Clinical results following meniscal sutures : does concomitant acl repair make a difference ?
Published online: Dec 27 2015
Ana Mª MARTIN-FUENTES, Cristina OJEDA-THIES, Jesus VILA-RICO
From Dept. of Orthopaedic Surgery and Traumatology, University Hospital “Doce de Octubre”, Madrid,
Abstract
Introduction : The purpose of this study is to analyze the clinical results of meniscal tears repaired with an all-inside suture with special attention to the results in stable versus anterior cruciate ligament (ACL)-deficient knees.
Methods : We studied 45 meniscal tears (32 medial, 13 lateral) repaired in 43 patients using a single all-inside suture system. The patients were divided in two groups and followed-up for at least 12 months. Group A (stable knees with isolated meniscal tears) consisted of 19 patients treated with all-inside sutures. Group B (ACL-deficient knees with meniscal tears) consisted of 24 patients treated with ACL reconstruction together with the meniscal repair. All the meniscal tears were located in red/red (35) or red/white (10) zone. Criteria for clinical success included absence of joint-line tenderness, locking, swelling, and a negative McMurray test. Preoperative and postoperative clinical evaluation also included the Tegner and Lysholm knee scores.
Results : The clinical success rate of the repairs was 86%. According to our criteria, six of 43 repaired menisci (14%) were considered failures. Mean Lysholm scores improved significantly in both groups (58 to 88.20) and the improvement was significantly greater in group B (From 54.47 to 88, p < 0.05). Twenty patients (83.3%) had an excellent or good result in group B and sixteen (84%) in group A, according to the Lysholm knee score.
Conclusions : Our clinical results show that arthroscopic meniscal repair with all-inside devices provided a high rate of meniscus healing and seem to be safe and effective, for isolated meniscal tears as well as for ACL-deficient knees with meniscal tears. Final functional scores were similar for ACL-competent and ACL-deficient knees.