Results of arthroscopic meniscal repair

Abstract

Objectives:Currently the arthroscopic treatment of meniscal pathology has become one of the most common procedures in orthopedic practice and although in most cases meniscectomy is done, meniscal sutures are the treatment of choice when a reparable lesion is diagnosed, especially in young patients. It has been reported that the meniscal repair leads to a lower incidence of developing degenerative changes in the long-term when compared with meniscectomy and nonsurgical treatment of meniscal injuries. The aim of this study was to determine the success rate of meniscal repair achieved in our sports medicine practice.Methods:Between 2006 and 2015, 62 meniscal tears in 58 patients with a mean age of 31 years (range 15-58) were repaired. Mean follow-up was 52 months (range 6-120 months). In 16 patients (28%) was associated with arthroscopic ACL reconstruction. The repair techniques used included outside-in sutures, inside-out sutures, all-inside sutures and a combination of techniques. Failure of the repair was defined by the requirement for repeat knee arthroscopy and partial or subtotal meniscectomy. The indication of arthroscopic revision was based on the presence of mechanical symptoms, after the suture.Results:Failure of meniscus repair occurred in four patients (failure rate: 6.45%), one case was associated with ACL reconstruction (failure rate: 6.25%) and 3 had undergone isolated meniscal suture (failure rate: 8%). The average time for the reoperation was 15 months (4-24). We had no intraoperative complications.Conclusion:The reported failure rate of meniscal repair in stable knees varies between 12% and 43%, with reports that demonstrate a clinical success rate of 100%. In this study, we obtained a success rate of 93.5%. These results are slightly higher than those in the literature, which can be attributed to careful selection of patients and the fact that clinical success tends to be better than the assessed arthroscopically. In summary, we consider the meniscal repair as a successful option in the treatment of meniscal rupture. Due to the importance it has recovered in the last time preserving the meniscus, in the future we should greatly increase our rate of meniscal suture. We hold that careful selection of patients and the type of injury to repair, optimizes the success of meniscal repairs.