Abstract
Introduction The gold standard technique for meniscal repair has been an inside-out technique. Current practice suggests that certain tears are incapable of healing although anecdotally this has not been our experience. This study reports our long-term results of an aggressive approach to meniscal preservation using an inside out technique.
Methods Between January 1990 and July 1997, 116 patients underwent 125 meniscal repairs in 116 knees. The average follow-up is 8.8 years (range 5.4 to 12.9). Repairs consisted of interrupted sutures using 2.0 PDS. Sutures were placed arthroscopically using a suture shuttle system and tied behind the capsule after making a small postero-medial or postero-lateral incision. The meniscus and bed was prepared using a Rasp or hand-held instruments. There were 49 left knees and 67 right knees in 77 males and 39 females. Repair involved 80 medial menisci and 45 lateral menisci. The average number of sutures used was 3.8 (range 1 to 12).
Results The average Lysholm scores were 86.0, with 54% excellent, 21% good, 17% fair and 8% poor. IKDC subjective scores averaged 81.5, with 39% excellent, 23% good, 25% fair and 13% poor. Failure of meniscal repair has been identified in 30% of patients. Of these two thirds were associated with a further significant injury. Of the failures 73% were professional or semi-professional athletes. The average time for return to sport after surgery was 9.5 months (range 3 to 18 months). Failure was reported at an average of 29.3 months after surgery (range 0 to 84 months).
Conclusions The long-term results of the meniscal suture using this arthroscopically assisted inside out technique in our unit are acceptable. In addition the majority of the failures have occurred in professional athletes. We would therefore expect our long term failure rate to be at the high end of the spectrum. These results are comparable to those using standard suturing techniques.
The abstracts were prepared by Mr Jerzy Sikorski. Correspondence should be addressed to him at the Australian Orthopaedic Association, Ground Floor, William Bland Centre, 229 Macquarie Street, Sydney NSW 2000, Australia.
None of the authors have received any payment or consideration from any source for the conduct of this study.
