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Peer-reviewedCC BYArthroscopy techniques

All‐Inside Stabilization of Discoid Lateral Meniscus Popliteal Hiatus‐Related Instability Using Anterior Cord Release With Meniscus Retention

  • Seikai Toyooka1
  • Haruki Miyazaki2
  • Yutoshi Osaki1
  • Noriaki Arai1
  • Hirotaka Kawano1
  • Takumi Nakagawa1
  1. 1Department of Orthopaedic Surgery Teikyo University School of Medicine Tokyo Japan.
  2. 2Department of Orthopaedic Surgery Ageo Central General Hospital Saitama Japan.
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Abstract

Discoid lateral meniscus is a common cause of lateral knee pain, snapping, catching, and intermittent locking. Although saucerization combined with repair has been widely used, postoperative remodeling, reduced meniscal volume, extrusion, and degenerative changes on magnetic resonance imaging have raised concerns regarding meniscal resection. A meniscus-retention concept using anterior cord release with robust suturing has been described, particularly for large displaced longitudinal tears with frank mechanical locking. In daily practice, however, many symptomatic cases present with popliteal hiatus-related posterior peripheral disruption and popliteomeniscal fascicle insufficiency, resulting in peripheral rim instability and anterior translation of the discoid meniscus during knee motion. Here, we describe a simple and physiologic, meniscus-retaining technique that combines anterior cord release to reduce anterior horn tension and facilitate peripheral reduction and targeted all-inside vertical mattress fixation around the popliteus tendon. A pragmatic avoidance criterion is emphasized for extensive, notch-locked displaced tears that likely require more robust fixation, in which inside-out repair is preferred. This technique aims to control dynamic instability while preserving native meniscal tissue and minimizing intra-articular environmental change.

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Cite

BibTeXRIS
BibTeX
@article{toyooka2026allinside,
  title = {{All‐Inside Stabilization of Discoid Lateral Meniscus Popliteal Hiatus‐Related Instability Using Anterior Cord Release With Meniscus Retention}},
  author = {Seikai Toyooka and Haruki Miyazaki and Yutoshi Osaki and Noriaki Arai and Hirotaka Kawano and Takumi Nakagawa},
  journal = {Arthroscopy techniques},
  year = {2026},
  month = oct,
  doi = {10.1002/atn2.70360},
  url = {https://europepmc.org/article/PMC/PMC13717125},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - All‐Inside Stabilization of Discoid Lateral Meniscus Popliteal Hiatus‐Related Instability Using Anterior Cord Release With Meniscus Retention
AU  - Seikai Toyooka
AU  - Haruki Miyazaki
AU  - Yutoshi Osaki
AU  - Noriaki Arai
AU  - Hirotaka Kawano
AU  - Takumi Nakagawa
PY  - 2026
DA  - 2026/10/28
JO  - Arthroscopy techniques
DO  - 10.1002/atn2.70360
UR  - https://europepmc.org/article/PMC/PMC13717125
AB  - Discoid lateral meniscus is a common cause of lateral knee pain, snapping, catching, and intermittent locking. Although saucerization combined with repair has been widely used, postoperative remodeling, reduced meniscal volume, extrusion, and degenerative changes on magnetic resonance imaging have raised concerns regarding meniscal resection. A meniscus-retention concept using anterior cord release with robust suturing has been described, particularly for large displaced longitudinal tears with frank mechanical locking. In daily practice, however, many symptomatic cases present with popliteal hiatus-related posterior peripheral disruption and popliteomeniscal fascicle insufficiency, resulting in peripheral rim instability and anterior translation of the discoid meniscus during knee motion. Here, we describe a simple and physiologic, meniscus-retaining technique that combines anterior cord release to reduce anterior horn tension and facilitate peripheral reduction and targeted all-inside vertical mattress fixation around the popliteus tendon. A pragmatic avoidance criterion is emphasized for extensive, notch-locked displaced tears that likely require more robust fixation, in which inside-out repair is preferred. This technique aims to control dynamic instability while preserving native meniscal tissue and minimizing intra-articular environmental change.
SN  - 2212-6287
ER  -