Limited Capsular Bridge Meniscus Repair.
Asaad Ahmad, Abdelmohdi AlKhawaja, Bourhan Alrayes
Abstract
Open AccessMeniscus preservation is the preferred approach for managing meniscal tears, with various techniques described in the literature. While the all-inside, inside-out, and outside-in techniques offer distinct advantages, each is limited by factors, such as soft tissue entrapment, insufficient repair strength, increased neurovascular risk, and high cost. This article describes a limited capsular bridge method designed to enhance biomechanical strength, particularly for complex tears, while minimizing soft tissue entrapment, reducing risk of neurovascular injury, and lowering cost. The technique involves a stepwise approach: a suture passer is used to place a vertical suture across the meniscus, and a spinal needle preloaded with a polydioxanone loop is used to pass both limbs of the suture extracapsular to create a limited capsular bridge. The suture ends are tied through a small skin incision with minimal extracapsular disruption. This provides a vertical repair configuration that offers improved biomechanical stability, lower soft tissue entrapment, neurovascular risks, and cost-effectiveness. While promising, it presents a steeper learning curve and is more time-consuming than traditional methods.