Background

Total knee arthroplasty (TKA) is a proven and cost-effective treatment for osteoarthritis. Despite the good to excellent long-term results, some patients remain dissatisfied. Our study aimed at establishing a predictive model to aid patient selection and decision-making in TKA.

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.