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Meniscus sutures by arthrotomy for a non-transfixing horizontal lesion associated with a cyst

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Abstract

Introduction

Meniscal cysts are rare in Stoller grade II horizontal lesions. Several techniques are described in the literature for their management, without any real gold standard. The objective of this work was to report a series of meniscal sutures associated with cyst resection by arthrotomy. The hypothesis was that the results were satisfactory and comparable with the data in the literature regardless of the technique reported without morbidity added by arthrotomy.

Materials and methods

This was a monocentric retrospective study on 13 patients, aged 33 on average with a grade II meniscus lesion associated with a cyst (9 lateral and 4 medial menisci). Pre-operative data available was the VAS (5.7/10) and the Lysholm score (61/100). Primary endpoints were as follows: pain (visual analogue scale), global satisfaction, Lysholm functional score, and return to sports and professional activities at a minimum of two years. Secondary endpoints were complications, possible recurrence, and/or surgical revision. Recurrences, complications, and surgical recovery were gathered.

Results

Patients were evaluated with an average follow-up of 32 months. All patients were satisfied or very satisfied. The VAS significantly improved (0.2/10, p < 0.05) as well as the Lysholm score (97/100, p < 0.05). All patients returned to their professional activity: 11 within two months, one within six weeks, and one in the first post-operative week (this patient being a student). Only one patient did not resume pre-operative sport level due to a femoropatellar syndrome, not linked to the meniscal surgery performed. However, only 11 patients resumed their previous sport level (84.6%). No recurrence or surgical revision occurred.

Discussion

The results are good and similar to the literature, confirming the working hypothesis. These results are equivalent to partial meniscectomies and arthroscopic sutures associated with a procedure on the cyst by arthroscopy or arthrotomy. The literature is in favour of a procedure on the cyst.

Conclusion

The results confirm the effectiveness of a direct approach suture of non-transfixing meniscal lesions associated with a cyst resection with a good functional recovery, without additional morbidity. The hypothesis was confirmed.

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Authors and Affiliations

  1. Service de Chirurgie Orthopédique et de Traumatologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67098, Strasbourg cedex, France

    Nicolas Girodano Orsini, Henri Favreau, David Eichler, François Bonnomet & Matthieu Ehlinger

  2. Département de Chirurgie Orthopédique, Hôpital Sainte-Marguerite, Hôpital Universitaire de Marseille, 270 boulevard Sainte Marguerite, 13009, Marseille, France

    Matthieu Ollivier

  3. Laboratoire ICube, équipe MMB, CNRS, Illkirch, France

    Matthieu Ehlinger

Authors
  1. Nicolas Girodano Orsini
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  2. Henri Favreau
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  3. David Eichler
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  4. Matthieu Ollivier
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  5. François Bonnomet
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  6. Matthieu Ehlinger
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Correspondence to Matthieu Ehlinger.

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Conflict of interest

NG, HF, DE: none

MO: education consultant Arthrex, Stryker, and Newclip

ME: education consultant for Lepine, Newclip, and Amplitude and associate editor of the SOFCOT teaching conferences

FB: education consultant for Amplitude and Serf

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Level of evidence: IV, retrospective study

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Orsini, N.G., Favreau, H., Eichler, D. et al. Meniscus sutures by arthrotomy for a non-transfixing horizontal lesion associated with a cyst. International Orthopaedics (SICOT) 44, 1071–1076 (2020). https://doi.org/10.1007/s00264-020-04491-3

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  • DOI: https://doi.org/10.1007/s00264-020-04491-3

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