No abstract

This study was designed to compare the clinical outcomes of meniscectomy versus repair and to study the effects of (1) duration of follow-up and (2) concomitant anterior cruciate ligament (ACL) reconstruction on clinical outcomes. Methods: A retrospective study was conducted, involving 112 knees of 106 patients who underwent meniscus surgery, either partial meniscectomy or meniscal repair between 2008 and 2016. There were 42 meniscectomies and 70 meniscal repairs. Patients were graded pre-and post-operatively using the International Knee Documentation Committee (IKDC) score and Tegner Activity Level Scale through case notes review. Statistical analysis was done using the paired Student's t-test (two-tailed) or Wilcoxon signed-rank test for paired scores. The two-sample Student's t-test (two-tailed) or Mann-Whitney U test was used for independent scores. Multiple variable linear regression analysis was used to assess the importance of the variables on outcomes. A statistical significance is taken as p < 0.05. Results: Meniscectomy and repair had good outcomes. IKDC scores improved from 46.6 to 81.7 after meniscectomy and from 45.9 to 84.4 after repair (p < 0.001). Meniscectomy fared worse in late follow-up (>18 months), decreasing from 88.2 in early follow-up (18 months) to 72.1 (p < 0.05). The post-operative scores in meniscal repair were maintained in the late follow-up group (82.9 compared to 87.1, p > 0.05). Concomitant ACL reconstruction improved the outcomes of meniscectomy (IKDC and Tegner: p < 0.05) and repair (IKDC and Tegner: p < 0.05). Conclusion: Both meniscectomy and meniscal repair are viable surgical techniques for meniscal injury and have good outcomes. Meniscal repair has a better prognosis in the long run.

Purpose: We report our experience with the effect of location and configuration of meniscal tears on clinical outcomes. Methods: A retrospective review of patients who underwent partial meniscectomy or meniscal repair between 2008 and 2016 was conducted. One hundred fourteen knees in 106 patients were included, comprising 43 partial meniscectomies and 71 meniscal repairs. Patients were graded pre- and postoperatively with the International Knee Documentation Committee (IKDC) score and Tegner Activity Level Scale. Meniscal tears were classified according to location (anterior horn, body, posterior horn, and others) and type (radial, horizontal, longitudinal, and complex) and subgroups were analyzed for their effect on outcomes. Results: All tears, whether treated with partial meniscectomy or repair, showed significant improvement in postoperative scores ( p < 0.05); 39.47% of tears involved the posterior horn alone, 10.53% involved the body alone, 3.51% involved the anterior horn alone, and 46.49% were complex tears that spanned more than one area. Complex tears treated with repair had significantly better scores (IKDC, p = 0.002; Tegner, p = 0.008) than complex tears treated with meniscectomy. Longitudinal tears showed results suggesting better short-term outcomes with meniscectomy than with repair (IKDC, p = 0.036; Tegner p = 0.018), a potential statistical anomaly. Horizontal and radial tears showed no significant difference in outcomes, regardless of treatment. Tears in different locations (anterior horn, body, posterior horn, and others) showed no significant difference in outcomes, regardless of treatment. Conclusion: Meniscal surgery yields significant improvement in postoperative scores. Complex tears showed significantly better postoperative scores when treated with repair.