CLINICAL EVIDENCE SHOWS NO DIFFERENCE OF ALL-INSIDE MENISCAL REPAIR USING THREE DIFFERENT MENISCAL REPAIR SYSTEMS IN AN ANTERIOR CRUCIATE LIGAMENT POPULATION

Abstract

Purpose: The goal of this study was the evaluation of arthroscopic meniscal repair results using three different repair devices (RapidLoc of Depuy Mitec, T–Fix of Acufex Microsurgical, and FasT-Fix of Smith& Nephew).

Methods: From 2001 to 2006, 265 patients with 280 meniscal tears underwent to meniscal repair using three different all-inside meniscal repair implants (88 patients using RapidLoc, 85 patients using T–Fix, and 92 patients using FasT-Fix). There were 181 medial and 99 lateral tears; 174 tears were located in Cooper radial zone 1 and 106 tears in zone 2. All patients had concurrent anterior cruciate ligament reconstruction. All cases were performed by a single surgeon. Follow-up assessment included clinical examination, arthrometry (KT-1000), the International Knee Documentation Committee (IKDC) criteria, and Lysholm functional questionnaires. Success clinical criteria included absence of joint-line tenderness, swelling, blocking, and negative McMurray and Appley test.

Results: Mean follow-up was 26 months (range, 9–36 months). Tear length averaged 2.7 cm (range, 1.2–4.3 cm). An average of 2.4 suture devices was used (1.9 of RapidLoc, 3.1 of T–Fix, and 2.2 of FasT-Fix). Twenty eight menisci repairs were consider as failures according to our criteria (success rate 92.4% for FasT-Fix, 87% for TFix, and 86,5% for RapidLoc). There were 16 re-look arthroscopies for device removal and partial meniscectomy, with 8 patients having failure of meniscal repair in zone 2. Both the subjective Lysholm and IKDC scores were significantly improved, with higher improvement in FasT-Fix patients’ group. Chronicity, location or length of the tear, and patients’ age did not affect the clinical outcome.

Conclusions: The compared meniscal repair systems showed comparable clinical results. Meniscal repair systems appeared to be a safe and effective technique providing a high rate meniscus healing in both complex tears and tears located in Cooper radial zone 2.