The Technique of the Bio Stinger Insertion

The appropriate length of BioStinger (Linvatec, Largo, FL) selected, is usually 13 mm, and loaded on the cannulated wire of the delivery unit (Fig. 6.20). The cannula is placed against the meniscus and 2 mm of cannulated wire is delivered into the torn fragment (Fig. 6.21). The fragment is then reduced to the peripheral rim.

When the torn fragment is reduced, the cannulated wire is advanced into the rim using the slider bar on the side of the device (Fig. 6.22). The BioStinger is inserted into the meniscus by depressing the handle on the end. The meniscus can be felt to ratchet into the meniscus (Fig. 6.23).

To prevent the cannulated wire from bending, firm pressure must be exerted on the cannula to keep this against the meniscus. The cannula is backed up 5 mm, and the head of the BioStinger inspected to be sure

Figure 6.21. The initial insertion of the guide wire into the meniscus.
Figure 6.22. The advancement of the guide wire across the meniscus tear.
Figure 6.23. The BioStinger is driven across the tear by depressing the handle of the delivery device.
Linvatec Biostinger
Figure 6.24. The BioStinger must be countersunk under the surface of the meniscus.

that it is countersunk under the surface of the meniscus (Fig. 6.24). The appearance of the completed meniscal repair using sutures in the middle segment and BioStinger posterior is shown in Figure 6.25.

The use of the fibrin clot was shown by Henning and later Jackson to improve the results of isolated meniscal repairs. Most repairs are done in association with ACL reconstruction and do not require the use of a fibrin clot. If the physician needs to repair an isolated tear, the addition of a fibrin clot will improve the results. To prepare the clot, the physician will need a glass syringe and a glass rod to stir the blood to form a firm clot. The clot is then inserted under the meniscus at the meniscus synovial border. Figure 6.26 shows the appearance of a fibrin clot placed under the meniscus at the tear site. The fibrin clot may also be produced by curetting a portion of the notch to produce bleeding. If the ACL reconstruction is done, then bleeding will be produced by the notchplasty.

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