MENISCAL REPAIR WITH AN ABSORBABLE SCREW (CLEARFIX)

Abstract

The aim of this prospective study is to investigate the effectiveness of a new method for arthroscopic all-inside meniscus repair (Clearfix meniscal screw system-Innovasive Devices Inc.).This system consists of delivery cannulae,screw implants and a screw driver.After tear debridement a screw is located on the driver and passed through the cannula to the insertion site, holding the two sides of the tear together under linear compression.In this study, 46 patients (48 repairs)are included, mean age 32,7 years,with a follow-up ranging from 6 to 48 months (average 18,8 months).Only longitudinal lesions in the red/red zone or red/white areas were repaired. Ligament stabilizing procedures were done in 39 patients (84,8%) who had ACL deficient knees,.Thirty-four (71%) injuries were considered chronic (injury to repair time more than 4 weeks) and 14 (29%) injuries were considered acute (injury to repair time less than 4 weeks).The evaluation of the results was based on the clinical examination,the “OAK ” knee evaluation scheme and the MRI.Criteria for clinical success included absence of joimt line tenderness, swelling and a negative Mc Murray test.Thirteen out of 48 repairs (27%) were considered as failures according to the above mentioned criteria.The average time for the procedure was 8 minutes.Postoperatively there were no complications directly associated with the device.Magnetic resonance imaging, however,showed a persisting grade III and IV lesion in 72,8% of the patients (n=35) according to Reicher classification.

Though the system offers two main advantages,that is the absence of serious complications and the reduced operative time, the failure rate in this study is quite high. This clinical study is in agreement with the recent experimental studies referring to the limited pull-out strength of this device.