Skip to main content
SpringerLink
Log in

Arthroscopic repair of horizontal cleavage meniscus tears provides good clinical outcomes in spite of poor meniscus healing

  • KNEE
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to evaluate the clinical outcomes and meniscus healing after arthroscopic repair of horizontal-cleavage meniscus tears, compared with vertical-longitudinal meniscus tears.

Methods

This was a retrospective review of a consecutive series of 52 meniscal repairs for horizontal-cleavage tears (n = 27) or vertical-longitudinal tears (n = 25); the groups were compared with respect to clinical symptoms and meniscal healing. Arthroscopic meniscal repair was performed using the inside-out technique with a marrow-stimulating technique. Clinical symptoms were evaluated using the Lysholm score and Knee injury and osteoarthritis outcome score (KOOS). Meniscus healing was evaluated by MRI.

Results

The mean follow-up periods were 35.4 ± 8.9 months in the horizontal-cleavage tear group and 39.8 ± 8.3 months in the vertical-longitudinal tear group. There were no significant differences in Lysholm score and KOOS, including each subscale, between the horizontal-cleavage tear- and vertical-longitudinal tear-groups at the final follow-up. At the final follow-up, MRI meniscus grades 0 and 1 were significantly more frequent in the vertical-longitudinal tear-group than in the horizontal-cleavage tear-group, while grade 3 was significantly more frequent in the horizontal-cleavage tear group than in the vertical-longitudinal tear group (p < 0.0001).

Conclusions

Although meniscus healing of horizontal-cleavage tears may be poor, arthroscopic repair should be considered for horizontal-cleavage tears because it does provide good clinical outcomes.

Level of evidence

IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ahn JH, Kwon OJ, Nam TS (2015) Arthroscopic repair of horizontal meniscal cleavage tears with marrow-stimulating technique. Arthroscopy 31:92–98

    Article  Google Scholar 

  2. Arnoczky SP, Warren RF (1982) Microvasculature of the human meniscus. Am J Sports Med 10:90–95

    Article  CAS  PubMed Central  Google Scholar 

  3. Billières J, Pujol N, The U45 Committee of ESSKA (2019) Meniscal repair associated with a partial meniscectomy for treating complex horizontal cleavage tears in young patients may lead to excellent long-term outcomes. Knee Surg Sports Traumatol Arthrosc 27:343–348

    Article  Google Scholar 

  4. Bolano LE, Grana WA (1993) Isolated arthroscopic partial meniscectomy. Functional radiographic evaluation at 5 years. Am J Sports Med 21:432–437

    Article  CAS  Google Scholar 

  5. Boyd KT, Myers PT (2003) Meniscus preservation; rationale, repair techniques and results. Knee 10:1–11

    Article  Google Scholar 

  6. Christoforakis J, Pradhan R, Sanchez-Ballester J, Hunt N, Strachan RK (2005) Is there an association between articular cartilage changes and degenerative meniscus tears? Arthroscopy 21:1366–1369

    Article  Google Scholar 

  7. Foad A (2012) Self-limited healing of a radial tear of the lateral meniscus. Knee Surg Sports Traumatol Arthrosc 20:933–936

    Article  Google Scholar 

  8. Gray JC (1999) Neural and vascular anatomy of the menisci of the human knee. J Orthop Sports Phys Ther 29:23–30

    Article  CAS  Google Scholar 

  9. Heckmann TP, Barber-Westin SD, Noyes FR (2006) Meniscal repair and transplantation: indications, techniques, rehabilitation, and clinical outcome. J Orthop Sports Phys Ther 36:795–814

    Article  Google Scholar 

  10. Kamimura T, Kimura M (2011) Repair of horizontal meniscal cleavage tears with exogenous fibrin clots. Knee Surg Sports Traumatol Arthrosc 19:1154–1157

    Article  PubMed Central  Google Scholar 

  11. Kim JM, Bin SI, Kim E (2009) Inframeniscal portal for horizontal tears of the meniscus. Arthroscopy 25:269–273

    Article  PubMed Central  Google Scholar 

  12. Koh JL, Zimmerman TA, Patel S, Ren Y, Xu D, Zhang LQ (2018) Tibiofemoral contact mechanics with horizontal cleavage tears and treatment of the lateral meniscus in the human knee: an in vitro cadaver study. Clin Orthop Relat Res 476:2262–2270

    Article  PubMed Central  Google Scholar 

  13. Lind M, Nielsen T, Faunø P, Lund B, Christiansen SE (2013) Free rehabilitation is safe after isolated meniscus repair: a prospective randomized trial comparing free with restricted rehabilitation regimens. Am J Sports Med 41:2753–2758

    Article  PubMed Central  Google Scholar 

  14. McDermott ID, Amis AA (2006) The consequences of meniscectomy. J Bone Jt Surg Br 88:1549–1556

    Article  CAS  Google Scholar 

  15. Misir A, Kizkapan TB, Yildiz KI, Arikan Y, Ozcafer R, Cetinkaya E (2019) Using only MRI is moderately reliable in the prediction of meniscal tear reparability. Knee Surg Sports Traumatol Arthrosc 27:898–904

    Article  PubMed Central  Google Scholar 

  16. Noyes FR, Barber-Westin SD (2002) Arthroscopic repair of meniscal tears extending into the avascular zone in patients younger than 20 years of age. Am J Sports Med 30:589–600

    Article  PubMed Central  Google Scholar 

  17. Outerbridge RE, Dunlop JA (1975) The problem of chondromalacia patellae. Clin Orthop Relat Res 110:177–196

    Article  Google Scholar 

  18. Rangger C, Klestil T, Gloetzer W, Kemmler G, Benedetto KP (1995) Osteoarthritis after arthroscopic partial meniscectomy. Am J Sports Med 23:240–244

    Article  CAS  Google Scholar 

  19. Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 28:88–96

    Article  CAS  Google Scholar 

  20. Rubman MH, Noyes FR, Barber-Westin SD (1998) Arthroscopic repair of meniscal tears that extend into the avascular zone. A review of 198 single and complex tears. Am J Sports Med 26:87–95

    Article  CAS  Google Scholar 

  21. Shanmugaraj A, Tejpal T, Ekhtiari S, Gohal C, Horner N, Hanson B et al (2019) The repair of horizontal cleavage tears yields higher complication rates compared to meniscectomy: a systematic review. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-019-05557-5

    Article  Google Scholar 

  22. Stärke C, Kopf S, Petersen W, Becker R (2009) Meniscal repair. Arthroscopy 25:1033–1044

    Article  Google Scholar 

  23. Stoller DW (1995) The knee. Semin Roentgenol 30:277–293

    Article  CAS  Google Scholar 

  24. Stoller DW, Martin C, Crues JV, Kaplan L, Mink JH (1987) Meniscal tears: pathologic correlation with MR imaging. Radiology 163:731–735

    Article  CAS  Google Scholar 

  25. Tiftikçi U, Serbest S (2016) Repair of isolated horizontal meniscal tears with all-inside suture materials using the overlock method: outcome study with a minimum 2-year follow-up. J Orthop Surg Res 11:131

    Article  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu, 501-1194, Gifu, Japan

    Hiroyasu Ogawa, Kazu Matsumoto & Haruhiko Akiyama

  2. Department of Advanced Joint Reconstructive Surgery, Gifu University Graduate School of Medicine, Gifu, Japan

    Hiroyasu Ogawa

  3. Department of Orthopaedic Surgery, Ogaki Tokushukai Hospital, Ogaki, Japan

    Masaya Sengoku

  4. Department of Orthopaedic Surgery, Yamauchi Hospital, Gifu, Japan

    Hiroki Yoshioka

Authors
  1. Hiroyasu Ogawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kazu Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masaya Sengoku
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroki Yoshioka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Haruhiko Akiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kazu Matsumoto.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to disclose.

Funding

No funding has been received for this study.

Ethical approval

Ethical approval for this study was obtained from the institutional review board at Gifu University Graduate School of Medicine (Approval No. 27-100).

Informed consent

Written informed consent for participation in the study was obtained from all patients.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ogawa, H., Matsumoto, K., Sengoku, M. et al. Arthroscopic repair of horizontal cleavage meniscus tears provides good clinical outcomes in spite of poor meniscus healing. Knee Surg Sports Traumatol Arthrosc 28, 3474–3480 (2020). https://doi.org/10.1007/s00167-019-05782-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-019-05782-y

Keywords

Search

Navigation