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Medical errors

Risk of Iatrogenic Peroneal Nerve Injury in All-inside Lateral Meniscus Repair with Vertical Stitch

Strategic Insights

— 2 min read

Study results on Nervous System Diseases and Conditions - Nerve Injury have been published from Songkhla, Thailand, by researchers at Prince of Songkla University. The study aimed to evaluate the risk of iatrogenic peroneal nerve injury in all-inside meniscal repair with a vertical stitch, comparing between 90 degrees and 120 degrees of knee flexion, using full-body fresh-frozen cadavers. The researchers found that there was a chance of iatrogenic peroneal nerve injury with vertical stitch deployment at the inner one-third of the medial border of the popliteus tendon, with injury incidences of 10% and 6.7% in 90 degrees and 120 degrees of knee flexion, respectively.

Key Takeaways:

  • The study used 15 cadavers, 8 male and 7 female, to evaluate the risk of iatrogenic peroneal nerve injury in all-inside meniscal repair with a vertical stitch.
  • The study found that vertical stitching at the lateral border of the popliteus tendon maintained a safe distance from the peroneal nerve.
  • However, a small risk of iatrogenic injury remained at the inner one-third of the medial border of the popliteus tendon.
  • The mean shortest distances related to the medial borders of the popliteus tendon in 90 degrees of knee flexion were statistically significantly shorter than those with the knee in 120 degrees of flexion.
  • The surgeons should avoid penetrating the lateral meniscus at the inner one-third of the medial border of the popliteus tendon, but if a repair must be done in this area, the surgeon should position the knee at 120 degrees of knee flexion.
  • The study provides valuable information for surgeons to consider when repairing lateral meniscus injuries.

Statistics:

  • Injury incidence was 10% in 90 degrees of knee flexion and 6.7% in 120 degrees of knee flexion.
  • Mean shortest distances related to the medial borders of the popliteus tendon in 90 degrees of knee flexion were statistically significantly shorter than those with the knee in 120 degrees of flexion.
  • Vertical stitching at the lateral border of the popliteus tendon maintained a safe distance from the peroneal nerve 100% of the time.

Sources:

  • NewsRx. Findings on Nerve Injury Detailed by Investigators at Prince of Songkla University (The Risk of Iatrogenic Peroneal Nerve Injury In All-inside Lateral Meniscus Repair Using a Vertical Stitch: a Cadaveric Study). Pain & Central Nervous System Week. October 27, 2025; p 189.
  • Orthopaedic Journal of Sports Medicine. The Risk of Iatrogenic Peroneal Nerve Injury In All-inside Lateral Meniscus Repair Using a Vertical Stitch: a Cadaveric Study. 2025;13(9).
  • Prince of Songkla University. Hat Yai, Songkhla, Thailand. Chaiwat Chuaychoosakoon et al.

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