Complications associated with the use of meniscal arrows.

Abstract

Meniscal repair has been shown to be beneficial and safe. 5,8,21 Many methods of repair have been developed, with three basic techniques being most commonly used: inside-out, outside-in, and the all-inside technique. The all-inside technique described in 1991 by Morgan 17 was developed for posterocentral tears of the meniscus and is technically demanding, often requiring the use of a 70° arthroscope and posterior portal placement. Other types of all-inside repairs have evolved, such as the suture hook and T-fix (Smith & Nephew, Andover, Massachusetts) suture anchor, both of which require arthroscopic knot-tying techniques. The use of bioabsorbable implants in meniscal repair and ACL reconstructions has become increasingly popular. The application of bioabsorbable implants for osteochondral fractures, interference screw fixation, and meniscal repair is an effective alternative to the use of metallic implants. 6,10,16 The polylactic acid meniscal arrow, originally reported in 1993 by Albrecht-Olsen et al., 1 was approved by the United States Food and Drug Administration in 1997. The absorbable implant does not require a posterior portal or rely on arthroscopic knot tying. This was thought to provide a safe and simplified all-inside technique. The reported complications from use of this technique have been limited. 3,5,7,9,13,19,20 Two surgeons at our institution performed 28 all-inside meniscal repairs using meniscal arrows over a 2-year period; all repairs were done using the manufacturer's suggested technique. The cross-bow insertion device was not used. Retrospectively, complications were noted in five patients reported as a series of cases.