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Arthroscopic meniscus repair in the ACL-deficient knee

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Abstract

Between 1985 and 1995, 45 patients underwent closed meniscus repair. There were 30 men and 15 women with a mean age of 32.5 years. In 23 patients, the anterior cruciate ligament was intact (group 1) whereas it was deficient in 22 patients (group 2). All patients were managed with the same postoperative program of partial weight bearing, immediate motion and rehabilitation of the knee. Five patients had a failed meniscal repair and underwent a repeat arthroscopy and a partial meniscectomy. These patients were considered as failures and excluded from the final scoring. After a mean follow-up of more than 9 years, all patients were subjected to a clinical examination using the Hospital for Special Surgery (HSS) knee rating system. Seven patients in group 2 had episodes of frequent giving way and had their anterior cruciate ligament (ACL) reconstructed 6 and 7 years after the initial meniscus repair. None of the other patients had any clinical symptoms or signs of a meniscal tear. In group 1, 20 patients and in group 2, 14 patients, all had a satisfactory knee score. Even though the failure rate of meniscus repair may be greater in an unstable knee, it is concluded that meniscal repair is not contraindicated in a knee with a deficient ACL.

Résumé

Entre 1985 et 1995 45 malades ont eu une réparation méniscale à foyer fermé. Il y avait 30 hommes et 15 femmes à l’âge moyen de 32,5 ans. Chez 23 malades le ligament croisé antérieur (LCA) était intact (Groupe 1), alors qu’il était défectueux chez 22 malades (Groupe 2). Tous les malades ont eu le même programme postopératoire avec appui partiel, mobilisation immédiate et rééducation du genou. Cinq malades ont présentés un échec et ont subi une arthroscopie secondaire avec méniscectomie partielle. Ces malades ont été considérés comme échecs et ont exclu du dernier marquage de points. Après une moyenne de suivi de plus de neuf ans tous les malades ont été soumis à un examen clinique qui utilise le score HSS pour l’estimation du genou. Sept malades du groupe 2 ont eu de fréquent épisodes de dérobement et ont eu leur LCA reconstruit 6 et 7 ans après la réparation du ménisque. Aucun des autres malades n’avait de symptôme clinique ou de signe d’une déchirure méniscale. Vingt malades du groupe 1 et 14 malades du groupe 2 avaient tous un score du genou satisfaisant. Bien que le taux d’échec de réparation du ménisque puisse être plus grand dans un genou instable, notre conclusion est que la réparation du ménisque n’est pas contre-indiquée sur un genou avec un LCA défectueux.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, ASZ Campus Aalst, Merestraat 80, 9300, Aalst, Belgium

    F. Steenbrugge & W. Van Nieuwenhuyse

  2. Department of Orthopaedic Surgery and Traumatology, University Hospital, Ghent, Belgium

    R. Verdonk

  3. Department of Radiology, University Hospital, Gent, Belgium

    K. Verstraete

Authors
  1. F. Steenbrugge
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  2. W. Van Nieuwenhuyse
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  3. R. Verdonk
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  4. K. Verstraete
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Correspondence to F. Steenbrugge.

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Steenbrugge, F., Van Nieuwenhuyse, W., Verdonk, R. et al. Arthroscopic meniscus repair in the ACL-deficient knee. International Orthopaedics (SICOT) 29, 109–112 (2005). https://doi.org/10.1007/s00264-004-0616-4

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  • DOI: https://doi.org/10.1007/s00264-004-0616-4

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