2017 ISAKOS Biennial Congress ePoster #1307

 

Arthroscopic Evaluation of Repaired Lateral Menisci of Radial/Flap Tears with Stable Knees

Hiroshi Amano, MD, PhD, Osaka, Osaka JAPAN
Yoshinari Tanaka, MD, PhD, Ibaraki, Osaka JAPAN
Keisuke Kita, MD, PhD, Osaka, Osaka JAPAN
Ryohei Uchida, MD, PhD, Amagasaki, Hyogo JAPAN
Yoshiki Shiozaki, MD, Sakai, Osaka JAPAN
Shuji Horibe, MD, PhD, Habikino, Osaka JAPAN

Osaka Rosai Hospital, Sakai, Osaka, JAPAN

FDA Status Not Applicable

Summary

The healing rate of the radial/flap tears of the lateral meniscus evaluated with second look arthroscopy was 61.1 % including complete and partial healing and complete radial tears which tears extended to the joint capsule were healed, whereas that tears in avascular zone, which were flap tears of L type or partial radial tears, were healed hardly.

Abstract

Introduction

Radial/flap tear of the lateral meniscus significantly impair the ability of the meniscus to withstand the tibiofemoral load. Therefore, this type of tear tends to repair recently to preserve meniscus function, although healing potential is low because of its vascularity and biomechanics. The purpose of this study is to clarify the arthroscopic evaluation of repaired lateral meniscus of radial/flap tear with stable knee.

Materials And Methods

Of 25 consecutive patients with an isolated radial/flap tear of the lateral meniscus, 18 patients (Male, 14; female, 4; mean age, 18.5 ± 3.6 years), who agree to undergoing a second look arthroscopy, were included in this study. All torn meniscus underwent a tie-grip suture with inside-out technique. The postoperative regime was immobilization for 2 weeks and no-weight bearing for 6-8 weeks. Return to sports activity was not allowed for 6 months. Second look arthroscopy to evaluate healing and physical examinations were performed at 6 months after repair. When the initial meniscus repair were performed, tear type were classified in 4 types as follows: partial radial tear (PR), the radial tear split was located in the inner zone; complete radial tear (CR), the radial split was extended to the peripheral rim; flap parrot beak type (PB), the curved tear split was extended to the peripheral rim; flap L type (L), flap tear split was located in the inner rim. PR type was 4 patients, CR type was 3 including 2 incomplete discoid, PB type was 5 including 1 incomplete discoid, and L type was 6. We evaluated healing of tears as complete healing, partial healing or failure.

Results

No patients had ROM restrictions, joint hydrops, joint line tenderness and catching sensation or locking of the knee. Four patients (22.2%) were complete healing, 7 (38.9%) were partial healing and 7 (38.9%) were failure. According to tear type, all CR type were complete healing and all L type were failure. Three (75%) of PR type and 4 (80 %) of PB type were partial healing. Incomplete discoid or CR type/PB type which tear types were extended to periphery were significantly associated with healing rates (P < 0.01).

Conclusions

The healing rate of radial/flap tear of the lateral meniscus was 61.1 % including partial healing and the outcome of the tears extended to vascular zone was good, whereas that flap tears of L type or radial tears in avascular zone were suggested to heal hardly. The further study is needed.