Work

Arthroscopic intercruciate trans-septal all-inside repair for lateral bucket-handle meniscus tear: A current technique

Year: 2026

Type: article

Abstract: Lateral bucket-handle meniscus tears are challenging to reduce and repair due to limited visualization of the posterior compartment and the risk of iatrogenic injury. We present an arthroscopic workflow that combines standard anterior portals with an intercruciate trans-septal route to enhance visualization and working space across the posterior compartments of the knee. Key steps include safe creation of posteromedial and posterolateral apertures, protected posterior portals, and guided passage of a Wissinger rod to connect compartments prior to reduction and fixation. Reduction is performed with careful meniscal preparation and controlled manipulation; fixation is achieved primarily with all-inside sutures, with optional inside-out reinforcement for stiffer or chronic tears. This technique serves as an alternative approach in selected cases where visualization is limited. This article details indications, contraindications, safety pearls, limitations, early institutional experience, and expected complications to support safe adoption of the technique.

Source: Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine

DOI: 10.1016/j.jisako.2025.101062

Authors: Nishand Guruseelan, Bancha Chernchujit, Steven Liew

Institution: Thammasat University

Language: English

Topic: Knee injuries and reconstruction techniques

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,000