2017 ISAKOS Biennial Congress ePoster #1338

 

Long-Term Outcome After All Inside Meniscal Repair Using The Fastfix System

Alexander Zimmerer, MD, Pforzheim GERMANY
Christian Sobau, MD, Pforzheim GERMANY
Andree Ellermann, MD, Pforzheim GERMANY

ARCUS Sportklinik, Pforzheim, GERMANY

FDA Status Not Applicable

Summary

We analyzed the outcome at a minimum of 12 years following meniscal repair using the all inside FastFix system. 73 percent had a successful surgery and no failure of the primary meniscal refixation. Only a fourth underwent new surgical treatment of the injured meniscus. Functional scores were significantly better with isolated meniscus tears than multiple injured knees on 4 items of the KOOS scale

Abstract

Objectives
The aim of this study was to evaluate the outcome at a minimum of 12 years following meniscal repair using the all inside FastFix system. In addition we analyzed whether there were differences between isolated meniscal tears (group I) or multiple injured knees (group m).

Methods

Patients who underwent all-inside meniscal repair using the FastFix System in the time period from 2001 to 2003 were analyzed. A median 12-year (range 136-171 months) follow-up was conducted in 2015, and surgical procedures to the knee following the meniscal repair were registered. Treatment failure was defined as a new surgical procedure to the same meniscus. Moreover functional outcome was evaluated using the KOOS and tegner activity score (TAS).

Results

At the time of follow-up 17 out of 63 patients (27 %) had undergone further surgery to the repaired meniscus. There was no significant difference between the isolated (4 out of 12) and combined group (13 out of 51) (p=0.582). The failure-rate was significantly higher in the female (female 48% versus male 15% (p=0.005)). Comparing the sports (ball sports, alpine sports, track and field) there was a significantly higher failure rate within the ball sports group (p=0.002)
Overall the patients showed at follow-up a mean TAS of 5,57 and functional KOOS subscales of: 91,35 for pain; 86,56 for symptoms; 94,65 for daily life activities; 80,34 for sport and leisure; 77,28 for quality of life.
Comparing the two groups there was no difference in the TAS (5,75 for the group I and 5,53 for the group M, p > 0.05). Only 1 item of the KOOS showed no significant difference: 95,33 versus 94,48 for daily life activities (p > 0.05). The other items showed significant differences: 94,83 versus 90,53 for pain (p=0.002); 90 versus 87,74 for symptoms (p=0.003); 83,75 versus 80,14 for sport and leisure (p=0.016); 85 versus 75,44 for quality of life (p=0.012).
Combined injuries were found in 81% (51 patients). 49 out of the 51 patients with combined injuries suffered an additional ACL rupture. There was no significant difference with regard to the meniscal repair failure rate when comparing the groups of simultaneous and delayed ACL repairs (p=0.521).

Conclusions

At more than 12 years' follow-up a fifth of the patients underwent a new surgical treatment of the injured meniscus. Functional scores were significantly better with isolated meniscus tears than multiple injured knees on 2 items of the KOOS scale (symptoms and quality of life). In contrast to these results both groups showed no difference in the tegner activity scores.