Abstract
Aim: To compare two arthroscopic all-inside methods of meniscal refixation (Fast-FixTM by Smith and Nephew and Clearfix screw by Innovasive Devices Inc.) in a prospective study.
Method: 85 patients (mean age 32.7 years) having 87 meniscal repairs (Group C: 27 with Clearfix screw and Group F: 60 with Fast-FixTM) were included in the study.
Ligament stabilizing procedures were done in 46 (54,1%) patients who had ACL deficient knees (18 reconstructions in Group C and 38 in Group F). Only longitudinal lesions in the red/red or red/white zone were repaired. Follow-up averaged 12.3 months with a range from 6 to 25 months. Only longitudinal lesions in the red/red or red/white zone were repaired. Patients were evaluated using clinical examination, the “OAK” knee evaluation scheme and Magnetic Resonance Imaging. Criteria for clinical success included absence of joint line tenderness, swelling and a negative McMurray test.
Results: 10 out of 87 repaired menisci (11.5%) were considered as failures according to the above mentioned criteria (3 in Group C (11,1%) and 7 in Group F (11,6%)). According to the “OAK” knee evaluation scheme 68 patients (80.%) had excellent or good result (Group C: 20 (80%), Group F: 48 (80%)). Magnetic resonance imaging, however, showed persisting grade III or IV lesions in 41 (47,1%) of 87 patients with successful result (Group C: 13 (47%), Group F: 28 (46,6%)). Postoperatively, we had 10 complications (11,3%) which were not directly associated with the meniscal repair device (Group C: 2 (3,7%), Group F: 7 (11,6%)).
Conclusion: Risk factors for failure of meniscus repair are chronicity of injury, location of tear more than 3 mm from the meniscosynovial junction and meniscus side (medial). At all events, both methods seem to be very promising because of their efficasy, safety and ease to use.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
