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

  • Shozaburo Terai
  • Yusuke HashimotoEmail author
  • Shinya Yamasaki
  • Shinji Takahashi
  • Nagakazu Shimada
  • Hiroaki Nakamura
Arthroscopy and Sports Medicine
  • 16 Downloads

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.

Keywords

Meniscus Meniscal cyst FasT-Fix MRI 

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

Notes

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.

Compliance with ethical standards

Conflict of interest

No authors declare any conflicts of interest relating to the submitted paper.

Ethical approval

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.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Shozaburo Terai
    • 1
  • Yusuke Hashimoto
    • 2
    Email author
  • Shinya Yamasaki
    • 3
  • Shinji Takahashi
    • 2
  • Nagakazu Shimada
    • 4
  • Hiroaki Nakamura
    • 2
  1. 1.Department of Orthopaedic SurgeryOsaka City Juso HospitalOsaka-shiJapan
  2. 2.Department of Orthopaedic SurgeryOsaka City University Graduate School of MedicineOsaka-shiJapan
  3. 3.Department of Orthopaedic SurgeryOsaka City General HospitalOsaka-shiJapan
  4. 4.Department of Orthopaedic SurgeryShimada HospitalHabikino-shiJapan

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