Taux d’échec de la réparation des déchirures de l’anse de seau du ménisque médial dans un genou stable : une étude rétrospective de 30 patients avec un suivi d’au moins 3 ans

Abstract

The purpose of this study is to identify the failure rate and parameters that influence the outcome and clinical healing following operative repair of bucket handle tears of the medial meniscus in stable knees. Between 2010 and 2017 all the patients with isolated bucket handle tears in the medial meniscus underwent surgical meniscus repair were included for analysis. Patients were analyzed on an average of 73.3 months (range 36–120 months) after surgery by the use of standardized subjective scoring instruments [Lysholm, International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS) and Tegner Activity Scale (TAS)]. Patient-specific, trauma-specific as well as surgery-specific factors to identify factors affecting the outcome and suture survival were evaluated. The final study population comprised 30 patients (5 women, 25 men). Patients were divided in two groups with healed menisci (group 1) and re-rupture subjects (group 2). There were 7 patients with healed menisci and 23 (76%) that sustained re-rupture and underwent meniscectomy. Group 1 achieved slightly higher outcome compared to group 2 [Lysholm 89.3 vs. 84.8; ( P = 0.76), IKDC 86.6 vs. 84.1 ( P = 0.81), KOOS 92.2 vs. 90.8 ( P = 0.71); TAS 6.9 vs. 6 ( P = 0.76)]. Lower patient age, long trauma to-repair time and the localization of tear in the white zone as well as its extension to all the medial meniscus had the strongest impact to provoke re-rupture. Strong impact to result in a significantly increased outcome was identified for higher age, short trauma-to-repair time and localization of the tear in red zone. This study shows a failure rate of up to 76% for the repair of bucket handle tears of the medial meniscus in stable knees. Age under 27, trauma to repair delay > 1 week and central tears were found as risk factors for a diminished clinical outcome and healing rate.