LARAI portal provides a safe method for lateral meniscus repair: three-dimensional computed tomography and cadaveric assessment
Abstract Background Lateral, All-Round and All-Inside (LARAI) portal is a viewing or working portal for observing and repairing the lesions of the lateral meniscus. However, there are safety concerns about popliteal artery (PA) injuries during the procedure. This study aimed to assess the safe dista...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-09-01
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| Series: | Journal of Orthopaedics and Traumatology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s10195-023-00727-1 |
| _version_ | 1797451838388174848 |
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| author | Yi Long Zhengzheng Zhang Min Zhou Jingyi Hou Yunfeng Zhou Liang Jiang Xiaoding Xu Rui Yang |
| author_facet | Yi Long Zhengzheng Zhang Min Zhou Jingyi Hou Yunfeng Zhou Liang Jiang Xiaoding Xu Rui Yang |
| author_sort | Yi Long |
| collection | DOAJ |
| description | Abstract Background Lateral, All-Round and All-Inside (LARAI) portal is a viewing or working portal for observing and repairing the lesions of the lateral meniscus. However, there are safety concerns about popliteal artery (PA) injuries during the procedure. This study aimed to assess the safe distance between the trajectory of the LARAI portal and PA. Materials and methods Both three-dimensional computed tomography (3D-CT) and cadavers were used to simulate the LARAI portal trajectory. In the 3D-CT study, between January 2020 and September 2020, 45 participants who underwent computed tomography angiography were included in the study. The shortest distance from the PA to the simulated trajectory needle (PS) was measured using 3D-CT. Mean −3SD −2 was calculated to assess the safety of the LARAI portal trajectory. If this value was more than zero, the trajectory was considered “safe.” In the cadaveric study, lower limbs from seven fresh-frozen cadavers were used to establish the “safe” trajectories of the LARAI portal, and the PS was measured. Results In the 3D-CT study, the longest PS (P < 0.001) was found 20 mm lateral to the edge of the patellar tendon trajectory at 0 mm from the posterior cruciate ligament (PCL). Safe trajectories were also found 10 mm, 15 mm, and 20 mm lateral to the edge of the patellar tendon at 0 mm from the PCL, as well as the 20 mm lateral to the edge of the patellar tendon at 3 mm from the PCL. The cadaveric study showed that the average PS of all safe trajectories closely adjoined to PCL was greater than 14 mm. Conclusions The LARAI portal trajectory in the “figure of four” is safe, and the optimal insertion point is 10–20 mm lateral to the edge of the patellar tendon and closely adjoined to the posterolateral margin of the PCL at knee joint line level. Level of evidence Level IV. |
| first_indexed | 2024-03-09T15:00:08Z |
| format | Article |
| id | doaj.art-9c391cd0c8324dabaf2a82290c39d0fe |
| institution | Directory Open Access Journal |
| issn | 1590-9999 |
| language | English |
| last_indexed | 2024-03-09T15:00:08Z |
| publishDate | 2023-09-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Orthopaedics and Traumatology |
| spelling | doaj.art-9c391cd0c8324dabaf2a82290c39d0fe2023-11-26T13:58:37ZengSpringerOpenJournal of Orthopaedics and Traumatology1590-99992023-09-0124111010.1186/s10195-023-00727-1LARAI portal provides a safe method for lateral meniscus repair: three-dimensional computed tomography and cadaveric assessmentYi Long0Zhengzheng Zhang1Min Zhou2Jingyi Hou3Yunfeng Zhou4Liang Jiang5Xiaoding Xu6Rui Yang7Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityDepartment of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityDepartment of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityDepartment of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityDepartment of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityDepartment of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityDepartment of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityAbstract Background Lateral, All-Round and All-Inside (LARAI) portal is a viewing or working portal for observing and repairing the lesions of the lateral meniscus. However, there are safety concerns about popliteal artery (PA) injuries during the procedure. This study aimed to assess the safe distance between the trajectory of the LARAI portal and PA. Materials and methods Both three-dimensional computed tomography (3D-CT) and cadavers were used to simulate the LARAI portal trajectory. In the 3D-CT study, between January 2020 and September 2020, 45 participants who underwent computed tomography angiography were included in the study. The shortest distance from the PA to the simulated trajectory needle (PS) was measured using 3D-CT. Mean −3SD −2 was calculated to assess the safety of the LARAI portal trajectory. If this value was more than zero, the trajectory was considered “safe.” In the cadaveric study, lower limbs from seven fresh-frozen cadavers were used to establish the “safe” trajectories of the LARAI portal, and the PS was measured. Results In the 3D-CT study, the longest PS (P < 0.001) was found 20 mm lateral to the edge of the patellar tendon trajectory at 0 mm from the posterior cruciate ligament (PCL). Safe trajectories were also found 10 mm, 15 mm, and 20 mm lateral to the edge of the patellar tendon at 0 mm from the PCL, as well as the 20 mm lateral to the edge of the patellar tendon at 3 mm from the PCL. The cadaveric study showed that the average PS of all safe trajectories closely adjoined to PCL was greater than 14 mm. Conclusions The LARAI portal trajectory in the “figure of four” is safe, and the optimal insertion point is 10–20 mm lateral to the edge of the patellar tendon and closely adjoined to the posterolateral margin of the PCL at knee joint line level. Level of evidence Level IV.https://doi.org/10.1186/s10195-023-00727-1LARAI portalMeniscusPopliteal arteryPosterior cruciate ligamentAll-inside |
| spellingShingle | Yi Long Zhengzheng Zhang Min Zhou Jingyi Hou Yunfeng Zhou Liang Jiang Xiaoding Xu Rui Yang LARAI portal provides a safe method for lateral meniscus repair: three-dimensional computed tomography and cadaveric assessment Journal of Orthopaedics and Traumatology LARAI portal Meniscus Popliteal artery Posterior cruciate ligament All-inside |
| title | LARAI portal provides a safe method for lateral meniscus repair: three-dimensional computed tomography and cadaveric assessment |
| title_full | LARAI portal provides a safe method for lateral meniscus repair: three-dimensional computed tomography and cadaveric assessment |
| title_fullStr | LARAI portal provides a safe method for lateral meniscus repair: three-dimensional computed tomography and cadaveric assessment |
| title_full_unstemmed | LARAI portal provides a safe method for lateral meniscus repair: three-dimensional computed tomography and cadaveric assessment |
| title_short | LARAI portal provides a safe method for lateral meniscus repair: three-dimensional computed tomography and cadaveric assessment |
| title_sort | larai portal provides a safe method for lateral meniscus repair three dimensional computed tomography and cadaveric assessment |
| topic | LARAI portal Meniscus Popliteal artery Posterior cruciate ligament All-inside |
| url | https://doi.org/10.1186/s10195-023-00727-1 |
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