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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 21, Issue 9, pp 2126–2130 | Cite as

Arthroscopic inside-out repair of complete radial tears of the meniscus with a fibrin clot

  • Ho Jong Ra
  • Jeong Ku Ha
  • Suk Hwan Jang
  • Dhong Won Lee
  • Jin Goo Kim
Knee

Abstract

Purpose

To report on the results of 12 complete radial tears of the meniscus treated using arthroscopic inside-out repair with fibrin clots, the results showed good meniscal healing and excellent clinical outcomes.

Methods

From 2007 to 2009, 12 patients with complete radial tears of the meniscus were treated by arthroscopic inside-out repair with fibrin clots. In all patients, the International Knee Documentation Committee (IKDC) subjective knee form and Lysholm score were determined pre- and post-operatively. We performed magnetic resonance imaging (MRI) and if indicated, we performed a second-look arthroscopic examination.

Results

At a mean of 30 ± 4 postoperative months, the Lysholm score and IKDC subjective knee score had improved from 65 ± 6 and 57 ± 7 to 94 ± 3 and 92 ± 3, respectively. Eleven of 12 cases showed complete healing on follow-up MRI. Six of 7 patients undergoing a second-look arthroscopic examination had healed completely.

Conclusion

This study shows successful meniscal repairs using fibrin clots in complete radial tears. This surgical procedure appears to be a good treatment method for complete radial tear of the meniscus.

Level of evidence

Case series, Level IV.

Keywords

Meniscus tear Complete radial tear Meniscus repair Fibrin clot 

References

  1. 1.
    Arnoczky SP, Warren RF, Spivak JM (1988) Meniscal repair using an exogenous fibrin clot. An experimental study in dogs. J Bone Joint Surg Am 70:1209–1217PubMedGoogle Scholar
  2. 2.
    Cannon WD Jr, Vittori JM (1992) The incidence of healing in arthroscopic meniscal repairs in anterior cruciate ligament-reconstructed knees versus stable knees. Am J Sports Med 20:176–181PubMedCrossRefGoogle Scholar
  3. 3.
    Choi NH, Kim TH, Son KM, Victoroff BN (2010) Meniscal repair for radial tears of the midbody of the lateral meniscus. Am J Sports Med 38:2472–2476PubMedCrossRefGoogle Scholar
  4. 4.
    Ciliz D, Ciliz A, Elverici E, Sakman B, Yuksel E, Akbulut O (2008) Evaluation of postoperative menisci with MR arthrography and routine conventional MRI. Clin Imaging 32:212–219PubMedCrossRefGoogle Scholar
  5. 5.
    De Smet AA (2005) MR imaging and MR arthrography for diagnosis of recurrent tears in the postoperative meniscus. Semin Musculoskelet Radiol 9:116–124PubMedCrossRefGoogle Scholar
  6. 6.
    Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA (2009) Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med 37:2259–2272PubMedCrossRefGoogle Scholar
  7. 7.
    Freedman KB, Nho SJ, Cole BJ (2003) Marrow stimulating technique to augment meniscus repair. Arthroscopy 19:794–798PubMedCrossRefGoogle Scholar
  8. 8.
    Hantes ME, Zachos VC, Zibis AH, Papanagiotou P, Karachalios T, Malizos KN, Karantanas AH (2004) Evaluation of meniscal repair with serial magnetic resonance imaging: a comparative study between conventional MRI and indirect MR arthrography. Eur J Radiol 50:231–237PubMedCrossRefGoogle Scholar
  9. 9.
    Hede A, Larsen E, Sandberg H (1992) The long term outcome of open total and partial meniscectomy related to the quantity and site of the meniscus removed. Int Orthop 16:122–125PubMedCrossRefGoogle Scholar
  10. 10.
    Henning CE, Lynch MA, Clark JR (1987) Vascularity for healing of meniscus repairs. Arthroscopy 3:13–18PubMedCrossRefGoogle Scholar
  11. 11.
    Henning CE, Lynch MA, Yearout KM, Vequist SW, Stallbaumer RJ, Decker KA (1990) Arthroscopic meniscal repair using an exogenous fibrin clot. Clin Orthop Relat Res 252:64–72PubMedGoogle Scholar
  12. 12.
    Jang SH, Ha JK, Lee DW, Kim JG (2011) Fibrin clot delivery system for meniscal repair. Knee Surg Relat Res 28(3):180–183CrossRefGoogle Scholar
  13. 13.
    Kurosawa H, Fukubayashi T, Nakajima H (1980) Load-bearing mode of the knee joint: physical behavior of the knee joint with or without menisci. Clin Orthop Relat Res 149:283–290PubMedGoogle Scholar
  14. 14.
    Matava MJ (2007) Meniscal allograft transplantation: a systematic review. Clin Orthop Relat Res 455:142–157PubMedCrossRefGoogle Scholar
  15. 15.
    Tetik O, Kocabey Y, Johnson DL (2002) Synovial abrasion for isolated, partial thickness, undersurface, medial meniscus tears. Orthopedics 25:675–678PubMedGoogle Scholar
  16. 16.
    Tielinen L, Lindahl J, Koskinen S, Hirvensalo E (2007) Clinical and MRI evaluation of meniscal tears repaired with bioabsorbable arrows. Scand J Surg 96:252–255PubMedGoogle Scholar
  17. 17.
    van Trommel MF, Simonian PT, Potter HG, Wickiewicz TL (1998) Arthroscopic meniscal repair with fibrin clot of complete radial tears of the lateral meniscus in the avascular zone. Arthroscopy 14:360–365PubMedCrossRefGoogle Scholar
  18. 18.
    Voloshin AS, Wosk J (1983) Shock absorption of meniscectomized and painful knees: a comparative in vivo study. J Biomed Eng 5:157–161PubMedCrossRefGoogle Scholar
  19. 19.
    Zhang Z, Arnold JA, Williams T, McCann B (1995) Repairs by trephination and suturing of longitudinal injuries in the avascular area of the meniscus in goats. Am J Sports Med 23:35–41PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Ho Jong Ra
    • 1
  • Jeong Ku Ha
    • 1
  • Suk Hwan Jang
    • 1
  • Dhong Won Lee
    • 1
  • Jin Goo Kim
    • 1
  1. 1.Department of Orthopedic Surgery, Seoul Paik HospitalInje UniversitySeoulKorea

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