Abstract
PurposeTo investigate factors associated with the consumption of a large number of sutures during arthroscopic meniscus repair procedures.MethodsAll patients who received meniscal repair, with or without concomitant anterior cruciate ligament (ACL) reconstruction, in our hospital from January 2015 to December 2019 were included in the current study. Demographic data (sex, age, body mass index (BMI), and injury-to-surgery interval) and surgical data (the site of the tear, side of the meniscus, presence of an ACL rupture or not and the number of sutures) were retrospectively collected from our medical records. The number of sutures was divided into two groups (1–2 sutures versus > 2 sutures). The stitching process was implemented through an all-inside technique using a meniscal repair device (Fast-Fix; Smith & Nephew). According to the length and stability of the meniscal tear, one to seven sutures were used. Univariate analysis consisted of chi-square tests. Multivariate logistic regression was then performed to adjust for confounding factors.ResultsA total of 242 patients, including 168 males and 57 females, was finally included. In the univariate analysis, we found that those patients who underwent meniscus repair within one month after meniscus tear were more likely to need fewer sutures than those who underwent surgery more than one month after injury (70/110 versus 59/115, p=0.062). In total, 75/109 (68.8%) lateral meniscal tears were repaired with fewer sutures than medial (34/72, 47.2%) and bilateral meniscus injuries (20/44, 45.4%; p=0.003). In the multivariate analysis, we found that the duration of injury (OR, 2.06; 95% CI, 1.16–3.64, p=0.013), presence of an ACL injury (OR, 3.76; 95% CI, 1.97–7.21, p< 0.001) and the side of the meniscus (OR, 0.31; 95% CI, 0.14–0.65, p=0.002) were associated with the number of sutures used during meniscal repair procedures.ConclusionsPatients who underwent meniscal repair within one month after meniscus tear, especially lateral menisci tears, were more likely to need fewer sutures.Study designCase-control study; level of evidence, 3.
Highlights
The meniscus is the second stabilizer in the knee joint and can slow the progression of osteoarthritis (OA) by absorbing shock and transmitting load [1,2,3]
Many observational studies have demonstrated that meniscectomy can dramatically improve pain and knee function at short-term follow-up, but the loss of meniscal tissue leads to the onset of early osteoarthritis [5, 6]
We found that those patients who underwent meniscus repair within one month after meniscus tear were more likely to need fewer sutures than those who underwent surgery more than one month after injury (70/110 versus 59/115, p=0.062)
Summary
The meniscus is the second stabilizer in the knee joint and can slow the progression of osteoarthritis (OA) by absorbing shock and transmitting load [1,2,3]. There are three options: nonoperative treatment, partial or total meniscectomy and meniscal repair. Nonoperative treatment has been regarded as an important choice to relieve knee pain and improve function, especially in patients with degenerative tears [4]. Many observational studies have demonstrated that meniscectomy can dramatically improve pain and knee function at short-term follow-up, but the loss of meniscal tissue leads to the onset of early osteoarthritis [5, 6]. Meniscal repair can preserve meniscal tissue, restoring its biomechanical function and reducing the risk of developing knee OA in the future
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