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Author Topic: Question about dissolvable "arrows"  (Read 1782 times)

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Offline gillian

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Question about dissolvable "arrows"
« on: October 15, 2004, 09:04:06 PM »
I have a question about repairs using dossolvable darts, anchors and arrows.  What does the surgeon anchor the torn part of the miniscus too?   The rest of the meniscus, the joint capsule or some other tissue?

Offline dm

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Re: Question about dissolvable "arrows"
« Reply #1 on: October 16, 2004, 01:27:41 AM »
depends on where it tore. I had suture anchors, which anchor into bone, because I'd torn the meniscus away from the attachment to the bone. If it tore along the rim, then he's basically stitch it closed like stitching up skin, I'd think.
multiple arthroscopies 2/00,3/01,6/01,1/03, 12/07,10/10. chondromalacia, severe medial joint space narrowing following 3 partial menisectomies, chronic pain problems, kneecap problems, OCD lesion, failed mfx.

Offline AndrewC

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Re: Question about dissolvable "arrows"
« Reply #2 on: October 16, 2004, 03:37:44 PM »
gillian

dm is right. The meniscus is stitched together with sutures or arrows....the idea is that healing will take place and the darts/sutures purely hold the mensucs together for long enough for it to heal

Big bucket handle tear to lateral meniscus from sporting injury. Arthroscopy and meniscal repair carried out June 2004. sloooowwww recovery!!

2018 - torn medial meniscus in RH knee, partial extrusion. ongoing issues,

Offline gillian

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Re: Question about dissolvable "arrows"
« Reply #3 on: October 18, 2004, 05:47:05 AM »
Hmm so I'm wondering why my OS anchored the arrow to the joint capsule?  I'm 100% sure he did that b/c my PT had me call him up to check on it.  I walked out of the hospital feeling like my whole knee had been cranked to the outside (I had a lateral repair) and it still feels that way but sometimes I feel tearing in there and then it feels a bit better.

I'm interested purely from the POV of being educated as far as getting the mal-tracking issues I've had since then addressed.  I've already had a LR and  the lateral side of my patella shaved.  At the reapir site you can feel a big lump and it hurts to touch.  Is that normal a year later?

Offline AndrewC

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Re: Question about dissolvable "arrows"
« Reply #4 on: October 18, 2004, 03:18:39 PM »
Hi

Did you have a LR and patellar shaving due to the maltracking issues that occurred as a result of the meniscal repair??? or did you have other issues that required the LR and it was done previously??

The reason I ask is because since my meniscal repair I have some minor maltracking on my operated leg that was not there pre injury......My OS has said it's muscle imbalance but I have been going to the gym 5x per week to strengthen my legs and it is not resolved yet....

As for your meniscal arrow being anchored to the joint capsule.....
I have posted a link below that gives an excellent insight (quite technical) into the use of meniscal arrows and the reasons they can cause almost "exactly" the same problems as you are having......
Apparently they can take 3 years to dissolve fully  :o and are sometimes problematic.
I believe meniscal repairs are often "anchored" to the joint capsule to stabilise the meniscus (both suture and arrow... & depending on the type of tear) but if this is not done "correctly" it can cause a whole world of problems from what I've read.....especially with darts.


http://www.findarticles.com/p/articles/mi_m0918/is_2_28/ai_63089369

Hope this helps a bit
« Last Edit: October 18, 2004, 03:34:32 PM by andrewc »
Big bucket handle tear to lateral meniscus from sporting injury. Arthroscopy and meniscal repair carried out June 2004. sloooowwww recovery!!

2018 - torn medial meniscus in RH knee, partial extrusion. ongoing issues,

Offline gillian

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Re: Question about dissolvable "arrows"
« Reply #5 on: October 19, 2004, 09:52:23 PM »
AndrewC, thank you so much that link really helps.

I had a twisiting injury and likely subluxed the patella when I tore the meniscus.  After the swelling went down I still had some pain inside the joint and some instability.  After about 6 months of work I was pretty fit (ie I spent the winter at the gym, and was snowboarding and playing ice hockey three times a week by spring) and decided to have surgery as everyone thought the cartiledge was moving around and would get worse.  After surgery I couldn't bend the knee for almost 8 weeks and my kneecap felt dragged to the outside.  After 3 months it was so bad I had to have another surgery for a LR and bone shaving.  They could still see the anchor at that point.

That helped a bit but it still feels like my leg was dissasembled and put back together wrong.  The best I can explain it is as that it feels like its been McConnell taped the wrong way, really really tightly, so that I can't bend it without twisting it.  After talking to someone who had a medial reefing done I am starting to think I may have had an inadvertent "lateral reefing" with the anchor in the joint capsule dragging everything to the outside.  

I did have some damage under the patella from a car accident years ago and some ligament damage so they're a bit lax and also a shallow groove.  That's really muddied the waters as I was diagnosed with mal-tracking issues twice based on that damage.  The only time it's hurt though was when the OS started digging around in there during my scope to clean it up!  ouch.  It's calmed down now.

I'm really trying to investigate my options as the knee is causing hip and foot problems, as well as the  fear that I will end up with arthritis sooner rather than later.
« Last Edit: October 19, 2004, 10:20:50 PM by gillian »

Offline AndrewC

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Re: Question about dissolvable "arrows"
« Reply #6 on: October 20, 2004, 01:40:44 AM »
Gillian....

Glad I could be of some help ;) and you found the article useful....

I feel really sorry for you as your situation sounds a real nightmare scenario  :o

I can't believe the OS took the drastic step of a Lateral Release 3 months into the repair when it seems blatently obvious that your problems were being caused by dodgy arrows incorrectly located in the joint capsule........

I mean if you were snowboarding etc up until the operation......and you felt that your knee cap was being dragged laterally after it + your knee wouldnt bend for two months?? (although I only had 90 degrees ROM post op for about 7 weeks)....Surely your OS realised it was the "repair" that was at fault???
What did the OS say?? did you just leave it in the OS hands so to speak and they did the LR etc or ??? did your OS not think it was his/her repair that was at fault?

Anyway....I hope things start looking up for you....what are your current plans??

I think if I was in your shoes I would definately not let the OS touch me again until I had got a second opinion off someone who has lots of experience with these types of complications....
To maybe remove the dodgy arrow(s) and take the situation from there......

All the best


Big bucket handle tear to lateral meniscus from sporting injury. Arthroscopy and meniscal repair carried out June 2004. sloooowwww recovery!!

2018 - torn medial meniscus in RH knee, partial extrusion. ongoing issues,

Offline gillian

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Re: Question about dissolvable "arrows"
« Reply #7 on: October 20, 2004, 02:02:46 AM »
The original OS insisted that I had the lateral mal-tracking before the first surgery and that it would just heal up.  I got quite fed up with him and I ended up going to a very big knee surgery out of state (I live in a small state and wanted a clean slate doctor wise) and they are the ones who did the LR/bone shaving.  I couldn't really walk at the time and I needed another opinion.  They also told me I didn't have a mal-tracking problem, just a very serious tilt.

I admit that I have zero muscle in that leg at the moment but I feel that the lack of muscle is a result of the knee problems rather than the other way round.  My new OS (I moved) is the one proposing the arrow is the problem.  I am pretty worried about another surgery so I'm trying to get all the info I can or to talk to other people who've had similar problems.  

I've been an athlete for ever and used to ride racehorses so I'm pretty experienced with getting hurt and healing up! and I know this is not healing right at all.















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