{
    "abstract": "All-inside techniques for meniscal repairs offer comparable outcomes and healing rates with reduced operative time and fewer incisions; however, iatrogenic neurovascular injuries during arthroscopic meniscal repairs are a significant concern.\nTo identify the zones of risk and incidence of injury concerning the common peroneal nerve (CPN) and popliteal artery in relation to the popliteal tendon (PT) from the anterolateral (AL) and anteromedial (AM) portals during a simulated all-inside technique in the pediatric population.\nDescriptive laboratory study.\nUsing axial knee magnetic resonance imaging scans of 124 patients, the all-inside technique was simulated by drawing direct lines from the AM and AL portals to the medial and lateral borders of the PT. If the line came into contact with the CPN, a risk of projected iatrogenic CPN injury was found. Measurements were then recorded to assess and define \"risk zones.\" A similar simulation was performed in relation to the popliteal artery to assess distance to projected iatrogenic injury.\nThe risk of CPN injury was significantly higher when using the AL portal (45%) compared with the AM portal (19%) when simulating repair at the lateral edge of the PT (\nThe authors found that the AM portal was safer for repairing the body of the lateral meniscus while simulating repair at the lateral edge of the PT, while the AL portal was safer for repairing the lateral meniscus while simulating repair from the medial edge of the PT.\nBy understanding these risk profiles, surgeons can adopt safer approaches for meniscal repairs in pediatric patients, thereby minimizing the likelihood of injuring sensitive neurovascular structures.",
    "authors": [
        {
            "affiliation": "Department of Orthopedic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.",
            "firstname": "Annat",
            "initials": "A",
            "lastname": "Houston"
        },
        {
            "affiliation": "Department of Orthopedic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.",
            "firstname": "Casey",
            "initials": "C",
            "lastname": "McDonald"
        },
        {
            "affiliation": "Department of Orthopedic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.",
            "firstname": "Andrew",
            "initials": "A",
            "lastname": "Eck"
        },
        {
            "affiliation": "Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.",
            "firstname": "Travis",
            "initials": "T",
            "lastname": "Kotzur"
        },
        {
            "affiliation": "Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.",
            "firstname": "David",
            "initials": "D",
            "lastname": "Momtaz"
        },
        {
            "affiliation": "Department of Orthopedic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.",
            "firstname": "David",
            "initials": "D",
            "lastname": "Heath"
        },
        {
            "affiliation": "Department of Orthopedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.",
            "firstname": "Grant D",
            "initials": "GD",
            "lastname": "Hogue"
        },
        {
            "affiliation": "Department of Orthopedic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.",
            "firstname": "Thomas",
            "initials": "T",
            "lastname": "DeBerardino"
        }
    ],
    "conclusions": "The authors found that the AM portal was safer for repairing the body of the lateral meniscus while simulating repair at the lateral edge of the PT, while the AL portal was safer for repairing the lateral meniscus while simulating repair from the medial edge of the PT.",
    "copyrights": "\u00a9 The Author(s) 2025.",
    "doi": "10.1177/23259671241304817\n10.1007/s00167-011-1489-x\n10.1097/BPB.0b013e328010b707\n10.1055/s-0030-1247723\n10.1007/s00167-022-07297-5\n10.1177/18632521221149056\n10.1016/j.arthro.2018.07.046\n10.1097/JSA.0b013e318204d01a\n10.1007/BF01552648\n10.1177/23259671231209260\n10.1007/s11832-010-0289-z\n10.1177/23259671211038397\n10.1016/j.arthro.2015.04.100\n10.2106/JBJS.L.00772\n10.1177/0363546516632504\n10.1177/0363546511411701\n10.1007/s00167-018-5060-x\n10.5435/JAAOS-D-18-00143\n10.1177/2325967119890325\n10.1016/0749-8063(89)90010-8\n10.2106/JBJS.CC.22.00460\n10.5435/00124635-200911000-00004\n10.1177/1947603520923143\n10.1016/j.arthro.2016.01.026\n10.1053/jars.2002.36146\n10.3109/03014460.2012.756122\n10.1016/S0968-0160(97)00027-6\n10.1016/j.csm.2022.05.010\n10.1016/S0749-8063(86)80080-9\n10.1007/s10140-013-1121-0\n10.1186/s40634-018-0166-0",
    "journal": "Orthopaedic journal of sports medicine",
    "keywords": [
        "all-inside",
        "arthroscopy",
        "meniscal repair"
    ],
    "methods": null,
    "publication_date": "2025-03-07",
    "pubmed_id": "40052185\n21468617\n17159536\n19216349\n36581681\n36755559\n30611346\n21293238\n7584170\n38021302\n21966312\n34631905\n26163307\n23467876\n26989072\n21737837\n30019073\n31026239\n31903403\n2544194\n36735799\n19880680\n32447965\n27056289\n12368795\n23327630\n21287977\n36210169\n3801104\n23525909\n30564981",
    "results": "The risk of CPN injury was significantly higher when using the AL portal (45%) compared with the AM portal (19%) when simulating repair at the lateral edge of the PT (",
    "title": "Identifying Risk Zones for Neurovascular Injury in Pediatric All-Inside Arthroscopic Lateral Meniscal Repair.",
    "xml": "<Element 'PubmedArticle' at 0x788502d290d0>"
}