Abstract
The medial meniscus is a secondary stabilizer to anterior tibial translation and provides significant stability, especially in an ACL-deficient knee. The purpose of this study is to evaluate the clinical outcome of medial meniscus repair in the unstable knee. Between 1997 and 2002, 11 patients, with a mean age of 25.8 years (range 15–39 years), underwent all-inside medial meniscus repair, using the Meniscus Arrow, for unstable medial meniscus tear in ACL-deficient knees. For various reasons none of these patients underwent ACL reconstruction. The average follow-up was 73 months (range 52–91 months). There were three failures (27.3%) defined as the need for reoperation and partial meniscectomy. The mean Tegner activity score decreased from 6.75 (pretrauma) to 4.5 (postoperatively). The average Lysholm and subjective IKDC scores were 83 and 77.4, respectively. Two patients were graded as B (nearly normal) and six as C (abnormal), according to the IKDC knee evaluation form. KT-2000 arthrometry demonstrated that sagittal knee laxity was more than 5 mm in all knees (side to side difference). MRI demonstrated grade three signal alterations at the repair site of meniscus in three patients and signs of cartilage damage in two patients. All patients were asymptomatic during daily activities but seven out of eight reported pain or effusion after sports. Medial meniscus repair in the ACL-deficient knee is not contraindicated. The need of reducing the level of physical activity is essential.
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Albrecht-Olsen P, Kristensen G, Burgaard P, Törmälä P (1993) Meniscus bucket-handle fixation with an absorbable Biofix tack: development of a new technique. Knee Surg Sports Traumatol Arthrosc 1:104–106
Anderson K, Marx RG, Hannafin J, Warren RF (2000) Chondral injury following meniscal rapair with a biodegradable implant. Arthroscopy 16:749–753
Baratz M, Fu FH, Mengato R (1986) Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee. Am J Sports Med 14:270–275
Bellabarba C, Bush-Joseph CA, Bach BR Jr, (1997) Patterns of meniscal injury in the anterior cruciate-deficient knee: a review of the literature. Am J Orthop 26:18–23
Belzer JP, Cannon WDJr (1993) Meniscus tears: Treatment in the Stable and unstable knee. J Am Orthop Surg 1:41–47
Boenisch UW, Faber KJ, Ciarelli M, Steadman JR, Arnoczky SP (1999) Pull-out strength and stiffness of meniscal repair using absorbable arrows or Ti-Cron vertical and horizontal loop sutures. Am J Sports Med 27:626–631
Borden P, Nyland J, Caborn DN, Pienkowski D (2003) Biomechanical comparison of the Fast-T-Fix meniscal repair suture system with vertical sutures and meniscus arrows. Am J Sports Med 31:374–378
Cannon WD, Vittori JM (1992) The incidence of healing in arthroscopic meniscus repairs in anterior cruciate ligament-reconstructed knees versus stable knees. Am J Sports Med 20:176–181
Casteleyn PP, Handelberg F (1996) Non-operative management of anterior cruciate ligament injuries in the general population. J Bone Joint Surg Br 78:446–451
DeHaven KE, Lohrer WA, Lovelock JE (1995) Long-term results of open meniscal repair. Am J Sports Med 23:524–530
DeHaven KE (1999) Meniscus repair. Am J Sports Med 27:242–250
Ellermann a, Siebold R, Buelow JU, Sobau C (2002) Clinical evaluation of meniscus repair with a bioabsorbable arrow: a 2- to 3-year follow-up study. Knee Surg Sports Traumatol Arthrosc 10:289–293
Fairbanks TJ (1948) Knee joints changes after meniscectomy. J Bone Joint Surg Br 4:664–670
Hanks GA, Gause TM, Handal JA, Kalenak A (1990) Meniscus repair in the anterior cruciate deficient knee. Am J Sports Med 18:606–611
Jackson JP (1968) Degenerative changes in the knee after meniscectomy. Br Med J 2:525–527
Jensen NC, Riis J, Robertsen K, Holm AR (1994) Arthroscopic repair of the ruptured meniscus: one to 6.3 years follow up. Arthroscopy 10:211–214
Krause WR, Pope MH, Johnson RJ (1976) Mechanical changes in the knee after meniscectomy. J Bone Joint Am 58A:599–604
Kurosawa H, Fukubayashi T, Nakajima H (1980) Load-bearing mode of the knee joint: Physical behaviour of the knee joint with or without menisci. Clin Orthop 149:283–290
Kurzweil PR, Tifford CD, Ignacio EM (2005) Unsatisfactory clinical results of meniscal repair using the meniscus arrow. Arthroscopy 21:905–910
Levy IM, Torzilli PA, Warren RF (1982) The effect of medial meniscectomy on anterior-posterior motion of the knee. J Bone Joint Surg Am 64A:883–888
Morgan CD, Wojtys EM, Casscells CD, Casscells SW (1991) Arthroscopic meniscal repair evaluated by second-look arthroscopy. Am J Sports Med 19:632–638
Mow VC, Mac AF (1987) Lubrication of the diarthrodial joints. In: Skalak R, Chien S (eds) Handbooks of bioengineering. McGraw-Hill, New York, pp 5.1–5.34
Muellner T, Egkher A, Nikolic A, Funovics M, Metz V (1999) Open meniscal repair: clinical and magnetic resonance imaging findings after twelve years. Am J Sports Med 27:16–20
Radin EL, Delamotte F, Maquet P (1984) Role of the menisci in the distribution of stress in the knee. Clin Orthop 185:290–294
Rankin CC, Linter DM, Noble PC, Paravic V, Greer E (2002) A biomechanical analysis of meniscal repair techniques. Am J Sports Med 30:492–497
Rosenberg TD, Scott SM, Coward DB et al (1988) Arthroscopic meniscal repair evaluated with repeat arthroscopy. Arthroscopy 2:14–20
Ross G, Grabil J, McDevitt E (2000) Chondral injury after meniscal rapair with bioabsorbable arrows. Arthroscopy 16:754–756
Scott GA, Jolly BL, Henning CE (1986) Combined posterior incision and arthroscopic intra-articular repair of the meniscus: An examination of factors affecting healing. J Bone Joint Surg Am 68(6):847–861
Sommerlath K (1988) The prognosis of repaired and intact menisci in unstable knees-a comparative study. Arthroscopy 4:93–95
Sommerlath K, Hamberg P (1989) Healed meniscal tears in unstable knees. A long-term follow-up of seven years. Am J Sports Med 17:161–163
Steenbrugge F, Verstraete K, Verdonk R (2004) Magnetic reasonance imaging of the surgically repaired meniscus: a 13-year follow-up study of 13 knees. Acta Orthop Scand 75:323–327
Streenburgge F, Van Nieuwenhuyse W, Verdonk R, Verstraete K. (2005) Arthroscopic meniscus repair in the ACL-deficient knee. Int Orthop 29:109–112
Tapper EM, Hoover NW (1969) Late results after meniscectomy. J Bone Joint Surg Am 51:517–526
Von Eisenhart-Rothe R, Bringmann C, Siebert M et al. (2004) Femoro-tibial and menisco-tibial translation patterns in petients with unilateral anterior cruciate ligament deficiency-a potential cause of secondary meniscal tears. J Orthop Res 22:275–282
Warren RF (1990) Meniscectomy and repair in the anterior cruciate ligament-deficient patient. Clin Orthp Relat Res 252:55–63
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Koukoulias, N., Papastergiou, S., Kazakos, K. et al. Mid-term clinical results of medial meniscus repair with the meniscus arrow in the unstable knee. Knee Surg Sports Traumatol Arthrosc 15, 138–143 (2007). https://doi.org/10.1007/s00167-006-0162-2
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DOI: https://doi.org/10.1007/s00167-006-0162-2