Summary

This retrospective evaluation of 119 patients with meniscal repair showed an overall failure rate of 21%. There was a statistically significant difference regarding the results for those operated before and after 2014, related to modifications in the technique and the number of sutures for each procedure.

Abstract

Introduction

The purpose of our study was to evaluate the clinical outcomes and failure rate of a series of patients who underwent meniscal repair with at least two-years of follow-up.

Materials And Methods

We retrospectively reviewed patients treated with meniscal repair between 2004 and 2016. We included patients with at least 2 years of follow-up. Patients with multiligamentous injury, tibial fracture and meniscal transplants were excluded.
Surgical details such as the affected menisci, type of rupture and meniscal repair technique used were analyzed. Clinical and functional outcomes were evaluated using Lysholm and IKDC scores. When available, patients were studied radiologically with x-rays and magnetic resonance (MR). We analyzed the failure rate (defined as a re-rupture that required surgery).
We compared failure rate for isolated meniscal repair vs associated with ACL reconstruction and patients operated before and after 2014 (surgical technique changed from outside-in to inside-out for meniscal body lesions).

Results

One hundred sixty nine patients were operated during that period of time. Ten patients didn´t meet inclusion criteria and forty were lost in follow-up. Out of the 119 patients evaluated, 35 had bucket-handle lesions treated with combined sutures, 25 treated with only one all inside suture and 59 treated with a combined suture technique. The mean postoperative Lysholm score was 85 (SD 14,08 ) and IKDC 70 (SD 10,22 ), and the mean return to sports time was 7,8 months (range 2-19). MR was performed in 71 patients. The overall failure rate was 21% (24 /119) at a mean time of 20 months (range 2-60 months) and 26% (9/35) for bucket-handle lesions at a mean time of 21 months (range 2-60 months).
Failure rate was 20% for the 48 isolated lesions at a mean of 23 months and 19% for 70 lesions associated to ACL-R at a mean of 17 months (p=0.53). Failure rate for isolated bucket-handle lesions was 27% at a mean of 27 months and 23% when associated to ACL-R at a mean of 12 months(p=1.0)
Overall failure rate for patients treated before 2014 was 27% (18/67) and 12% after 2014 (6/52) (p=0.03). Overall failure rate for bucket-handle lesions before 2014 was 36% (8/23) and 8% after 2014 (1/12) (p=0.03). Isolated bucket-handle lesions failure rate was 45% (5/11) before 2014 and 0% (0/7) after 2014 (p=0.01) and when associated to ACL-R, failure rate was 25% (3/12) before 2014 and 20% (1/5) after 2014 (p=0.09).

Conclusion

Overall failure rate of our series was 21%. We found no differences between isolated lesions and associated to ACL reconstruction. There was a statistically significant difference regarding failure rate results for those operated before and after 2014. This might be the result of an improvement in the surgical devices, modifications in the technique and the number of sutures for each procedure.