Arthroscopic meniscal repair with an absorbable screw: results and surgical technique

Abstract

The results of a new method for arthroscopic all-inside meniscus repair using a biodegradable cannulated screw (Clearfix meniscal screw) were assessed in a medium-term follow-up prospective study. The Clearfix meniscal screw system consists of delivery cannulae, screw driver, and screw implants. After tear debridement, a screw is located on the driver and passed through the cannula to the insertion site, holding the two sides of the tear together under linear compression. Forty-eight patients (48 repairs) with a mean age of 32.7 years were included in the study. Ligament stabilizing procedures were done in 39 patients (81%) who had anterior cruciate ligament deficient knees. Only longitudinal lesions in the red/red or red/white zone were repaired. Follow-up averaged 19 months, with a range from 12 to 48 months. Patients were evaluated using clinical examination, the "Orthopaedische Arbeitsgemeinschaft Knie (OAK)" knee evaluation scheme and magnetic resonance imaging (MRI). Criteria for clinical success included absence of joint-line tenderness, absence of swelling and a negative McMurray test. Postoperatively, there were no complications directly associated with the device. Twelve of 48 repaired menisci (25%) were considered failures according to the above-mentioned criteria. According to the OAK knee evaluation scheme, 38 patients (79%) had an excellent or good result. MRI, however, showed persisting grade III or IV lesions in 35 patients (73%). Analysis showed that age, length of tear, and simultaneous anterior cruciate ligament reconstruction did not affect the clinical outcome. In contrast, risk factors for failure of meniscus repair are chronicity of injury, location of tear more than 3 mm from the meniscosynovial junction and meniscus side (medial).

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

“…The time required for meniscal repair averaged 38.5 min for group A (range 25-55), 18.1 min for group B (range 10-22), and 13.6 min for group C range (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The time for meniscal repair was significantly longer in group A in comparison with the two other groups.…”

“…Today, a plethora of devices for all-inside meniscal repair are available with a success rate ranging from 75 to 90% [3,4,16,17,20,22]. However, only three published studies comparing the ''gold standard'' suture repair technique with the meniscus arrow are available.…”

Meniscal Repair and Transplantation: Indications, Techniques, Rehabilitation, and Clinical Outcome

“…However, preservation of meniscal tissue is an over whelming rationale in young active patients and several authors have demonstrated that tears located in the central onethird avascular zone can be successfully repaired. 6,12,58,59,68,80,82,90 sults of meniscal repair using fixators, such as arrows, 22,29,43,48,50,83,84 staples, 49 and all-inside biodegradable screws 32,38,69 ; however, arthroscopicassisted suture repair remains the gold standard and is our preferred method. In addition, we have demonstrated that a rehabilitation program that implements immediate knee motion the first postoperative day after meniscus repair (performed either alone or with anterior cruciate ligament [ACL] reconstruction) is not deleterious to the healing meniscus tissue and prevents knee arthrofibrosis.…”

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

“…Hemarthrosis happens while ACL reconstruction releases growth factors and results in chemo taxis needed for meniscal repair (25). However, different researchers reported no significant difference regarding meniscal repair in isolated and with ACL reconstruction at the same time (26)(27)(28). In the current study, according to IKDC questionnaire and scales S, A, and SP, patients with ACL reconstruction at the same time had higher level of satisfaction compared with other patients.…”