Table 2.

Pearls, Pitfalls, and Risks

Pearls:

• The arthroscopic lateral capsulodesis is performed in cases where a redundant capsule is observed or where extrusion of the midbody of the lateral meniscus has been identified with magnetic resonance imaging before meniscal allograft transplantation (MAT).

• Remove any marginal osteophyte on the lateral edge of the tibial plateau.

• Perform a minimum of two 2.4-mm tibial tunnels from the anteromedial aspect of the tibia with the help of an anterior cruciate ligament tibial guide with a distance of 1 cm in between.

• Identify each tunnel to avoid tunnel collision.

• Using a suture passer, leave a small suture loop inside the joint to retrieve the capsulodesis suture strand.

• Use No. 1 polydioxanone as a shuttle suture, replace it by a high-strength strand, and retrieve it through each tibial tunnel.

• Tie the 2 suture ends on the anteromedial tibial cortex always before the meniscal graft introduction and fixation.

Pitfalls and risks:

• Failure to address concomitant conditions such as chondral lesions or instability will lead to poor results.

• An error in the sequence of tying the sutures, after graft introduction and fixation, can lead to poor results and MAT extrusion.

• To avoid tunnel collision, make sure to identify each tunnel and place the guide with a minimum of 1 cm of distance between them.

• Stiffness can occur if the patient is not able to follow the established rehabilitation protocol. Partial weight bearing with a knee immobilizer is allowed at 3 wk and progressed to full weight bearing at approximately 6 wk. Progressive range of motion without exceeding 90° of flexion until the fourth week is followed by unrestricted progression per tolerance.