Circumferential-Surrounding (“Sandwich”) Meniscal Repair: A Salvage Technique to Save the Meniscus

Meniscal injuries are extremely common in the general and athletic populations. The management strategy has switched from meniscectomy to meniscal-preserving techniques. It is nowadays extensively accepted that surgeons have to do their best to repair the meniscus and try to preserve as much tissue as possible. However, in many cases the tissue quality is poor and the tear pattern is complex. In such scenarios, meniscal repair has a lower success rate. In the present surgical technique, an arthroscopic all-inside circumferential-surrounding meniscal repair technique is presented. Any meniscal tissue or the meniscal rim is first debrided to a bleeding bed. Then, an all-inside device is used to create vertical sutures from capsule to capsule surrounding the entire meniscus (circumferential-surrounding). Care should be taken not to tighten the suture too much to avoid cutting the meniscal tissue. This easy and effective repair technique “packs” the meniscal tear fragments altogether and allows the surgeon to save the meniscus when facing with irreparable, degenerative, complex meniscus tears.