Knee joint capsular disruption and repair
Meniscal extrusion can occur due detachment of the knee capsule from structures of the knee. Disclosed herein are methods to repair the meniscal detachment. Additionally, cadaveric and synthetic models can be used to teach said methods of repair.
1. A method of repairing a capsular disruption and a meniscal extrusion comprising:
inserting one or more anchors through a knee joint capsule at the capsular disruption, wherein the capsular disruption comprises at least one of a tear of coronary fibers of a meniscotibial ligament or a tear of coronary fibers of a meniscofemoral ligament; and
securing the knee joint capsule to a knee joint structure to decrease a length of the meniscal extrusion, wherein securing the knee joint capsule to the knee joint structure comprises inserting the one or more anchors into the knee joint structure, wherein the knee joint structure comprises at least one of a tibia, a femur, tibial periosteum, or femoral periosteum.
2. The method of claim 1 , wherein the one or more anchors comprises a suture anchor or a soft tissue anchor.
3. The method of claim 1 , wherein inserting one or more anchors through the knee joint capsule comprises inserting a first anchor and a second anchor.
4. The method of claim 3 , wherein the first anchor is inserted below a knee joint line and at an anterior distal portion of the knee joint capsule, and wherein the second anchor is inserted posterior to the first anchor.
5. The method of claim 3 , wherein the second anchor is inserted through the knee joint capsule within about 2 cm of the first anchor.
6. The method of claim 5 , wherein the second anchor is inserted through the knee joint capsule within about 1 cm to about 1.5 cm of the first anchor.
7. The method of claim 3 , wherein the method further comprises securing sutures from each of the first and second anchors to the opposite anchor.
8. The method of claim 3 , wherein the method further comprises securing the first anchor to the second anchor with a flexible strand.
9. The method of claim 1 , wherein inserting one or more anchors through the knee joint capsule comprises percutaneously inserting the one or more anchors.
10. The method of claim 1 , wherein the method further comprises drilling a hole in a bone for inserting the anchor.
11. The method of claim 1 , further comprising:
visualizing a spinal needle with an arthroscope to identify a location for inserting one or more anchors through the knee joint capsule, wherein the spinal needle is inserted through the skin into the knee joint structure.
12. The method of claim 1 , further comprising:
inserting a biological product into the knee to stimulate healing.
13. The method of claim 12 , wherein the biological product is selected from the group consisting of stem cells, bone marrow concentrate, platelet-rich plasma (PRP), a tissue graft, and combinations thereof.
14. The method of claim 1 , wherein the knee is a knee of a patient, a cadaveric knee, or a synthetic knee.
15. The method of claim 1 , wherein the capsular disruption comprises the tear of coronary fibers of the meniscotibial ligament, and wherein inserting the one or more anchors into the knee joint structure comprises inserting the one or more anchors into the tibia.