Arthroscopic meniscal repair: a comparative study between three different surgical techniques

Abstract

The purpose of this prospective study was to evaluate and compare the results of arthroscopic meniscal repair using three different techniques. Between January 2002 and March 2004, 57 patients who met the inclusion criteria underwent an arthroscopic meniscal repair. The outside-in technique was used in 17 patients (group A), the inside-out in 20 patients (group B), while the rest of the 20 patients (group C) were managed by the all-inside technique using the Mitek RapidLoc soft tissue anchor (Mitek Surgical Products, Westwood, MA, USA). Anterior cruciate ligament (ACL) reconstruction was performed in 29 patients (51%). The criteria for clinical success included absence of joint line tenderness, locking, swelling, and a negative McMurray test. The minimum follow-up was one year for all groups. The mean follow-up was 23 months for group A, 22 months for group B, and 22 months for group C. All meniscal repairs were considered healed according to our criteria in group A, while 19 out of 20 repairs (95%) healed in group B. Finally 7 of 20 repairs (35%) were considered failures in group C and this difference was statistically significant in comparison with other groups. The time required for meniscal repair averaged 38.5 min for group A, 18.1 min for group B, and 13.6 min for group C. Operation time for meniscal repair in group A was statistically longer in comparison with other groups. There were no significant differences among the three groups concerning complications. According to our results, arhtroscopic meniscal repair with the inside-out technique seems to be superior in comparison with the other methods because it offers a high rate of meniscus healing without prolonged operation time.

Arthroscopic Meniscal Repair in Outside-In Technique: A Clinical and Paraclinical Study

“…Different studies reported no complications if the technique was performed by a trained surgeon (18). However, in the study by Hantes et al (8), in all 37 patients undergone meniscal tear repair by suturing technique, 4 had saphenous nerve neuropathy that all recovered during the follow-up. Other researchers also reported their consequences that all recovered during the study (19,20).…”

“…Although some studies reported that healing rate in the age range of 20 -30 years was in its highest level (21,22), in the current study, there was no significant association between age and recovery rate according to IKDC and KOOS questionnaires. Although the prevalence of meniscal injury is higher in males than females, different studies showed no significant difference in the results of meniscal tear repair (8,23). In the current study, there was a significant association between gender and IKDC and symptom (S) scale scores.…”

“…Studies evaluated and compared these methods (7,8); however, advantages and disadvantages of these methods were not compared thoroughly. According to some published studies, there is more failure in all inside method compared with the regular suturing method.…”

RapidLoc Meniscus Repair Technique

“…44Y46 The all-inside meniscal repair devices may require a different approach from the suture repairs, and there is some indication that healing rates for these devices may be lower than suture repairs. 47 In general, rehabilitation efforts are focused on regaining full range of motion, muscle strength, flexibility, and endurance.…”

International Skeletal Trauma Symposia

“…More clinical data is needed to decide which anchor performs the best. [45][46][47][48][49][50][51][52] Rehabilitation protocols must be decided intraoperatively based on the surgeons' judgment of the stability of the repair. When associated with ACL reconstruction the rehabilitation follows the standard protocol with rare exceptions.…”