Abstract
Purpose
The mean reported healing rate after meniscal repair is 60 % of complete healing, 25 % of partial healing and 15 % of failure. However, partially or incompletely healed menisci are often asymptomatic in the short term. It is unknown whether the function of the knee with a partially or incompletely healed meniscus is disturbed in the long term. The purpose of this study was to assess the long-term outcomes of meniscal repairs according to the initial rate of healing.
Methods
Forty-one consecutive meniscal repairs were performed between 2002 and 2003. The median age at the time of surgery was 22 years (9–40). There were 25 medial and 16 lateral menisci. When present, all ACL lesions underwent reconstruction (61.3 % of cases). According to Henning’s criteria, by Arthro-CT at 6 months, twenty cases had healed completely, seven partially healed and four cases healed incompletely.
Results
At a mean follow-up of 114 ± 10 months, 31 patients were retrospectively followed for clinical and imaging assessments. Objective IKDC score was good in 92 % of the cases (17 IKDC A, 8 B and 2 C). The mean KOOS distribution was as follows: pain 94.3 ± 9; symptoms 90.9 ± 15; daily activities 98.7 ± 2; sports activities 91.1 ± 14; and quality of life 91.5 ± 15. Twenty-three patients displayed no signs of osteoarthritis when compared to the non-injured knee, six patients had grade 1 osteoarthritis and two grade 2. The subjective IKDC score did not decrease with time (ns). Moreover, there were no differences between lateral and medial menisci (ns), in stable or stabilised knees (ns). The initial meniscal healing rate did not significantly influence clinical or imaging outcomes (ns). Four patients with no healing underwent a meniscectomy (12.9 %).
Conclusion
Arthroscopic all-inside meniscal repair with hybrid devices may provide long-term protective effects, even if the initial healing is incomplete.
Level of evidence
Case series, Level IV.
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References
Abdelkafy A, Aigner N, Zada M, Elghoul Y, Abdelsadek H, Landsiedl F (2007) Two to nineteen years follow-up of arthroscopic meniscal repair using the outside-in technique: a retrospective study. Arch Orthop Trauma Surg 127:245–252
Ahlback S, Rydberg J (1980) X-ray classification and examination technics in gonarthrosis. Lakartidningen 77:2091–2093, 2096
Ahn JH, Lee YS, Yoo JC, Chang MJ, Koh KH, Kim MH (2010) Clinical and second-look arthroscopic evaluation of repaired medial meniscus in anterior cruciate ligament-reconstructed knees. Am J Sports Med 38:472–477
Ahn JH, Wang JH, Yoo JC (2004) Arthroscopic all-inside suture repair of medial meniscus lesion in anterior cruciate ligament-deficient knees: results of second-look arthroscopies in 39 cases. Arthroscopy 20:936–945
Brucker PU, von Campe A, Meyer DC, Arbab D, Stanek L, Koch PP (2011) Clinical and radiological results 21 years following successful, isolated, open meniscal repair in stable knee joints. Knee 18:396–401
Cannon WD Jr, Vittori JM (1992) The incidence of healing in arthroscopic meniscal repairs in anterior cruciate ligament-reconstructed knees versus stable knees. Am J Sports Med 20:176–181
Eggli S, Wegmuller H, Kosina J, Huckell C, Jakob RP (1995) Long-term results of arthroscopic meniscal repair. An analysis of isolated tears. Am J Sports Med 23:715–720
Grant JA, Wilde J, Miller BS, Bedi A (2012) Comparison of inside-out and all-inside techniques for the repair of isolated meniscal tears: a systematic review. Am J Sports Med 40:459–468
Henning CE, Lynch MA, Clark JR (1987) Vascularity for healing of meniscus repairs. Arthroscopy 3:13–18
Johnson MJ, Lucas GL, Dusek JK, Henning CE (1997) Isolated arthroscopic meniscal repair: a long-term outcome study (more than 10 years). Am J Sports Med 27:44–49
Lee GP, Diduch DR (2005) Deteriorating outcomes after meniscal repair using the meniscus arrow in knees undergoing concurrent anterior cruciate ligament reconstruction: increased failure rate with long-term follow-up. Am J Sports Med 33:1138–1141
Logan M, Watts M, Owen J, Myers P (2009) Meniscal repair in the elite athlete: results of 45 repairs with a minimum 5-year follow-up. Am J Sports Med 37:1131–1134
Majewski M, Stoll R, Widmer H, Muller W, Friederich NF (2006) Midterm and long-term results after arthroscopic suture repair of isolated, longitudinal, vertical meniscal tears in stable knees. Am J Sports Med 34:1072–1076
McGinty JB (1996) The importance of the meniscus. Am J Knee Surg 9:109
Melton JT, Murray JR, Karim A, Pandit H, Wandless F, Thomas NP (2011) Meniscal repair in anterior cruciate ligament reconstruction: a long-term outcome study. Knee Surg Sports Traumatol Arthrosc 19:1729–1734
Morgan CD, Wojtys EM, Casscells CD, Casscells SW (1991) Arthroscopic meniscal repair evaluated by second-look arthroscopy. Am J Sports Med 19:632–637 (discussion 7–8)
Muellner T, Egkher A, Nikolic A, Funovics M, Metz V (1999) Open meniscal repair: clinical and magnetic resonance imaging findings after twelve years. Am J Sports Med 27:16–20
Noyes FR, Barber-Westin SD (2012) Treatment of meniscus tears during anterior cruciate ligament reconstruction. Arthroscopy 28:123–130
Owen J (2005) 12.9 Year results of meniscal repair using an arthroscopically assisted inside-out technique. J Bone Joint Surg 87-B:151
Paxton ES, Stock MV, Brophy RH (2011) Meniscal repair versus partial meniscectomy: a systematic review comparing reoperation rates and clinical outcomes. Arthroscopy 27:1275–1288
Pujol N, Panarella L, Selmi TA, Neyret P, Fithian D, Beaufils P (2008) Meniscal healing after meniscal repair: a CT arthrography assessment. Am J Sports Med 36:1489–1495
Rockborn P, Gillquist J (2008) Results of open meniscus repair. Long-term follow-up study with a matched uninjured control group. J Bone Joint Surg Br 82:494–498
Shelbourne KD, Dersam MD (2004) Comparison of partial meniscectomy versus meniscus repair for bucket-handle lateral meniscus tears in anterior cruciate ligament reconstructed knees. Arthroscopy 20:581–585
Siebold R, Dehler C, Boes L, Ellermann A (2007) Arthroscopic all-inside repair using the meniscus arrow: long-term clinical follow-up of 113 patients. Arthroscopy 23:394–399
Steenbrugge F, Verdonk R, Verstraete K (2002) Long-term assessment of arthroscopic meniscus repair: a 13-year follow-up study. Knee 9:181–187
Stein T, Mehling AP, Welsch F, von Eisenhart-Rothe R, Jager A (2010) Long-term outcome after arthroscopic meniscal repair versus arthroscopic partial meniscectomy for traumatic meniscal tears. Am J Sports Med 38:1542–1548
Tengrootenhuysen M, Meermans G, Pittoors K, van Riet R, Victor J (2011) Long-term outcome after meniscal repair. Knee Surg Sports Traumatol Arthrosc 19:236–241
van Trommel MF, Simonian PT, Potter HG, Wickiewicz TL (1998) Different regional healing rates with the outside-in technique for meniscal repair. Am J Sports Med 26:446–452
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Pujol, N., Tardy, N., Boisrenoult, P. et al. Long-term outcomes of all-inside meniscal repair. Knee Surg Sports Traumatol Arthrosc 23, 219–224 (2015). https://doi.org/10.1007/s00167-013-2553-5
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DOI: https://doi.org/10.1007/s00167-013-2553-5