Advertisement

Archives of Orthopaedic and Trauma Surgery

, Volume 127, Issue 4, pp 245–252 | Cite as

Two to nineteen years follow-up of arthroscopic meniscal repair using the outside-in technique: a retrospective study

  • Ashraf AbdelkafyEmail author
  • Nicolas Aigner
  • Mohamed Zada
  • Yassein Elghoul
  • Hesham Abdelsadek
  • Franz Landsiedl
Original Article

Abstract

Purpose: To perform a long-term follow-up evaluation of the outside-in technique of arthroscopic meniscal repair. Type of study: Retrospective study. Methods: Between the years 1986 and 2002, 93 cases of arthroscopic meniscal repair using the outside-in technique have been operated by the senior author (F.L.). Forty-one patients were available for the follow-up evaluation with a mean follow-up of 11.71 years. The International Knee Documentation Committee (IKDC), the modified Lysholm score, the SF-36 (short form 36) health survey score, a visual analogue scale (VAS) for assessment of patients’ satisfaction and another VAS for assessment of patients’ pain were used retrospectively to evaluate the patients. We also used the Kellgren and Lawrence (K/L) classification of osteoarthritis to evaluate the preoperative X-rays and the X-rays done at the time of the follow-up evaluation. Failure was defined as having a meniscectomy procedure post-operatively. Results: From the 93 patients, 52 could not be retrieved for the follow-up evaluation, while 41 were available for it; 36 patients were clinically successful and 5 were considered as failure. Thirty-six patients were classified as grade “A” in the objective IKDC score, mean modified Lysholm score was 87.29 (SD 16.43), while mean SF-36 score was 85.73 (SD 14.17). The results of the VAS for operation satisfaction ranging from −10 to +10 revealed that the mean of the answers was 8.05 (SD 2.99). The results of the VAS for pain ranging from 0 to 10 revealed that the mean of the patients’ pain at the time of the follow-up evaluation was 1.8 (SD 2.42). Twenty out of 24 (only 24 preoperative X-rays were available) were classified as having no osteoarthritis pre-operatively, whereas only 12 out of the 41 patients were classified as having no osteoarthritis (normal) at the time of the follow-up evaluation according to the K/L classification which indicates progression of osteoarthritis. No complications related to the outside-in arthroscopic meniscal repair procedure were reported. Conclusion: We conclude that arthroscopic meniscal repair using the outside-in technique is a safe surgical procedure with a good clinical outcome.

Keywords

Knee arthroscopy Arthroscopic meniscal repair Outside-in technique Follow-up evaluation 

References

  1. 1.
    Greis PE, Bardana DD, Holmstrom MC, Burke RT (2002) Meniscal injury I: basic science and evaluation. J Am Acad Orthop Surg 10:168–176PubMedGoogle Scholar
  2. 2.
    Henning CE (1983) Arthroscopic repair of meniscus tears. Orthopedics 6:1130–1132Google Scholar
  3. 3.
    Warren R (1985) Arthroscopic meniscal repair. Arthroscopy 1:170–172PubMedCrossRefGoogle Scholar
  4. 4.
    Morgan CD (1991) The “all inside” meniscus repair. Arthroscopy 7:120–125PubMedCrossRefGoogle Scholar
  5. 5.
    Mulhollan JS (1993) Meniscus repair. In: Parisien JS (ed) Techniques in therapeutic arthroscopy. Lippincott Williams & Wilkins, Philadelphia, p 21Google Scholar
  6. 6.
    Rodeo SA (2000) Arthroscopic meniscal repair with the use of the outside-in technique. J Bone Joint Surg 82-A:127–141Google Scholar
  7. 7.
    Landsiedl F (1992) Improved outside-in technique of arthroscopic meniscal suture. Arthroscopy 8:130–131PubMedCrossRefGoogle Scholar
  8. 8.
    Hefti F, M¨uller W, Jakob RP et al (1993) Evaluation of knee ligament injuries with the IKDC form. Knee Surg Sports Traumatol Arthrosc 1:226–234CrossRefPubMedGoogle Scholar
  9. 9.
    Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop 198:43PubMedGoogle Scholar
  10. 10.
    Kalantar-Zadeh K, Kopple JD, Block G, Humphreys MH (2001) Association among SF-36 quality of life measures and nutrition, hospitalization and mortality in hemodialysis. J Am Soc Nephrol 12(12):2797–2806PubMedGoogle Scholar
  11. 11.
    Kellgren JH, Lawrence JS (1957) Radiological assessment of osteoarthrosis. Ann Rheum Dis 16:494–501PubMedCrossRefGoogle Scholar
  12. 12.
    Jones H, Lemos M, Wilk R, Smiley P, Gutierrez R, Schepsis A (2002) Two-year follow-up of meniscal repair using a bioabsorbable arrow. Arthroscopy 18:64–69PubMedCrossRefGoogle Scholar
  13. 13.
    Morgan CD, Casscells SW (1986) Arthroscopic meniscus repair: a safe approach to the posterior horns. Arthroscopy 2:3–12PubMedCrossRefGoogle Scholar
  14. 14.
    Morgan C, Wojtys E, Casscells C, Casscells S (1991) Arthroscopic meniscal repair evaluated by second-look arthroscopy. Am J Sports Med 19:632–637PubMedGoogle Scholar
  15. 15.
    Van Trommel M, Simonian P, Potter H, Wickiewicz T (1998) Different regional healing rates with the outside-in technique for meniscal repair. Am J Sports Med 26:446–452PubMedGoogle Scholar
  16. 16.
    Mariani PP, Santori N, Adriani E, Mastantuono M (1996) Accelerated rehabilitation after arthroscopic meniscal repair: a clinical and magnetic resonance imaging evaluation. Arthroscopy 12:680–686PubMedCrossRefGoogle Scholar
  17. 17.
    Felson DT (1990) The epidemiology of knee osteoarthritis: results from the Framingham osteoarthritis study. Semin Arthritis Rheum 20:42–50CrossRefPubMedGoogle Scholar
  18. 18.
    Asahina S, Muneta T, Yamamoto H (1996) Arthroscopic meniscal repair in conjunction with anterior cruciate ligament reconstruction: factors affecting the healing rate. Arthroscopy 12:541–545PubMedCrossRefGoogle Scholar
  19. 19.
    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 20:176–181PubMedGoogle Scholar
  20. 20.
    Warren RF (1990) Meniscectomy and repair in the anterior cruciate ligament-deficient patient. Clin Orthop 252:55–63PubMedGoogle Scholar
  21. 21.
    Shelbourne KD, Dersam MD (2004) Comparison of partial meniscectomy versus meniscal repair of bucket handle lateral meniscus tears in ACL reconstructed knees. Arthroscopy 20:581–585PubMedCrossRefGoogle Scholar
  22. 22.
    Gill S, Diduch D (2002) Outcomes after meniscal repair using the meniscus arrow in knees undergoing concurrent anterior cruciate ligament reconstruction. Arthroscopy 18:569–577PubMedCrossRefGoogle Scholar
  23. 23.
    Escalas F, Quadras J, Caceres A, Benaddi J (1997) T-Fix anchor sutures for arthroscopic meniscal repair. Knee Surg sports Traumatol Arthrosc 5:72–76CrossRefPubMedGoogle Scholar
  24. 24.
    Barrett GR, Treasy SH, Ruff CH (1997) Preliminary results of the T-Fix endoscopic meniscus technique in an ACL reconstruction population. Arthroscopy 13:218PubMedCrossRefGoogle Scholar
  25. 25.
    Laprell H, Stein V, Peterson W (2002) Arthroscopic all-inside meniscal repair using a new refixation device: a prospective study. Arthroscopy 18:387PubMedCrossRefGoogle Scholar
  26. 26.
    Owen JE, Watts MC, Myers PT, Gandhe A (2005) 5.4 to 12.9 year results of meniscal repair using an arthroscopically assisted inside-out suture technique. J Bone Joint Surg 87-B(Suppl II):151CrossRefGoogle Scholar
  27. 27.
    Hockings M, Borrill J, Rae PJ (2005) Arthroscopic meniscal repair; mid to long term clinical results. J Bone Joint Surg 87-B(Suppl):151–152CrossRefGoogle Scholar
  28. 28.
    Eggli S, Wegmuller H, Kosina J, Huckell C, Jakob RP (1995) Long-term results of arthroscopic meniscal repair. Anal Isol Tears 23:715–720Google Scholar
  29. 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 8:1CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Ashraf Abdelkafy
    • 2
    Email author
  • Nicolas Aigner
    • 1
  • Mohamed Zada
    • 2
  • Yassein Elghoul
    • 2
  • Hesham Abdelsadek
    • 2
  • Franz Landsiedl
    • 1
  1. 1.First General Orthopaedic DepartmentOrthopaedic Hospital Vienna-SpeisingViennaAustria
  2. 2.Orthopaedic and Traumatology Department, Faculty of MedicineSuez Canal UniversityIsmailiaEgypt

Personalised recommendations