2017 ISAKOS Biennial Congress ePoster #1092
Repair of Meniscal Ramp Lesions Through a Posteromedial Portal During ACL Reconstruction: Outcome Study with a Minimum 2-Year Follow Up
Mathieu Thaunat, MD, Lyon, Auvergne Rhône Alpes FRANCE
Jean-Marie Fayard, MD, Lyon, Rhône FRANCE
Nicolas Jan, MD, Lille, France FRANCE
Adnan Saithna, MD, FRCS, Scottsdale, AZ UNITED STATES
Bertrand Sonnery-Cottet, MD, PhD, Lyon, Rhône FRANCE
Centre orthopédique Santy, lyon, FRANCE
FDA Status Cleared
Summary
Purpose: To evaluate the results of arthroscopic all-inside suture repair of medial meniscal ramp lesions through a posteromedial portal during ACL reconstruction.Our results show that arthroscopic meniscal repair of ramp lesions during ACL reconstruction through a posteromedial portal provided a high rate of meniscus healing at the level of the tear
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Abstract
Purpose
To evaluate the results of arthroscopic all-inside suture repair of medial meniscal ramp lesions through a posteromedial portal during ACL reconstruction.
Methods
All patients who underwent a suture of the posterior segment of the medial meniscus using a suture hook device through a posteromedial portal during ACL reconstruction with minimum 2 year-follow-up were included in the study. Repair was performed for longitudinal tears within the rim of less than 3 mm (capsulomeniscal junction or red-red zone) or 3 to 5 mm (red-white zone) of an unstable torn meniscus. Patients were assessed pre- and postoperatively with IKDC score, and Tegner activity scale. Instrumented knee testing was performed with the Rolimeter arthrometer. Complications including reoperation for failed meniscal repair were also recorded.
Results
132 patients met the inclusion criteria. The mean follow-up time was 27 months (range, 24 to 29 months). The average subjective IKDC rose from 63.8 +/-13.5 (range, 27-92) preoperatively to 85.7 +/- 12 (range, 43-100) at last follow up (P< 0,0001). The rolimeter test decreased from a side to side difference in anterior knee laxity of 7mm (range, 5-14mm) to a mean value of 0.4mm (range: -3mm-+5mm) at last follow up up (P< 0,0001). The Tegner activity scale at the last follow-up (6.9 +/-1.72) was slightly lower than before surgery (7.2+/-1.92) (P= 0.0017). 9 patients (6.8%) had failure of the meniscal repair. In 5 cases, recurrent tears were related to a newly formed tear located anteriorly to the initial tear.
Conclusions
Our results show that arthroscopic meniscal repair of ramp lesions during ACL reconstruction through a posteromedial portal provided a high rate of meniscus healing at the level of the tear and appeared to be safe and effective in this group of patients.