ISAKOS: 2019 Congress in Cancun, Mexico
ISAKOS

2019 ISAKOS Biennial Congress ePoster #1010

 

Clinical Outcomes of Meniscal Repair: A 40-Case Series

Patrícia Wircker, MD, Lisboa PORTUGAL
Teresa Alves-Da-Silva, MD, Lisbon PORTUGAL
Miguel Duarte-Silva, MD, Parede - Cascais, Lisboa PORTUGAL
Joao Caetano, MD, Carnaxide, Lisboa PORTUGAL
Rafael Dias
João Figueiredo, MD, Lisboa PORTUGAL
João Vieira Sousa, MD, Lisboa PORTUGAL
Nuno Corte-Real, MD, Lisboa PORTUGAL

Hospital de Cascais, Dr. José de Almeida, Cascais, Lisboa, PORTUGAL

FDA Status Cleared

Summary

The objective of the study was to review the clinical results of meniscus repair in young adults and analyse the epidemiological, clinical and surgical factors affect success. This study included forty (40) patients with a minimum follow-up of 6 months. IKDC subjective evaluation mean values were 35,05 ± 8,9

Abstract

Meniscal lesions are the most common intra-articular knee injury. Despite being historically underappreciated, the healing potential of meniscal tissue is currently widely acknowledged.
If the tear is peripheral and longitudinal and in younger patients, repair of a meniscal lesion is still highly recommended although the literature reports 15%-30% failures for all-inside repair.
The objective of the study was to review the clinical results of meniscus repair in young adults and analyse the epidemiological, clinical and surgical factors affect success.

This study included forty (40) patients with a minimum follow-up of 6 months. Their average age was 25 years (range 14 to 43 years), divided into 29 men and 11 women.
The preoperative data comprised the following parameters: age, gender, sports activity, trauma-to-surgery time. As for the intra and postoperative data comprised, the parameters included are: meniscal injury characteristics, location, number of sutures, presence of concomitant anterior cruciate ligament (ACL) injury, operative technique, postoperative ranges of motion.
Preoperative and follow-up evaluation was performed using the Subjective International Knee Documentation Committee (IKDC) questionnaires.
In order to determine the success in repaired menisci, the following clinical criteria were considered: absence of locking, catching, or giving way; no history of recurrent effusions; no joint line tenderness; a negative McMurray test; and no subsequent surgical procedures on the repaired meniscus.

Twenty-five lateral and 24 medial menisci were repaired using an all inside technique in 75%. The majority of injuries lesions were in the posterior horn, located in red-red or red-white zones.
The ACL was intact in 13 cases, whereas 27 (67.5%) patients underwent concomitant ACL reconstruction.
The median duration of follow-up was 18.9 months (range 6-36 months).
Five patients (12.5%) presented complications, namely postoperative, ligamentoplasty failure and mechanical failure of the suture. Return to sports activity (excluding complications) took an average of 5.85 months (min 4, max 9).
Clinical healing was present in 35 (87.5%) of the 40 repaired menisci.
In total, 32 of 40 patients (80%) could go back to their original sports activities.
IKDC subjective evaluation mean values were 35,05 ± 8,98 for preoperative and 82.83 ± 16.14 for postoperative.

In young adults, repair of traumatic meniscus tear, and most particularly in vascularized zones, showed high success rates in terms of recovery time and functional outcome. These rates are comparable to those previously reported in the literature.
The failures of treatment were associated with concomitant ACL injury.
Patients with isolated meniscal repair or concurrent ACL reconstruction had their IKDC score significantly improved postoperatively.

This report of midterm follow-up demonstrates that arthroscopic meniscal repair appears to be safe and effective to preserve meniscus, either as an isolated procedure and when it is performed with concurrent ACL reconstruction.
The present results show that arthroscopic meniscal repair in young adults provides good healing rates which allows acceptable return to recreational sports and good function at a low reoperation rate.
The success of the treatment was further supported by favourable results on patient-based outcome measures.
Arthroscopic all inside repair using the all inside device appears to be a safe and effective surgery to preserve meniscus.