Comparison of Arthroscopic Medial Meniscal Suture Repair Techniques
- 14 August 2009
- journal article
- research article
- Published by SAGE Publications in The American Journal of Sports Medicine
- Vol. 37 (11), 2144-2150
- https://doi.org/10.1177/0363546509339010
Abstract
Background There are no reports comparing meniscal healing between inside-out and all-inside repairs using sutures. Hypothesis No difference in healing rate exists between meniscal repairs with inside-out and all-inside suture repair in conjunction with anterior cruciate ligament reconstruction with hamstring tendon. Study Design Cohort study; Level of evidence, 2. Methods Forty-eight consecutive patients underwent meniscal repairs of longitudinal tears of the posterior horn of the medial meniscus combined with anterior cruciate ligament reconstructions. All-inside repair was attempted when the tears were located in the red-red zone or the ramp area of the meniscus. If a tear that was in the ramp area or red-red zone extended to the midbody of the meniscus, or if there was a tear in red-white zone, the inside-out repair technique was used. Fourteen patients had all-inside meniscal repairs, and 34 patients had inside-out meniscal repairs with absorbable sutures. Identical postoperative rehabilitation protocols were used. Postoperative evaluations included Lysholm knee scoring scale, Tegner activity levels, Lachman and pivot-shift tests, and KT-1000 arthrometer. Assessment of meniscal status was performed using joint line tenderness, McMurray test, and range of motion. Follow-up magnetic resonance imaging scans were obtained on all patients. Results Mean follow-up was 35.7 months. No patient had joint line tenderness or reported pain or clicking on McMurray test. There was no significant difference in range of motion between groups. Follow-up magnetic resonance imaging scans demonstrated that 10 (71.4%) menisci were healed and 4 (28.6%) partially healed in the all-inside group; 24 (70.6%) menisci were healed and 10 (29.4%) partially healed in the inside-out group. There was no significant difference in meniscal healing between groups. There were no differences in Lachman test, KT-1000 arthrometer side-to-side differences measurements, Lysholm scores, and Tegner activity scales. There was a significant difference in pivot-shift test between groups ( P = .023). There were 2 complications associated with surgery. In the inside-out group, 1 patient required manipulation, and 2 patients had limited motion at final follow-up. Two patients in the inside-out group experienced transient saphenous nerve injury. Conclusion There was no significant difference in meniscal healing between inside-out and all-inside repair techniques in combination with anterior cruciate ligament reconstructions.Keywords
This publication has 24 references indexed in Scilit:
- Meniscal Repair Using an All-Inside, Rapidly Absorbing, Tensionable DeviceArthroscopy: The Journal of Arthroscopic & Related Surgery, 2008
- Femoral Bioabsorbable Cross-Pin Fixation in Anterior Cruciate Ligament ReconstructionArthroscopy: The Journal of Arthroscopic & Related Surgery, 2007
- Effectiveness of Bioabsorbable Arrows Compared with Inside-Out Suturing for Vertical, Reparable Meniscal LesionsThe American Journal of Sports Medicine, 2007
- MR Imaging of the Postoperative Meniscus: Repair, Resection, and ReplacementSeminars in Musculoskeletal Radiology, 2006
- Arthroscopic meniscal repair: a comparative study between three different surgical techniquesKnee Surgery, Sports Traumatology, Arthroscopy, 2006
- Cross-pin femoral fixation versus metal interference screw fixation in anterior cruciate ligament reconstruction with hamstring tendons: Results of a controlled prospective randomized study with 2-year follow-upArthroscopy: The Journal of Arthroscopic & Related Surgery, 2005
- Arthroscopic all-inside suture repair of medial meniscus lesion in anterior cruciate ligament—deficient knees: Results of second-look arthroscopies in 39 casesArthroscopy: The Journal of Arthroscopic & Related Surgery, 2004
- Chondral injury following meniscal repair with a biodegradable implantArthroscopy: The Journal of Arthroscopic & Related Surgery, 2000
- Subcutaneous Migration of Meniscal Arrows after Failed Meniscus RepairThe American Journal of Sports Medicine, 2000
- Pull-Out Strength and Stiffness of Meniscal Repair Using Absorbable Arrows or Ti-Cron Vertical and Horizontal Loop SuturesThe American Journal of Sports Medicine, 1999