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Prevalence, development, and factors associated with cyst formation after meniscal repair with the all-inside suture device

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

To investigate the prevalence of cyst formation after using all-inside meniscal repair device and analysed the risk factors associated with it.

Methods

Between August 2008 and September 2013, 51 menisci of 46 patients were included in the study, 46 menisci of which had concomitant anterior cruciate ligament (ACL) ruptures and had an ACL reconstruction. Magnetic resonance imaging (MRI) of the knee was performed at 3, 6, 12 and 24 months after meniscal surgery. The MRIs were assessed to detect the development of cysts encasing the suture anchors and to evaluate meniscal healing. Statistical analysis was performed using multiple regression analysis.

Results

Out of the 51 menisci examined, MRI revealed cysts in 15 menisci. Cysts were detected in 3 menisci at 6 months, in 9 menisci at 12 months, and in 3 menisci at 24 months after surgery. Only 3 patients (6.5%) were symptomatic, and cystectomy was performed in 2 of these patients and arthroscopic debridement in the other. Compared with using both the suture device and an inside-out suture repair, using the suture device alone was more likely to be associated with cyst development [odds ratio (OR), 12.04]. The medial meniscus was also significantly more likely to develop a cyst compared with the lateral meniscus (OR, 12.48). There was an increased outcome for the number of device use (P = 0.033). Though it was not statistically significant, the patients with anterior knee laxity (side-to-side difference > 3 mm using a knee arthrometer) were more likely to develop cysts than those without anterior knee laxity (P = 0.06). There were no significant differences between the remaining variables.

Conclusions

The prevalence of cyst formation around the suture implant was 29%, but most cases were not symptomatic. Significant risk factors for cyst formation included the use of a suture device alone, and a location in the medial meniscus.

Level of evidence

III.

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Abbreviations

MRI:

Magnetic resonance imaging

PEEK:

Polyether ether ketone

DLM:

Discoid lateral meniscus

ACL:

Anterior cruciate ligament

AM:

Anteromedial

PL:

Posterolateral

IKDC:

International Knee Documentation Committee

SSD:

Side-to-side difference

OR:

Odds ratio

CI:

Confidence interval

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Acknowledgements

We thank Junsei Takigami M.D., Ph.D. from Shimada Hospital and Kazuya Nishino M.D. from Osaka City University for their technical support and data analysis.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Osaka City Juso Hospital, 2-12-27 Nonaka-kita, Yodogawa-ku, Osaka-shi, Osaka-fu, 532-0034, Japan

    Shozaburo Terai

  2. Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka-shi, Osaka-fu, 545-8585, Japan

    Yusuke Hashimoto, Shinji Takahashi & Hiroaki Nakamura

  3. Department of Orthopaedic Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka-shi, Osaka-fu, 531-0031, Japan

    Shinya Yamasaki

  4. Department of Orthopaedic Surgery, Shimada Hospital, 100-1 Kashiyama, Habikino-shi, Osaka-fu, 583-0875, Japan

    Nagakazu Shimada

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  1. Shozaburo Terai
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Correspondence to Yusuke Hashimoto.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Terai, S., Hashimoto, Y., Yamasaki, S. et al. Prevalence, development, and factors associated with cyst formation after meniscal repair with the all-inside suture device. Arch Orthop Trauma Surg 139, 1261–1268 (2019). https://doi.org/10.1007/s00402-019-03176-w

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