Abstract
Aim
The aim of this prospective study was to analyze the results of meniscal tears repaired with Fast-Fix All-inside suture in stable versus anterior cruciate ligament (ACL)-deficient knees.
Patients
Forty patients, everybody professional players, all underwent arthroscopic surgery, were divided into two groups and followed-up for at least 24 months. Group A (stable knee affected with isolated meniscal tears) consisted of 20 patients treated exclusively with Fast-Fix suture. Group B (ACL-deficient knees affected with meniscal tears) consisted of 20 patients in which we performed a Fast-Fix suture with concurrent ACL reconstruction (hamstring duplicated). Comparing both Groups together, we have noticed that the good clinical result of meniscal sutures with ACL reconstruction associated has occurred faster than isolated meniscal suture, regardless of the meniscus, the knee, and age of the patient. In fact 6 months after surgery, in Group A, there was a success by 65% against 85% for the Group B with 8.3 points International Knee Documentation Committee (IKDC) difference in favor of the latter. Whereas 24 months after surgery, the percentage was increased achieving 90% in Group A and 95% in Group B with 12.6 points IKDC difference in favor of the Group B. A statistical analysis of variable, both after 6 and 24 months, showed a significant improvement of knee conditions for patients with ACL reconstruction.
Conclusion
In conclusion, other than observing the better results in meniscal tears with ACL-deficient knee, we observed that among all cases the best healing occurred in patients affected by meniscal longitudinal vertical tears located in Red–Red zone of external meniscus with an extension of 10 mm in ACL-deficient knee, treated with Fast-Fix suture and ACL reconstruction associated.
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References
Greis P, Bardana D, Holmstrom M, Burks R (2002) Meniscal injury: I. Basic science and evaluation. J Am Acad Orthop Surg 10:168–176
Majewski M, Susanne H, Klaus S (2006) Epidemiology of athletic knee injuries: a 10-year study. Knee 13(3):184–188
Hughston JC, Andrews JR, Cross MJ, Moschi A (1976) Classification of knee ligament instabilities. Part I. The medial compartment and cruciate ligaments. J Bone Jt Surg Am 58:159–172
Seedhom BB (1976) Loadbearing function of the menisci. Physiotherapy 62:223
Poehling GG, Ruch DS, Chabon SJ (1990) The landscape of meniscal injuries. Clin Sports Med 9:539–549
Duncan JB, Hunter R, Purnell M, Freeman J (1995) Meniscal injuries associated with acute anterior cruciate ligament tears in alpine skiers. Am J Sports Med 23:170–172
Fairbank TJ (1948) Knee joint changes after meniscectomy. J Bone Jt Surg 30B:664–670
Krause WR, Pope MH, Johnson RJ, Wilder DG (1976) Mechanical changes in the knee after meniscectomy. J Bone Jt Surg 58 A:599–604
Seedhom BB, Dowson D, Wright V (1974) Function of the menisci: a preliminary study. J Bone Jt Surg 56B:381
Walker PS, Erkmann MG (1975) The role of the menisci in force transmission across the knee. Clin Orthop Relat Res 109:184–192
Levi M, Torzilli PA, Warren RF (1982) The effect of medial meniscectomy on anterior–posterior motion of the knee. J Bone J Surg 64A:883–888
Radin EL, De Lamotte F, Maquet P (1984) Role of the menisci in the distribution of stress in the knee. Clin Orthop Relat Res 185:290–294
Hsieh H-H, Walker PS (1976) Stabilizing mechanisms of the loaded and unloaded knee joint. J Bone Jt Surg 58A:87–93
Greis P, Bardana D, Holmstrom M, Burks R (2002) Meniscal injury: II. Treatment. J Am Acad Orthop Surg 10:177–187
Arnoczky SP, Warren RF (1982) Microvasculature of the human meniscus. Am J Sports Med 10:90–95
Irrgang JJ, Anderson AF, Boland AL et al (2001) Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med 29(5):600–613
Reish MW, Kurzweil PR (2007) Fast-Fix meniscus repair. Tech Knee Surg 6(3):161–167
Shelbourne KD, Patel DV, Adsit WS, Porter DA (1996) Rehabilitation after meniscal repair. Clin Sports Med 15(3):595–612
Barber FA, Click SD (1997) Meniscus repair rehabilitation with concurrent anterior cruciate reconstruction. Arthroscopy 13(4):433–437
Roi GS, Creta D, Nanni G, Marcacci M, Zaffagnini S, Snyder-Mackler L (2005) Return to official Italian First Division soccer games within 90 days after anterior cruciate ligament reconstruction: a case report. J Orthop Sports Phys Ther 35(2):52–61 (discussion 61–66)
Muellner T, Weinstabl R, Schabus R, Vecsei V, Kainberger F (1997) The diagnosis of meniscal tears in athletes: a comparison of clinical and magnetic resonance imaging investigations. Am J Sports Med 25:7–12
McCarthy E, Marx R, DeHven K (2002) Meniscus repair: consideration in treatment and update of clinical result. Clin Orthop Relat Res 402:122–134
Ellermann A, Siebold R, Buelow JU, Sobau C (2002) Clinical evaluation of meniscus repair with a bioabsorbable arrow: a 2- to3-year follow-up study. Knee Surg Sport Traumatol Arthrosc 10:289–293
Stärke C, Kopf S, Petersen W, Becker R (2009) Meniscal repair. Arthroscopy 25(9):1033–1044
Barret GR, Field MH, Treacy SH, Ruff CG (1998) Clinical results of meniscus repair in patient 40 years and olders. Arthroscopy 14:824–829
Cannon WD, Vittori JM (1992) The incidence of healing in arthroscopic meniscus repair in anterior cruciate ligament-reconstructed knee versus stable knee. Am J Sport Med 20:176–181
Henning CE, Lynch MA, Clark JR (1987) Vascularity for healing of meniscus repairs. Arthroscopy 3:13–18
Morgan CD, Wojtys EM, Casscells SW (1991) Arthroscopic meniscus repair evaluated by second look arthroscopy. Am J Sport Med 19:632–637
Rosenberg TD, Scott SM, Coward DB et al (1986) Arthroscopic meniscal repair evaluated with repeat arthroscopy. Arthroscopy 2:14–20
Shelbourne KD, Jari S, Gray T (2003) Outcome of untreated traumatic articular cartilage defects of the knee: a natural history study. J Bone Jt Surg Am 85-A(Suppl 2):8–16
Ventura A, Terzaghi C, Borgo E, Verdoia C, Gallazzi M, Failoni S (2005) Use of growth factors in ACL surgery: preliminary study. J Orthop Traumatol 6:76–79
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Tucciarone, A., Godente, L., Fabbrini, R. et al. Meniscal tear repaired with Fast-Fix sutures: clinical results in stable versus ACL-deficient knees. Arch Orthop Trauma Surg 132, 349–356 (2012). https://doi.org/10.1007/s00402-011-1391-5
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DOI: https://doi.org/10.1007/s00402-011-1391-5