Clinical Results after Arthroscopic Meniscus Repair for Recurrent Subluxation of the Lateral Meniscus

Abstract

Purpose:This study was undertaken to diagnose and to document clinical results and the technical aspects of arthroscopic meniscus repair for treating the recurrent subluxation with peripheral tears around popoliteal hiatus of the LM.Methods:Twenty two patients (23 knees) with symptomatic recurrent subluxation of the LM treated by arthroscopic meniscus repair were included. The inclusion criteria were (1) patients with knee pain, locking or snapping symptoms despite 3 months of conservative treatment, (2) non-discoid lateral meniscus, (3) stable knee, and (4) tears involving the red-white or red–red zone. All tears were repaired with either the modified all-inside suture technique only or a combination of the modified all-inside and modified outside-in techniques. Clinical results were evaluated preoperatively and at final follow-up using Tegner activity level, Lysolm knee, and Hospital for Special Surgery (HSS) scores.Results:All patients returned to their prior life activities with little or no limitations, and no reoperation was required after an average follow-up of 52.3 months(range, 24–160). At the final follow-up, all knees achieved a full range of motion. Catching sensation was experienced in three knees, and limited function during squatting and jumping was complained in two knees. However no patient had recurrence of a locking episode. At the last follow-up, the mean Tegner activity level had improved significantly from 3.7 (range, 2–6) to 7.2 (range, 3–10, p<0.0001), mean Lysolm knee score improved from 75.1 92.0 (range, 76-100) preoperatively to 92.0 (range, 76-100) at final follow-up (p < 0.0001), and mean preoperative HSS score improved from 83.4 to 94.6 at final follow-up (p < 0.0001).Conclusion:Arthroscopic meniscus repair using the modified all-inside suture and outside-in techniques showed excellent clinical outcomes for treating symptomatic recurrent subluxation with peripheral tears around popoliteal hiatus of the LM without any complications or recurrence.longitudinal tear of posterior horn of lateral meniscusThe 30° arthroscope, inserted from anteromedial portal to the posterolateral compartment, shows longitudinal tear of posterior horn of lateral meniscus (LMPH) at meniscocapsular junction area (black arrows).three vertical sutures at the longitudinal tearThe 70° arthroscope shows three vertical sutures at the longitudinal tear of the posterior horn of lateral meniscus (LMPH).