Functional Evolution of Meniscal Repair Using Absorbable Implants

Abstract

To evaluate the functional evolution of knees after repair of longitudinal meniscal rupture with absorbable arrow implant. Methods: Between June 1997 and February 2001, 23 patients with a mean age of 26.3 years were evaluated. The mean follow-up time was 72.87 months (45-96). We performed 19 medial and 4 lateral meniscal repairs. The patients were pre and postoperatively evaluated regarding joint function according to the Lysholm scale, and, postoperatively, according to IKDC. Results: For better understanding, the 23 treated cases were divided into three groups. Twenty one had ACL injuries, eleven of whom were submitted to ligament reconstruction (Group I). All these 11 cases were regarded as satisfactory. The remaining 10 cases of the 21 with ACL lesion were not submitted to ligament reconstruction (Group II). Of these, 5 evolved satisfactorily, not requiring ligament reconstruction. The remaining five evolved with complaint of ligament instability, being all submitted to reconstruction. Four of these had an integral meniscus and one presented a failure of the medial meniscus. The remaining two cases who did not present ACL injury (Group III), one patient evolved satisfactorily and one developed a failure of the lateral meniscus. According to the Lysholm scale, preoperative mean score was 57.53 and the postoperative mean score was 86.95, evidencing a statistically significant improvement (Wilcoxon p < 0.01). The non-parametric ANOVA was employed for ordinal data with repeated measurements to assess pre- and postoperative measurements, considering Groups I and II. We assessed knee stabilization and found no statistically significant difference between Groups I and II (p = 0.648). Even if there were differences between the two groups, both had the same behavior. On postoperative assessment with IKDC, 4 patients were grade A, 13 were grade B, and 6 were grade C. Two C results were caused by a meniscal rupture. Conclusion: Of the 23 patients, only two presented known failures of the sutured meniscus. According to the Lysholm scale, there was a significant improvement in the treated patients. The ACL repair caused no bias on the results.

Meniscal repair by all-inside technique with Fast-Fix device

“…This can be demonstrated partly by the relative scarcity of studies published in the Brazilian literature on this topic and partly by the difficulty of having these devices released for use through healthcare service agreements and within the Brazilian National Health System (SUS), given that they make the final cost of surgery higher. Auditors and managers do not understand the real benefit that this increased expenditure brings for patients and consequently deny requests to use these devices 23, 24, 25. The technological gap that exists between Brazil and more developed countries should also be mentioned, considering that approval for devices developed outside of Brazil that are more advanced ends up being delayed by controlling bodies.…”

Meniscal Repair Outcome in 3829 Patients With a Minimum Follow-up From 2 Years Up to 5 Years: A Meta-analysis on the Overall Failure Rate and Factors Influencing Failure

“…In 1581 patients, meniscal repair was performed with concomitant ACLR. # In 1016 patients, meniscal repair outcome was reported in knees without any reported injury to the ACL, ** and in 286 patients, 31,59 meniscal repair outcome was reported for ACL-deficient knees. The pooled failure rate of meniscal repair with concomitant ACLR was 8.5% (95% CI, 0.061-0.109), and the pooled failure rate for meniscal repair in knees without any reported injury to the ACL was 14.0% (95% CI, 0.089-0.192).…”

“… # References 1, 6, 13, 14, 17, 19, 21, 31, 37, 41, 51, 56, 58, 59, 62, 63, 67, 70, 72, 73, 75, 80, 81. …”

“… ** References 1-3, 6, 13, 17, 19, 22, 24, 31-33, 37, 41, 43, 47, 49, 50, 55, 58, 59, 71, 73, 75, 80. …”

“… a References 1, 6, 11, 12, 14, 15, 19, 22, 29, 31-33, 35, 37, 41, 43, 55, 56, 58-60, 69, 73, 75, 79. …”