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Long-term outcome after all-inside meniscal repair using the RapidLoc system

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

Abstract

Purpose

The purpose of the present study was to evaluate the outcome at a minimum of 7 years following meniscal repair using the RapidLoc (suture anchor) system. It was hypothesized that most patients would have an intact meniscus, as has been reported in several short- and medium-term studies.

Methods

In the time period from 2002 to 2007, all patients with a vertical longitudinal tear of the meniscus that was judged to be repairable were treated with rasping of the tear area and nearby parameniscal synovium and fixation of the torn part with the use of RapidLoc implants. Using a surgeon-administered form, baseline information about the arthroscopic findings and procedures performed was recorded (at the time of surgery). A median 10-year (range 7–12 years) follow-up was conducted in 2014–2015, and surgical procedures to the knee following the (index) meniscal repair were registered. Treatment failure was defined as a new surgical procedure to the same meniscus.

Results

At the time of follow-up, 39 out of 82 patients (48 %) had undergone further surgery to the repaired meniscus (failures). Nine of these occurred within the first 6 months after surgery, 21 within the first 12 months and 26 within the first 24 months. Thus, the failure rate was 11 % at 6 months, 23 % at 12 months and 28 % at 2 years. One-third (N = 13) of the failures occurred 2 years or later after the (index) meniscal repair.

Conclusions

Long-term results of meniscal repair using the RapidLoc implants were found to be poor with a high failure rate. In a large proportion of the cases, re-rupture appeared several years after the index surgery, and a commonly used follow-up period of 2 years would therefore fail to detect them. In the day-by-day clinical work, of interest to orthopaedic surgeons is that meniscal repair using an all-inside technique similar to the one used by the authors may not solve the problem in the long run.

Level of evidence

IV.

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References

  1. Albrecht-Olsen P, Kristensen G, Burgaard P, Joergensen U, Toerholm C (1999) The arrow versus horizontal suture in arthroscopic meniscus repair. A prospective randomized study with arthroscopic evaluation. Knee Surg Sports Traumatol Arthrosc 7:268–273

    Article  CAS  PubMed  Google Scholar 

  2. Albrecht-Olsen PM, Bak K (1993) Arthroscopic repair of the bucket-handle meniscus. 10 failures in 27 stable knees followed for 3 years. Acta Orthop Scand 64:446–448

    Article  CAS  PubMed  Google Scholar 

  3. Barber FA, Coons DA, Ruiz-Suarez M (2006) Meniscal repair with the RapidLoc meniscal repair device. Arthroscopy 22:962–966

    Article  PubMed  Google Scholar 

  4. Barrett GR, Field MH, Treacy SH, Ruff CG (1998) Clinical results of meniscus repair in patients 40 years and older. Arthroscopy 14:824–829

    Article  CAS  PubMed  Google Scholar 

  5. Billante MJ, Diduch DR, Lunardini DJ, Treme GP, Miller MD, Hart JM (2008) Meniscal repair using an all-inside, rapidly absorbing, tensionable device. Arthroscopy 24:779–785

    Article  PubMed  Google Scholar 

  6. Bogunovic L, Kruse LM, Haas AK, Huston LJ, Wright RW (2014) Outcome of all-inside second-generation meniscal repair: minimum five-year follow-up. J Bone Joint Surg Am 96:1303–1307

    Article  PubMed  PubMed Central  Google Scholar 

  7. Cannon WD, Vittori JM (1992) The incidence of healing in arthroscopic meniscal repairs in anterior cruciate ligament-reconstructed knees versus stable knees. Am J Sports Med 20:176–181

    Article  PubMed  Google Scholar 

  8. Clancy WG, Graf BK (1983) Arthroscopic meniscal repair. Orthopedics 6:1125–1129

    CAS  PubMed  Google Scholar 

  9. DeHaven KE (1985) Meniscus repair–open vs. arthroscopic. Arthroscopy 1:173–174

    Article  CAS  PubMed  Google Scholar 

  10. Fairbank TJ (1948) Knee joint changes after meniscectomy. J Bone Joint Surg Br 30-B:664–670

    Google Scholar 

  11. Gifstad T, Grøntvedt T, Drogset JO (2007) Meniscal repair with biofix arrows: results after 4.7 years’ follow-up. Am J Sports Med 35:71–74

    Article  PubMed  Google Scholar 

  12. Goodwillie AD, Myers K, Sgaglione NA (2014) Current strategies and approaches to meniscal repair. J Knee Surg 27:423–434

    Article  PubMed  Google Scholar 

  13. Grant JA, Wilde J, Miller BS, Bedi A (2012) Comparison of inside-out and all-inside techniques for the repair of isolated meniscal tears: a systematic review. Am J Sports Med 40:459–468

    Article  PubMed  Google Scholar 

  14. Güneş T, Bostan B, Erdem M, Asci M, Sen C, Kelestemur MH (2009) Biomechanical evaluation of arthroscopic all-inside meniscus repairs. Knee Surg Sports Traumatol Arthrosc 17:1347–1353

    Article  PubMed  Google Scholar 

  15. Henning CE, Lynch MA, Clark JR (1987) Vascularity for healing of meniscus repairs. Arthroscopy 3:13–18

    Article  CAS  PubMed  Google Scholar 

  16. Hjelle K, Solheim E, Strand T, Muri R, Brittberg M (2002) Articular cartilage defects in 1000 knee arthroscopies. Arthroscopy 18:730–734

    Article  PubMed  Google Scholar 

  17. Hutchinson ID, Moran CJ, Potter HG, Warren RF, Rodeo SA (2014) Restoration of the meniscus: form and function. Am J Sports Med 42:987–998

    Article  PubMed  Google Scholar 

  18. Ikeuchi H (1982) Arthroscopic treatment of the discoid lateral meniscus. Technique and long-term results. Clin Orthop Relat Res 167:19–28

    PubMed  Google Scholar 

  19. Järvelä S, Sihvonen R, Sirkeoja H, Järvelä T (2010) All-inside meniscal repair with bioabsorbable meniscal screws or with bioabsorbable meniscus arrows: a prospective, randomized clinical study with 2-year results. Am J Sports Med 38:2211–2217

    Article  PubMed  Google Scholar 

  20. Kalliakmanis A, Zourntos S, Bousgas D, Nikolaou P (2008) Comparison of arthroscopic meniscal repair results using 3 different meniscal repair devices in anterior cruciate ligament reconstruction patients. Arthroscopy 24:810–816

    Article  PubMed  Google Scholar 

  21. Kise NJ, Drogset JO, Ekeland A, Sivertsen EA, Heir S (2015) All-inside suture device is superior to meniscal arrows in meniscal repair: a prospective randomized multicenter clinical trial with 2-year follow-up. Knee Surg Sports Traumatol Arthrosc 23:211–218

    Article  PubMed  PubMed Central  Google Scholar 

  22. Morgan CD (1991) The “all-inside” meniscus repair. Arthroscopy 7:120–125

    Article  CAS  PubMed  Google Scholar 

  23. Naqui SZH, Thiryayi WA, Hopgood P, Ryan WG (2006) A biomechanical comparison of the Mitek RapidLoc, Mitek Meniscal repair system, clearfix screws and vertical PDS and Ti-Cron sutures. Knee 13:151–157

    Article  CAS  PubMed  Google Scholar 

  24. Nepple JJ, Dunn WR, Wright RW (2012) Meniscal repair outcomes at greater than five years: a systematic literature review and meta-analysis. J Bone Joint Surg Am 94:2222–2227

    Article  PubMed  PubMed Central  Google Scholar 

  25. Popescu D, Sastre S, Garcia AI, Tomas X, Reategui D, Caballero M (2015) MR-arthrography assessment after repair of chronic meniscal tears. Knee Surg Sports Traumatol Arthrosc 23:171–177

    Article  PubMed  Google Scholar 

  26. Pujol N, Barbier O, Boisrenoult P, Beaufils P (2011) Amount of meniscal resection after failed meniscal repair. Am J Sports Med 39:1648–1652

    Article  PubMed  Google Scholar 

  27. Pujol N, Tardy N, Boisrenoult P, Beaufils P (2015) Long-term outcomes of all-inside meniscal repair. Knee Surg Sports Traumatol Arthrosc 23:219–224

    Article  PubMed  Google Scholar 

  28. Quinby JS, Golish SR, Hart JA, Diduch DR (2006) All-inside meniscal repair using a new flexible, tensionable device. Am J Sports Med 34:1281–1286

    Article  PubMed  Google Scholar 

  29. Rockborn P, Messner K (2000) Long-term results of meniscus repair and meniscectomy: a 13-year functional and radiographic follow-up study. Knee Surg Sports Traumatol Arthrosc 8:2–10

    Article  CAS  PubMed  Google Scholar 

  30. Roos H, Laurén M, Adalberth T, Roos EM, Jonsson K, Lohmander LS (1998) Knee osteoarthritis after meniscectomy: prevalence of radiographic changes after twenty-one years, compared with matched controls. Arthritis Rheum 41:687–693

    Article  CAS  PubMed  Google Scholar 

  31. Sgaglione NA (2002) Meniscus repair: update on new techniques. Tech Knee Surg 1:113–127

    Article  Google Scholar 

  32. Sihvonen R, Paavola M, Malmivaara A, Itälä A, Joukainen A, Nurmi H, Kalske J, Järvinen TLN, Finnish Degenerative Meniscal Lesion Study (FIDELITY) Group (2013) Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med 369:2515–2524

    Article  CAS  PubMed  Google Scholar 

  33. Small NC (1986) Complications in arthroscopy: the knee and other joints: Committee on Complications of the Arthroscopy Association of North America. Arthroscopy 2:253–258

    Article  Google Scholar 

  34. Solheim E, Krokeide AM, Melteig P, Larsen A, Strand T, Brittberg M (2014) Symptoms and function in patients with articular cartilage lesions in 1000 knee arthroscopies. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3472-9

    Google Scholar 

  35. Stone RG, VanWinkle GN (1986) Arthroscopic review of meniscal repair: assessment of healing parameters. Arthroscopy 2:77–81

    Article  CAS  PubMed  Google Scholar 

  36. Tuckman DV, Bravman JT, Lee SS, Rosen JE, Sherman OH (2006) Outcomes of meniscal repair: minimum of 2-year follow-up. Bull Hosp Jt Dis 63:100–104

    PubMed  Google Scholar 

  37. van Trommel MF, Simonian PT, Potter HG, Wickiewicz TL (1998) Different regional healing rates with the outside-in technique for meniscal repair. Am J Sports Med 26:446–452

    PubMed  Google Scholar 

  38. Walter RP, Dhadwal AS, Schranz P, Mandalia V (2014) The outcome of all-inside meniscal repair with relation to previous anterior cruciate ligament reconstruction. Knee 21:1156–1159

    Article  CAS  PubMed  Google Scholar 

  39. Warren RF (1985) Arthroscopic meniscus repair. Arthroscopy 1:170–172

    Article  CAS  PubMed  Google Scholar 

  40. Wasserstein D, Dwyer T, Gandhi R, Austin PC, Mahomed N, Ogilvie-Harris D (2013) A matched-cohort population study of reoperation after meniscal repair with and without concomitant anterior cruciate ligament reconstruction. Am J Sports Med 41:349–355

    Article  PubMed  Google Scholar 

  41. Westermann RW, Wright RW, Spindler KP, Huston LJ, Wolf BR, MOON Knee Group (2014) Meniscal repair with concurrent anterior cruciate ligament reconstruction: operative success and patient outcomes at 6-year follow-up. Am J Sports Med 42:2184–2192

    Article  PubMed  PubMed Central  Google Scholar 

  42. Xu C, Zhao J (2015) A meta-analysis comparing meniscal repair with meniscectomy in the treatment of meniscal tears: the more meniscus, the better outcome? Knee Surg Sports Traumatol Arthrosc 23:164–170

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Teres Bergen, Bergen, Norway

    Eirik Solheim & Janne Hegna

  2. Deaconess University Hospital, Haraldsplass, Bergen, Norway

    Eirik Solheim & Eivind Inderhaug

  3. Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway

    Eirik Solheim & Eivind Inderhaug

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  1. Eirik Solheim
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  2. Janne Hegna
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Correspondence to Eirik Solheim.

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Solheim, E., Hegna, J. & Inderhaug, E. Long-term outcome after all-inside meniscal repair using the RapidLoc system. Knee Surg Sports Traumatol Arthrosc 24, 1495–1500 (2016). https://doi.org/10.1007/s00167-015-3642-4

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