Abstract
Purpose
The purpose of this systematic review was to assess sport-specific outcomes after repair of isolated meniscal tears.
Methods
A systematic electronic search of the MEDLINE and Cochrane database was performed in May 2016 to identify studies that reported sport-specific outcomes after isolated meniscal repair. Included studies were abstracted regarding study characteristics, patient demographics, surgical technique, rehabilitation, and outcome measures. The methodological quality of the included studies was assessed with the Coleman Methodology Score (CMS).
Results
Twenty-eight studies with a total of 664 patients met the inclusion criteria. The methodological quality of the included studies was moderate, with a mean CMS of 69.7 ± 8.3. The mean patient age was 26 ± 7.2 years and 71% of patients were male. Mean preoperative Tegner score improved from 3.5 ± 0.3 to 6.2 ± 0.8 postoperatively. Comparing preinjury and postoperative Tegner scores, comparable values were observed (6.3 ± 1.1 and 5.7 ± 0.8, respectively). Return to sports on the preinjury level was achieved in 89%. Mixed-level populations returned to their preinjury activity level in 90% and professional athletes in 86%. Mean delay of return to sports varied between 4.3 and 6.5 months, with comparable results between professional and mixed-level athletes. The pooled failure rate was 21%. The failure rate was lower in professional athletes compared to mixed-level athletes (9% vs. 22%).
Conclusion
This systematic review suggests that isolated repair of meniscal tears results in good to excellent sport-specific outcomes and a high return to sports rate in both recreational and professional athletes. The failure rate is comparable to systematic reviews not focusing on sportive patients.
Level of evidence
Level IV systematic review of Level I to Level IV studies.
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References
Ahn JH, Kim K-I, Wang JH, Kyung BS, Seo MC, Lee SH (2013) Arthroscopic repair of bucket-handle tears of the lateral meniscus. Knee Surg Sports Traumatol Arthrosc 23:205–210
Ahn JH, Kwon O-J, Nam T-S (2015) Arthroscopic repair of horizontal meniscal cleavage tears with marrow-stimulating technique. Arthroscopy 31:92–98
Albrecht-Olsen PM, Bak K (2009) Arthroscopic repair of the bucket-handle meniscus: 10 failures in 27 stable knees followed for 3 years. Acta Orthop Scand 64:446–448
Alford JW, Lewis P, Kang RW, Cole BJ (2005) Rapid progression of chondral disease in the lateral compartment of the knee following meniscectomy. Arthroscopy 21(12):1505–1509
Alvarez-Diaz P, Alentorn-Geli E, Llobet F, Granados N, Steinbacher G, Cugat R (2016) Return to play after all-inside meniscal repair in competitive football players: a minimum 5-year follow-up. Knee Surg Sports Traumatol Arthrosc 24:1997–2001
Andrade R, Vasta S, Papalia R, Pereira H, Oliveira JM, Reis RL, Espregueira-Mendes J (2016) Prevalence of articular cartilage lesions and surgical clinical outcomes in football (soccer) players’ knees: a systematic review. Arthroscopy 32:1466–1477
Aune KT, Andrews JR, Dugas JR, Cain EL (2014) Return to play after partial lateral meniscectomy in national football league athletes. Am J Sports Med 42:1865–1872
Barber FA, Coons DA (2006) Midterm results of meniscal repair using the biostinger meniscal repair device. Arthroscopy 22:400–405
Bedi A, Kelly N, Baad M, Fox AJS, Ma Y, Warren RF, Maher SA (2012) Dynamic contact mechanics of radial tears of the lateral meniscus: implications for treatment. Arthroscopy 28:372–381
Bogunovic L, Kruse LM, Haas AK, Huston LJ, Wright RW (2014) Outcome of all-inside second-generation meniscal repair: minimum five-year follow-up. J Bone Joint Surg 96:1303–1307
Bonneux I, Vandekerckhove B (2002) Arthroscopic partial lateral meniscectomy long-term results in athletes. Acta Orthop Belg 68:356–361
Brophy RH, Gill CS, Lyman S, Barnes RP, Rodeo SA, Warren RF (2009) Effect of anterior cruciate ligament reconstruction and meniscectomy on length of career in National Football League athletes: a case control study. Am J Sports Med 37:2102–2107
Brucker PU, Campe von A, Meyer DC, Arbab D, Stanek L, Koch PP (2011) Clinical and radiological results 21 years following successful, isolated, open meniscal repair in stable knee joints. Knee 18:396–401
Chiang C-W, Chang C-H, Cheng C-Y, Chen AC-Y, Chan Y-S, Hsu K-Y, Chen W-J (2011) Clinical results of all-inside meniscal repair using the FasT-Fix meniscal repair system. Chang Gung Med J 34:298–305
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 38:2472–2476
Coleman BD, Khan KM, Maffulli N, Cook JL, Wark JD (2000) Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Victorian Institute of Sport Tendon Study Group. Scand J Med Sci Sports 10:2–11
Fairbank TJ (1948) Knee joint changes after meniscectomy. J Bone Joint Surg Br 30:664–670
Fithian DC, Kelly MA, Mow VC (1990) Material properties and structure-function relationships in the menisci. Clin Orthop Relat Res 252:19–31
Fox AJS, Wanivenhaus F, Burge AJ, Warren RF, Rodeo SA (2015) The human meniscus: a review of anatomy, function, injury, and advances in treatment. Clin Anat 28:269–287
Gallacher PD, Gilbert RE, Kanes G, Roberts SNJ, Rees D (2010) White on white meniscal tears to fix or not to fix? Knee 17:270–273
Griffin JW, Hadeed MM, Werner BC, Diduch DR, Carson EW, Miller MD (2015) Platelet-rich plasma in meniscal repair: does augmentation improve surgical outcomes? Clin Orthop Relat Res 473:1665–1672
Hetsroni I, Lillemoe K, Marx RG (2011) Small medial meniscocapsular separations: a potential cause of chronic medial-side knee pain. Arthroscopy 27:1536–1542
Higgins J, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560
Hoffelner T, Resch H, Forstner R, Michael M, Minnich B, Tauber M (2010) Arthroscopic all-inside meniscal repair—does the meniscus heal? Skeletal Radiol 40:181–187
Hoshikawa Y, Kurosawa H, Fukubayashi T, Nakajima H, Watarai K (1983) The prognosis of meniscectomy in athletes. The simple meniscus lesions without ligamentous instabilities. Am J Sports Med 11:8–13
Irrgang JJ, Anderson AF, Boland AL, Harner CD, Kurosaka M, Neyret P, Richmond JC, Shelborne KD (2001) Development and validation of the International knee documentation committee subjective knee form. Am J Sports Med 29:600–613
Ishida K, Kuroda R, Sakai H, Doita M, Kurosaka M, Yoshiya S (2006) Rapid chondrolysis after arthroscopic partial lateral meniscectomy in athletes: a case report. Knee Surg Sports Traumatol Arthrosc 14:1266–1269
Jørgensen U, Sonne-Holm S, Lauridsen F, Rosenklint A (1987) Long-term follow-up of meniscectomy in athletes. A prospective longitudinal study. J Bone Joint Surg Br 69:80–83
Kim S-G, Nagao M, Kamata K, Maeda K, Nozawa M (2013) Return to sport after arthroscopic meniscectomy on stable knees. BMC Sports Sci Med Rehabil BioMed Central 5:23
Kotsovolos ES, Hantes ME, Mastrokalos DS, Lorbach O, Paessler HH (2006) Results of all-inside meniscal repair with the FasT-Fix meniscal repair system. Arthroscopy 22:3–9
Kraus T, Heidari N, Švehlík M, Schneider F, Sperl M, Linhart W (2012) Outcome of repaired unstable meniscal tears in children and adolescents. Acta Orthop 83:261–266
Krych AJ, McIntosh AL, Voll AE, Stuart MJ, Dahm DL (2008) Arthroscopic repair of isolated meniscal tears in patients 18 Years and younger. Am J Sports Med 36:1283–1289
Lee SJ, Aadalen KJ, Malaviya P, Lorenz EP, Hayden JK, Farr J, Kang RW, Cole BJ (2006) Tibiofemoral contact mechanics after serial medial meniscectomies in the human cadaveric knee. Am J Sports Med 34:1334–1344
Lind M, Nielsen T, Fauno P, Lund B, Christiansen SE (2013) Free rehabilitation is safe after isolated meniscus repair: a prospective randomized trial comparing free with restricted rehabilitation regimens. Am J Sports Med 41:2753–2758
Logan M, Watts M, Owen J, Myers P (2009) Meniscal Repair in the elite athlete: results of 45 repairs with a minimum 5-year follow-up. Am J Sports Med 37:1131–1134
Lucas G, Accadbled F, Violas P, de Gauzy JS, Knörr J (2015) Isolated meniscal injuries in paediatric patients: outcomes after arthroscopic repair. Orthop Traumatol Surg Res 101:173–177
Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154
Ma Martin-Fuentes A, Ojeda-Thies C, Vila-Rico J (2015) Clinical results following meniscal sutures : does concomitant ACL repair make a difference. ? Acta Orthop Belg 81:690–697
Majewski M (2006) Midterm and long-term results after arthroscopic suture repair of isolated, longitudinal, vertical meniscal tears in stable knees. Am J Sports Med 34:1072–1076
Makris EA, Hadidi P, Athanasiou KA (2011) The knee meniscus: structure-function, pathophysiology, current repair techniques, and prospects for regeneration. Biomaterials 32:7411–7431
Marcacci M, Marcheggiani Muccioli GM, Grassi A, Ricci M, Tsapralis K, Nanni G, Bonanzinga T, Zaffagnini S (2014) Arthroscopic meniscus allograft transplantation in male professional soccer players: a 36-month follow-up study. Am J Sports Med 42:382–388
Mariani PP, Garofalo R, Margheritini F (2008) Chondrolysis after partial lateral meniscectomy in athletes. Knee Surg Sports Traumatol Arthrosc 16:574–580
Mintzer CM, Richmond JC, Taylor J (1998) Meniscal repair in the young athlete. Am J Sports Med 26:630–633
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535
Nawabi DH, Cro S, Hamid IP, Williams A (2014) Return to play after lateral meniscectomy compared with medial meniscectomy in elite professional soccer players. Am J Sports Med 42:2193–2198
Obremskey WT, Pappas N, Attallah-Wasif E, Tornetta P, Bhandari M (2005) Level of evidence in orthopaedic journals. J Bone Joint Surg 87:2632–2638
Osti L, Liu SH, Raskin A, Merlo F, Bocchi L (1994) Partial lateral meniscectomy in athletes. Arthroscopy 10:424–430
Paxton ES, Stock MV, Brophy RH (2011) Meniscal repair versus partial meniscectomy: a systematic review comparing reoperation rates and clinical outcomes. Arthroscopy 27:1275–1288
Perdue PS, Hummer CD, Colosimo AJ, Heidt RS, Dormer SG (1996) Meniscal repair: outcomes and clinical follow-up. Arthroscopy 12:694–698
Petty CA, Lubowitz JH (2011) Does arthroscopic partial meniscectomy result in knee osteoarthritis? a systematic review with a minimum of 8 years’ follow-up. Arthroscopy 27:419–424
Pujol N, Bohu Y, Boisrenoult P, Macdes A, Beaufils P (2012) Clinical outcomes of open meniscal repair of horizontal meniscal tears in young patients. Knee Surg Sports Traumatol Arthrosc 21:1530–1533
Roos H, Laurén M, Adalberth T, Roos EM, Jonsson K, Lohmander LS (1998) Knee osteoarthritis after meniscectomy: prevalence of radiographic changes after twenty-one years, compared with matched controls. Arthritis Rheum 41:687–693
Schmitt A, Batisse F, Bonnard C (2016) Results with all-inside meniscal suture in pediatrics. Orthop Traumatol Surg Res 102:207–211
Stärke C, Kopf S, Petersen W, Becker R (2009) Meniscal repair. Arthroscopy 25:1033–1044
Stein T, Mehling AP, Jost K, Auhuber TC, Jäger A (2009) Measurements of the quadriceps femoris function after meniscus refixation at the stable athlete’s knee. Arch Orthop Trauma Surg 129:1063–1069
Stein T, Mehling AP, Welsch F, Eisenhart-Rothe von R, Jäger A (2010) Long-term outcome after arthroscopic meniscal repair versus arthroscopic partial meniscectomy for traumatic meniscal tears. Am J Sports Med 38:1542–1548
Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 43–49
Tsai AM, McAllister DR, Chow S, Young CR, Hame SL (2004) Results of meniscal repair using a bioabsorbable screw. Arthroscopy 20:586–590
Tucciarone A, Godente L, Fabbrini R, Garro L, Salate Santone F, Chillemi C (2011) Meniscal tear repaired with Fast-Fix sutures: clinical results in stable versus ACL-deficient knees. Arch Orthop Trauma Surg 132:349–356
Vanderhave KL, Moravek JEJ, Sekiya JK, Wojtys EM (2011) Meniscus tears in the young athlete: results of arthroscopic repair. J Pediatr Orthop 31:496–500
Xu C, Zhao J (2015) A meta-analysis comparing meniscal repair with meniscectomy in the treatment of meniscal tears: the more meniscus, the better outcome? Knee Surg Sports Traumatol Arthrosc 23:164–170
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Eberbach, H., Zwingmann, J., Hohloch, L. et al. Sport-specific outcomes after isolated meniscal repair: a systematic review. Knee Surg Sports Traumatol Arthrosc 26, 762–771 (2018). https://doi.org/10.1007/s00167-017-4463-4
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DOI: https://doi.org/10.1007/s00167-017-4463-4