Introduction: Meniscal injuries are common and a potential source of osteoarthritis of the knee. This has led to the development of techniques to repair meniscal tears. The goal of this study was to look at the independent variables that have an influence on the outcome and identify factors that might improve future clinical results.

Method: A total of 119 meniscal repairs were included in this study and evaluated at minumum 72 months postoperatively (range 72–86). Meniscal repair was done by an arthroscopically assisted technique: inside-out, all-inside or by a combination of both techniques. Patients with menisci repaired were clinically evaluated. We performed examinations using the International Knee Documentation Committee (IKDC) form and the Lysholm score. Radiological analysis of the knees was done by means of the Ahlback classification pre- and postoperatively. Variables that were analyzed were age, gender, type of repair, chronicity of the lesion, zone of injury, morphology of the tear, involvement of the anterior cruciate ligament (ACL), and the compartment involved. Statistical analysis was done by means of logistic regression.

Results: The overall clinical success rate for meniscal repair was 74.0%. In 73.1% of the cases, the mensiscal injury was associated with an injury of the ACL. Patients with an associated ACL injury had a better chance for a successfull outcome, but this was only significantly when the ACL injury was repaired (p< 0.05). There was no difference between the male and female patients regarding outcome. A delay in treatment for 6 weeks or more resulted in significantly worse results (p< 0.001). Younger patients had significantly better outcome results (p< 0.05). Better results were obtained when the inside-out technique was used for meniscal repair (p< 0.05).

Discussion: Our data confirm the good outcome results of meniscal repair. In our hands, a meniscal repair has the highest likelihood of success in young patients, with a concomitant ACL injury that is repaired at the same time. Better outcome scores were observed when the inside-out technique was used and when menisci where repaired within 6 weeks of the initial injury.

This randomized clinical trial compares fixed- and mobile-bearing total knee prostheses in terms of the patients’ clinical outcome parameters (Knee Society Clinical Rating, WOMAC, SF-12), range of motion and performance during gait analysis for level-ground walking. Our results show no significant differences in the clinical outcomes and gait performance of the fixed- and mobile-bearing total knee arthroplasties.

The purpose of this study was to compare the clinical outcomes and gait parameters of patients with a fixed-bearing or mobile-bearing total knee arthroplasty (TKA).

Fifty-five patients were entered into a prospective, randomized clinical trial comparing fixed- versus mobile-bearing TKAs (Genesis II, Smith & Nephew, Memphis, TN). From this patient population, fifteen fixed-bearing and fifteen mobile-bearing TKA patients were matched based on age, sex and BMI to undergo gait analysis. Patients performed trials of level-ground walking at a self-selected velocity while three-dimensional kinetic and kinematic data were collected.

The fixed-bearing and mobile-bearing TKA patient groups were comparable regarding Knee Society Clinical Rating (181 ± 22 versus 171 ± 28), WOMAC scores (7 ± 5 versus 9 ± 12), SF-12 and range of motion (121° ± 11° versus 125° ± 6°).

Patients with fixed- and mobile-bearing TKAs performed similarly in the gait analysis in terms of their velocity, percent weight acceptance in the operated versus the non-operated limb, peak flexion in stance and swing phases, the support moments and extension moments at the ankle, knee and hip. Decreased peak extension in the mid-stance and swing phases was observed in the operative limb versus the non-operative limb for both fixed- and mobile-bearing TKAs (P=0.02 and 0.04). Decreased peak extension was also observed during mid-stance and swing phases in the mobile-bearing TKAs versus the fixed-bearing TKAs (P=0.064 and 0.052).

Fixed-bearing and mobile-bearing TKAs perform similarly in terms of their clinical outcome measures and the kinetics and kinematics of level-ground walking.

Funding for this project obtained from Smith & Nephew, Memphis, TN.