Arthroscopic Meniscal Repair Results

Abstract

Scott et al. [1] followed 178 repairs and 167 patients by postoperative arthroscopy or arthrography. In an average duration of follow-up of 100 weeks, 61.8% of the menisci healed, 16.9% healed incompletely, and 21.3% did not heal. Of all menisci, 92% were categorized as clinically stable, and 80% of the patients returned to active sports participation. Positive correlations with healing were found in patients who had a narrow peripheral meniscal rim, 0–2 mm, and in patients whose repair was associated with reconstruction of the anterior cruciate ligament (ACL). Nonabsorbable sutures, 2–0 Ethibond at 3-mm intervals, were used. Before November 1981, when the technique for dissection of the perimeniscal synovial membrane was introduced, 46.9% of the medial menisci had healed. After that date, the incidence of healing increased to 62.4%. The overall rate of healing for both medial and lateral menisci rose from 54.8% to 64.0% (P = 0.06). The authors compared peripheral meniscal rims of 0– 2 mm with 3–5 mm; the former were found to heal significantly better. Single longitudinal tears had a higher rate of healing (64.5%) than 13 double longitudinal tears (38.5%). However, the length of the tear did not substantially affect the rate of healing. Also, 75% of the menisci patients with a preoperative history of locking healed either completely or incompletely, in contrast with 81% of patients who denied having locking; duration of locking had no effect on the rate of healing. In addition, 66 displaced bucket-handle tears that were repaired did not have a statistically significant difference in rate of healing when compared with the remainder of the menisci that were repaired (P = 0.25). Intervals between injury and surgery less than 2 weeks and those more than 3 weeks were not significantly different in terms of rate of healing.