Isolated revision meniscal repair – failure rates, clinical outcome, and patient satisfaction

Abstract

BackgroundFailure of isolated primary meniscal repair must be expected in approximately 10–25% of cases. Patients requiring revision surgery may benefit from revision meniscal repair, however, the results of this procedure remain underreported. The purpose of this study was therefore to evaluate the outcome and failure rates of isolated revision meniscal repair in patients with re-tears or failed healing after previous meniscal repair in stable knee joints.MethodsA chart review was performed to identify all patients undergoing revision meniscal repair between 08/2010 and 02/2016. Only patients without concomitant procedures, without ligamentous insufficiency, and a minimum follow-up of 24 months were included. The records of all patients were reviewed to collect patient demographics, injury patterns of the meniscus, and details about primary and revision surgery. Follow-up evaluation included failure rates, clinical outcome scores (Lysholm Score, KOOS Score), sporting activity (Tegner scale), and patient satisfaction.ResultsA total of 12 patients with a mean age of 22 ± 5 years were included. The mean time between primary repair and revision repair was 27 ± 21 months. Reasons for failed primary repairs were traumatic re-tears in 10 patients (83%) and failed healing in two patients (17%). The mean follow-up period after revision meniscal repair was 43 (± 23.4) months. Failure of revision meniscal repair occurred in 3 patients (25%). In two of these patients, successful re-revision repair was performed. At final follow-up, the mean Lysholm Score was 95.2 (± 4.2) with a range of 90–100, representing a good to excellent result in all patients. The final assessment of the KOOS subscores also showed good to excellent results. The mean Tegner scale was 6.8 ± 1.8, indicating a relatively high level of sports participation. Ten patients (83%) were either satisfied or very satisfied with the outcome.ConclusionIn patients with re-tears or failed healing after previous isolated meniscal repair, revision meniscal repair results in good to excellent knee function, high level of sports participation, and high patient satisfaction. The failure rate is slightly higher compared to isolated primary meniscal repair, but still acceptable. Therefore, revision meniscal repair is worthwhile in selected cases in order to save as much meniscal tissue as possible.

Does ACL reconstruction have any influence in meniscal repair? Sports return, quality of life and failure rate. 2-12 years follow up.

“…Fuch et al found high outcomes in quality of life in isolated meniscal repair, with a follow up of 3 years, measured by KOOS QOL, with a medium score of 81.8 ± 12.1. (32) In a recent retrospective study by Cinque et al (33), in 85 patients with ACL reconstruction with or without meniscal repair, they found similar outcomes in quality of life than our study, using SF-12 they found in physical components medium value of 52,8, and in mentall components they found 53,2. And also they didn't found a statiscally signi cant difference between ages and quality of life outcomes.…”

Which Factors Are Associated With the Prevalence of Meniscal Repair?

“…While the reoperation rates of meniscal repair is likely to be higher than that of meniscetomy at short-term follow-up. Neverthless, given the increased risk of partial meniscetomy predisposing patients to early onset degenerative changes, preversation of meniscal tissue should be attempted whenever possible [9][10][11]. However, to our knowledge, no study was conducted to assess the potential factors associated with the prevalence of meniscal repair.…”

“…Comparing with meniscetomy, meniscal repair can preserve its tissue, thus restore its biomechanical function reducing the risk of developing knee OA in the future. In the above setting, a consensus has been reached that meniscal tissue should be preserved as much as possible [9][10][11].…”

¿Does ACL reconstruction have any influence in meniscal repair?. Sports return, quality of life and failure rate. 2-12 years follow up.

“…About quality of life, Fuch et al found high outcomes in quality of life in isolated meniscal repair, with a follow up of 3 years , measured by KOOS QOL, with a medium score of 81.8 ± 12.1. [33].…”