Lateral Meniscoplasty With Semitendinosus Tendon Combined With Capsulodesis.

BACKGROUND: Subtotal lateral meniscectomy may lead to increased tibiofemoral contact pressures and early degenerative changes. Meniscal reconstruction using autograft tissue has been shown to restore load distribution and joint stability. This video demonstrates an arthroscopic technique for lateral meniscoplasty using a doubled semitendinosus tendon, combined with capsulodesis, to limit the meniscal extrusion rate. INDICATIONS: Patients with postmeniscectomy syndrome and a sufficient residual meniscal rim who present with lateral compartment pain and preserved articular cartilage. TECHNIQUE DESCRIPTION: The patient is positioned supine with the leg hanging freely in a leg holder. Standard anteromedial and anterolateral portals are established. Capsulodesis is performed using two 3-mm PEEK implants placed on the lateral tibial plateau margin, creating shuttle sutures that secure the capsule. The semitendinosus tendon is harvested, doubled, and prepared as a 12 to 15 cm graft. Posterior and anterior tibial tunnels are drilled using a meniscal root guide and shuttle sutures are passed. The graft is introduced sequentially through these tunnels and positioned arthroscopically. Central fixation is achieved using all-inside sutures, with outside-in sutures securing the anterior horn. The tibial fixation is completed using PEEK interference screws. RESULTS: The final arthroscopic inspection confirms anatomic graft positioning and congruent adaptation of the new graft to the lateral tibial plateau, restoring the meniscal contour. DISCUSSION/CONCLUSION: Lateral meniscoplasty using a semitendinosus autograft combined with capsulodesis represents a biologic reconstructive option to restore the lateral meniscal rim and improve load transmission. Early biomechanical and clinical studies have demonstrated that semitendinosus autografts can function as viable meniscal substitutes, restore kinematics and improve joint contact pressures. PATIENT CONSENT DISCLOSURE STATEMENT: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.