Increasingly large or complex meniscal tears may require additional implants for adequate repair. All-inside meniscal repair devices were developed to decrease surgical time and complications of traditional inside-out meniscal repair but may induce microtears in menisci. The purpose of this study is to evaluate the influence of the number of all-inside meniscal repair implants on repair failure risk. We hypothesized that the use of higher numbers of all-inside meniscus repair implants is associated with increased failure risk.
A retrospective chart review identified 523 meniscus repairs performed in 473 patients between 2006 and 2013 by a sports medicine fellowship trained orthopedic surgeon at a single institution. Patient demographics (age, BMI) and surgical data (side of repair, number of implants used, and concomitant ACL reconstruction) were recorded. Following exclusion of inside-out and outside-in repairs, repairs in both menisci, or an unspecified number of implants, 304 patients were included for analysis. Repair failure was defined as repeat surgery on the index meniscus identified through chart review or patient interviews. Logistic regression modeling was utilized to evaluate the relationship between the number of implants used and repair failure.
293 (96.4%) patients who underwent all-inside meniscus repair were included. The mean follow-up time was 3.21 years following surgery. Repair failure was noted in 22.1% of medial and 19.7% of lateral meniscus repairs. Among included patients, there was no significant increase in failure odds as all-inside implant number increased in the medial (OR 1.11, 95% CI 0.81-1.52, p=0.509) or lateral (OR 0.80, 95% CI 0.45-1.41, p= 0.430) meniscus when controlling for patient age, BMI, and concomitant ACLR.
A higher number of all-inside implants does not significantly increase risk of meniscus repair failure.