Failed meniscal repair increases the risk for osteoarthritis and poor knee function at an average of 9 years follow-up

Abstract

Purpose The purpose of this study was to determine the effect of meniscal repair on OA in the knee joint and patient-related outcomes. Methods Three-hundred and sixteen meniscal repairs performed between 1999 and 2011 were analysed. Patient-related outcome measures were assessed through mailed questionnaires including KOOS, Lysholm score and Tegner activity level. Patients answering the questionnaires were encouraged to perform a radiographic evaluation with Rosenberg views, assessed according to Kellgren–Lawrence (KL) classification. The primary endpoint was to determine the effect of meniscal repair on the development of radiographic OA defined as a KL grade 2 or more. Results Mean follow-up time was 9.3 years (SD 3.6), 162 (51%) patients answered the questionnaires, and 86 patients completed the X-ray. The odds ratio for OA with a failed meniscus repair was 5.1 (p = 0.007) adjusted for gender and age at time of follow-up. KOOS showed a clinically important difference in the sport and recreation subscale (p = 0.041). Conclusions There was an increased risk for OA in the affected compartment with a failed meniscus fixation. This supports the fact that the meniscus is an important protector of the cartilage in the knee. The meniscus injury affects the long-term health-related quality of life according to KOOS and in light of this study we recommend repair of a torn meniscus whenever possible. Level of evidence III.

Osteoarthritis Development Following Meniscectomy vs. Meniscal Repair for Posterior Medial Meniscus Injuries: A Systematic Review

“…The posterior root of the medial meniscus plays a critical role in maintaining knee joint homeostasis and biomechanical integrity [21][22][23][24]. Meniscal injury can significantly impact the knee biomechanics, while its healing process can be influenced by various comorbidities, surgical procedures, or infections [25][26][27][28][29][30][31].…”

The Danger Zone for Iatrogenic Neurovascular Injury in All-Inside Lateral Meniscal Repair in Relation to the Popliteal Tendon: An MRI Study

“… 8 , 9 , 13 , 16 When facing a meniscal injury during an arthroscopic procedure, most orthopaedic surgeons prefer performing a meniscal repair rather than a meniscectomy to decrease the risk of the patient’s later developing osteoarthritis. 21 , 22 The all-inside technique is used widely in meniscal repairs, especially in the body and posterior horn of the meniscus, because it is a simple procedure with low operative time and does not require any additional skin incisions. 2 , 3 , 12 …”

“…8,9,13,16 When facing a meniscal injury during an arthroscopic procedure, most orthopaedic surgeons prefer performing a meniscal repair rather than a meniscectomy to decrease the risk of the patient's later developing osteoarthritis. 21,22 The all-inside technique is used widely in meniscal repairs, especially in the body and posterior horn of the meniscus, because it is a simple procedure with low operative time and does not require any additional skin incisions. 2,3,12 In all-inside lateral meniscal repair of the body and posterior horn of the lateral meniscus, most surgeons usually repair the lateral meniscus in the area lateral to the lateral border of the popliteal tendon (PT) and medial to the medial border of the PT to avoid penetrating the PT.…”