of the meniscus arrange into two main orientations: circumferential fibres parallel to the long axis of the meniscus and radial fibres perpendicular to the long axis of the meniscus. Meniscal sutures are placed either in vertical or in horizontal orientations. Vertical sutures better hold circumferential fibres because it encircles them like a rope holding a bunch of tree branches. In the same manner, horizontal sutures better hold radial fibres. The Simplified Cruciate Suture consists of two vertical oblique sutures. Placing two vertical sutures in an oblique orientation captures greater meniscal tissue volume, holds and grasps both circumferential and radial collagen fibres of the meniscus into a three-dimensional plane with eventual high fixation strength of the repaired meniscal tear. Simplified cruciate suture is indicated for the repair of long bucket handle tears where it is placed in the middle of the tear like an anchor, and additional vertical and horizontal sutures are placed anterior and posterior to it as needed. Level of evidence V.
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