Meniscal repair compared with meniscectomy for bucket-handle medial meniscal tears in anterior cruciate ligament-reconstructed knees.

Abstract

Repair of meniscal tears is generally preferred over meniscectomy. Repair of unstable bucket-handle tears of the medial meniscus leads to better outcomes than partial meniscectomy. Retrospective review of prospectively collected data. We reviewed the records of 155 patients who had isolated bucket-handle medial meniscal tears and anterior cruciate ligament tears. Fifty-six menisci were repaired; 99 that were degenerative and crushed beyond repair were removed. Patients were evaluated at a mean follow-up of 6 to 8 years after surgery with the International Knee Documentation Committee examination and a modified Noyes questionnaire. The mean subjective scores were similar for patients in both the repair (N = 51) and meniscectomy (N = 87) groups. However, in the repair group, the mean subjective score of 93.9 for nondegenerative menisci was significantly better than the 87.1 for degenerative menisci. Objective grades for 25 patients in the repair group were normal or nearly normal in 22 patients (88%) and for 51 of 56 patients (91%) in the removal group. Radiographic subscores for the repair group were normal or nearly normal in 23 patients in the repair group and 49 in the removal group. Outcomes from meniscal repair were not superior to those from partial removal. Patients with repaired degenerative tears had significantly lower subjective scores than those with nondegenerative tears.